Only a small minority of patients with hemorrhoids actually require surgery. Most patients can be effectively treated with prescription over-the-counter medications or office-based procedures. Hemorrhoid surgery takes commonly takes about half an hour. It is typically done as an outpatient procedure so patients go home the same day. We are quite familiar with the pain associated with hemorrhoid surgery and do everything possible to help patients avoid surgery. When patients do require surgery, we are well-versed in helping them decrease the pain as well as avoid opioids. We think that topical post-operative creams are beneficial. Additionally, another drug that we believe can be helpful is called Exparel. It is an injectable long-acting local anesthetic (basically very similar to lidocaine). Your doctor can inject it at the time of surgery. It usually lasts between 2-3 days, thereby helping with pain relief during the first days after surgery.