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Postoperative Pain Management in Patients With Ulcerative Colitis
Norika Katagiri1, Ryutaro Sakai1, Takashi Izutsu2
1Department of Anesthesiology, Kanagawa Dental University Hospital, Yokosuka, Kanagawa, Japan.
Anesthesia Progress
|September 29, 2020
Summary
Managing pain in inflammatory bowel disease (IBD) is complex. This study shows pentazocine patient-controlled analgesia effectively controlled postoperative pain in ulcerative colitis patients without worsening their IBD.
Area of Science:
- Gastroenterology
- Pain Management
- Pharmacology
Background:
- Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease, presents challenges in pain management due to analgesic limitations.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in IBD patients due to relapse risks. Opioids carry complications like ileus and toxic megacolon.
- Limited data exists on pain management for IBD patients undergoing noncolorectal surgery.
Purpose of the Study:
- To describe the successful management of postoperative pain in two ulcerative colitis patients undergoing oral and maxillofacial surgery.
- To evaluate the efficacy and safety of intravenous patient-controlled analgesia (PCA) with pentazocine in this patient population.
Main Methods:
- Case report of two patients with ulcerative colitis (UC).
- Postoperative pain management utilized intravenous patient-controlled analgesia (PCA) with pentazocine.
- Concurrent administration of droperidol for nausea and vomiting prophylaxis in one case.
Main Results:
- Pentazocine PCA effectively controlled postoperative pain in both UC patients.
- No IBD exacerbations or significant complications related to pentazocine were observed.
- One patient experienced acute dystonia, attributed to droperidol, not pentazocine.
Conclusions:
- Intravenous pentazocine PCA can be a safe and effective option for managing postoperative pain in patients with ulcerative colitis.
- This approach may avoid complications associated with traditional analgesics in IBD patients.
- Further research is warranted to confirm these findings in a larger cohort.
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