This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Evidence‐based management of pain after haemorrhoidectomy surgery. BJS 2010; 97: 1155-1168.
Published: 30th June 2010
Authors: G. P. Joshi, E. A. M. Neugebauer
Background
Haemorrhoidectomy is associated with intense postoperative pain, but optimal evidence‐based 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.
Method
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. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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