Transdermal fentanyl improves management of postoperative hemorrhoidectomy pain.
OBJECTIVE
Outpatient postoperative hemorrhoidectomy pain remains a difficult problem. The purpose of this study is to evaluate the use of transdermal fentanyl for analgesia following hemorrhoidectomy.


METHODS
Patients were prospectively randomized in a double-blind fashion to one of two groups, placebo or transdermal fentanyl. Forty-two patients were eligible for the study (placebo, 21; fentanyl, 17; 4 were excluded). A visual analog scale was used to evaluate postoperative pain (0 = no pain; 10 = worst pain).


RESULTS
Fewer patients in the fentanyl group (10/17) required postoperative parental narcotics than the placebo group (21/21) (P < 0.05 Fisher's exact test). The amount of narcotics consumed postoperatively was significantly less in the fentanyl group (97.05 mg of meperidine +/- 23.27) than in the placebo group (236.19 +/- 30.46) (P < .05 Student's t-test). Pain scores in the fentanyl group were significantly lower (less pain) than in the placebo group (P < 0.05 Kruskal-Wallis).


CONCLUSIONS
Results indicate that use of transdermal fentanyl provides an effective analgesic alternative that improves the transition to noninvasive outpatient pain management in the hemorrhoidectomy patient.
Kilbride
M
M
Department of Anesthesia, Michigan State University, East Lansing.
Morse
M
M
Senagore
A
A
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005283:Fentanyl / Q000008:administration & dosage* / Q000627:therapeutic use; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008614:Meperidine / Q000627:therapeutic use; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies
D008614:Meperidine; D005283:Fentanyl