Preemptive Analgesia reduces postoperative pain in Anorectal Surgery

Preemptive analgesia is safe and reduces postoperative pain in the early period following anorectal surgery, reports a study published in the journal Diseases of the Colon & Rectum.

Van Backer and his associates conducted a study to evaluate the effectiveness of preemptive analgesia in decreasing postoperative pain.

The randomized, double-blinded, placebo-controlled trial included 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. Preoperative oral acetaminophen and gabapentin followed by intravenous ketamine and dexamethasone were given before incision compared with oral placebos. Ninety patients were enrolled. Because of patient withdrawal, screen failures, and loss to follow-up, 61 patients were analyzed (30 in the preemptive analgesia group and 31 in the control group).

The primary outcomes measured were postoperative pain scores, the percentage of patients utilizing breakthrough narcotics, and rates of side effects.

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Key study findings:

• Patients in the active group had significantly less pain in the postanesthesia care unit and at 8 hours postoperatively.


• Significantly fewer participants in the active group used narcotics in the postanesthesia care unit and at 8 hours postoperatively. Average pain scores were excellent for both groups.


• There was no difference in the number of medication-related side effects between the 2 groups.

The authors concluded that preemptive analgesia is safe and results in decreased pain in the early postoperative period following anorectal surgery and suggest that it should be implemented by surgeons performing these procedures.

For reference log on to 10.1097/DCR.0000000000001069