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
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