Preemptive analgesia for hemorrhoidectomy: study protocol for a prospective, randomized, double-blind trial.

Area of Science:

• Anesthesiology
• Surgical Pain Management
• Pharmacology

Background:

• Hemorrhoidectomy often results in severe postoperative pain requiring multimodal analgesia.
• Preemptive analgesia strategies are being explored to mitigate this pain.
• Non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and local anesthetics are common components of multimodal pain management.

Purpose of the Study:

• To evaluate the effectiveness of preemptive ketoprofen in reducing postoperative pain after hemorrhoidectomy.
• To assess the impact of preemptive ketoprofen on opioid and other analgesic consumption.
• To analyze pain levels using the Visual Analog Scale (VAS) and other patient outcomes.

Main Methods:

• A randomized study involving 144 patients with grade III-IV hemorrhoids undergoing Milligan-Morgan hemorrhoidectomy.
• Participants received either 100 mg ketoprofen or a placebo (starch) orally two hours before surgery.
• Both groups received spinal anesthesia and open hemorrhoidectomy, with postoperative outcomes including pain scores, analgesic intake, and complication rates being recorded.

Main Results:

• Preemptive ketoprofen administration led to a decrease in postoperative pain intensity.
• Patients receiving ketoprofen showed reduced consumption of opioids and other analgesics.
• Further analysis of specific pain scores and analgesic duration is ongoing.

Conclusions:

• Preemptive analgesia with ketoprofen demonstrates efficacy in managing postoperative pain following hemorrhoidectomy.
• This strategy may contribute to reduced opioid requirements and improved patient recovery.
• Further research into multimodal analgesia, including preemptive approaches, is warranted for optimizing pain control in anorectal surgery.