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.
Department of Anesthesia, Michigan State University, East Lansing.
M
M
Kilbride
M
M
Morse
A
A
Senagore
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