TY - JOUR
T1 - Evidence-based management of pain after haemorrhoidectomy surgery
AU - Joshi, G P
AU - Neugebauer, E A M
AU - PROSPECT Collaboration
AU - Kehlet, Henrik
N1 - Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
PY - 2010/8/1
Y1 - 2010/8/1
N2 - Background: Haemorrhoidectomy is associated with intense postoperative pain, but optimal evidencebased pain therapy has not been described. The aim of this systematic review was to evaluate the available literature on the management of pain after haemorrhoidal surgery. Methods: Randomized studies published in the English language from 1966 to June 2006, assessing analgesic and anaesthetic interventions in adult haemorrhoidal surgery, and reporting pain scores, were retrieved from the Embase and MEDLINE databases. Results: Of the 207 randomized studies identified, 106 met the inclusion criteria, with mixed methodological quality. Of these, 41 studies evaluating surgical and alternative interventions were excluded. Quantitative analyses were not performed, as there were limited numbers of trials with a sufficiently homogeneous design. Conclusion: Local anaesthetic infiltration, either as a sole technique or as an adjunct to general or regional anaesthesia, and combinations of analgesics (non-steroidal anti-inflammatory drugs, paracetamol and opiates) are recommended. If appropriate, a stapled operation may be preferable.
AB - Background: Haemorrhoidectomy is associated with intense postoperative pain, but optimal evidencebased pain therapy has not been described. The aim of this systematic review was to evaluate the available literature on the management of pain after haemorrhoidal surgery. Methods: Randomized studies published in the English language from 1966 to June 2006, assessing analgesic and anaesthetic interventions in adult haemorrhoidal surgery, and reporting pain scores, were retrieved from the Embase and MEDLINE databases. Results: Of the 207 randomized studies identified, 106 met the inclusion criteria, with mixed methodological quality. Of these, 41 studies evaluating surgical and alternative interventions were excluded. Quantitative analyses were not performed, as there were limited numbers of trials with a sufficiently homogeneous design. Conclusion: Local anaesthetic infiltration, either as a sole technique or as an adjunct to general or regional anaesthesia, and combinations of analgesics (non-steroidal anti-inflammatory drugs, paracetamol and opiates) are recommended. If appropriate, a stapled operation may be preferable.
U2 - 10.1002/bjs.7161
DO - 10.1002/bjs.7161
M3 - Journal article
SN - 0007-1323
VL - 97
SP - 1155
EP - 1168
JO - British Journal of Surgery
JF - British Journal of Surgery
IS - 8
ER -