Preemptive Analgesia Decreases Pain Following Anorectal Surgery: A Prospective, Randomized, Double-Blinded, Placebo-Controlled Trial

Diseases of the Colon and Rectum
Justin T Van BackerPeter A Cataldo

Abstract

Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Studies in the orthopedic, urologic, and gynecologic literature support this practice, but the use of preemptive analgesia in anorectal surgery is understudied. This study aimed to evaluate the effectiveness of preemptive analgesia in decreasing postoperative pain. This is a randomized, double-blinded, placebo-controlled trial. This study was conducted at the University of Vermont Medical Center, a tertiary care referral center in Burlington, Vermont. Patients who were over 18 years of age, ASA Physical Status Classes I, II, or III, and undergoing surgery for anal fissure, fistula or condyloma or hemorrhoids were selected. Preoperative oral acetaminophen and gabapentin followed by intravenous ketamine and dexamethasone were given before incision compared with oral placebos. The primary outcomes measured were postoperative pain scores, percentage of patients utilizing breakthrough nar...Continue Reading

References

Mar 1, 1993·Diseases of the Colon and Rectum·I M Richman
Oct 10, 1997·Anesthesia and Analgesia·F ChungJ Su
Jan 12, 2002·Diseases of the Colon and Rectum·Béatrice Vinson-BonnetFrancis Bonnet
Apr 18, 2003·The European Journal of Surgery = Acta Chirurgica·Peter LabasJuraj Fillo
Mar 26, 2004·Anesthesia and Analgesia·Rebecca F K KwokWallace K Y Chiu
Jun 10, 2009·Burns : Journal of the International Society for Burn Injuries·P Richardson, L Mustard
Jul 7, 2009·The Orthopedic Clinics of North America·Raymond TangChristopher Kim
May 18, 2013·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Ole MathiesenHenrik Kehlet
Oct 2, 2014·International Journal of Colorectal Disease·Vitaliy PoylinDeborah Nagle

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Citations

Feb 12, 2019·Obstetrics and Gynecology·Lindsay C TurnerJonathan P Shepherd
Jul 25, 2019·Current Opinion in Anaesthesiology·Amanda H Kumar, Ashraf S Habib
Feb 4, 2021·Current Urology Reports·Jeffrey L EllisJay Simhan
Nov 3, 2020·Journal of the Anus, Rectum and Colon·Siripong Sirikurnpiboon, Paiboon Jivapaisarnpong
Aug 18, 2020·The Journal of Surgical Research·Srinivas Joga IvaturyLauren R Wilson
Jul 15, 2020·The Journal of Surgical Research·Jennifer A LeinickeEmily Steinhagen

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