Study strengths and limitations
This trial had some limitations but also considerable strengths. In terms of limitations, the use of bottom-up technique for cost analysis of the two techniques was the major limitation in this study and this was due to lack of a standardized locally available price reference tool in the country for open haemorrhoidectomy under local anaesthesia versus saddle block. However, despite the above limitations, this study provides evidence-based data for the average cost of OH in rural setting of Uganda, which is one of the developing countries. Noteworthy, the findings from this trial are largely generalizable to hospitals in LMICs with similar settings.