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Gabapentin significantly decreases posthemorrhoidectomy pain: a prospective study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Surgery for hemorrhoidectomy remains a painful procedure despite advances in pain management. Gabapentin is widely used for control of acute and chronic pain. Our aim was to evaluate the effect of gabapentin on posthemorrhoidectomy pain and opioid use.

Methods

A prospective, open-label study. Patients requiring hemorrhoid surgery were recruited to be in control (standard of care) or treatment group (standard of care plus daily gabapentin).

Results

Twenty-one treatment and 18 control patients were recruited. One patient from study group and two patients from control group were excluded due to failure to follow up. Pain levels for gabapentin group were significantly lower on postoperative days 1, 7, and 14 compared to the standard treatment group (3.68 vs. 6.82 p < 0.01, 2.68 vs. 5 p = 0.02 and 0.75 vs. 3.64 p < 0.001 respectively). There was a trend toward less opioids taken in gabapentin group for postoperative days 1, 7, and 14 (4.69 vs. 6.36; 2.13 vs. 2.73, and 0.125 vs. 0.9) but it did not reach statistical significance. The average hemorrhoidal grade and number of hemorrhoidal complexes removed was slightly higher in gabapentin group. Five control group patients experienced postoperative complications versus two gabapentin group patients. No gabapentin related complications were seen in the treatment group. The average cost of gabapentin course was $5.34 per patient.

Conclusions

Daily use of gabapentin in perioperative period significantly decreased reported levels of postoperative pain. This effective, inexpensive addition improves pain after hemorrhoid surgery. Randomized placebo-controlled studies would better define the usefulness of this medication for posthemorrhoidectomy pain.

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References

  1. Racalbuto A, Aliotta I, Corsaro G, Lanteri R, Di Cataldo A, Licata A (2004) Hemorrhoidal stapler prolapsectomy vs. Milligan–Morgan hemorrhoidectomy: a long-term randomized trial. Int J Colorectal Dis 19:239–244

    Article  CAS  PubMed  Google Scholar 

  2. Shao WJ, Li GC, Zhang ZH, Yang BL, Sun GD, Chen YQ (2008) Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg 95:147–160

    Article  PubMed  Google Scholar 

  3. Nystrom PO, Qvist N, Raahave D, Lindsey I, Mortensen N, Stapled or Open Pile Procedure (STOPP) trial study group (2010) Randomized clinical trial of symptom control after stapled anopexy or diathermy excision for haemorrhoid prolapse. Br J Surg 97:167–176

    Article  PubMed  Google Scholar 

  4. Basdanis G, Papadopoulos VN, Michalopoulos A, Apostolidis S, Harlaftis N (2005) Randomized clinical trial of stapled hemorrhoidectomy vs open with Ligasure for prolapsed piles. Surg Endosc 19:235–239

    Article  CAS  PubMed  Google Scholar 

  5. Stolfi VM, Sileri P, Micossi C et al (2008) Treatment of hemorrhoids in day surgery: stapled hemorrhoidopexy vs Milligan–Morgan hemorrhoidectomy. J Gastrointest Surg 12:795–801

    Article  PubMed  Google Scholar 

  6. Senagore AJ, Singer M, Abcarian H et al (2004) A prospective, randomized, controlled multicenter trial comparing stapled hemorrhoidopexy and Ferguson hemorrhoidectomy: perioperative and one-year results. Dis Colon Rectum 47:1824–1836

    Article  CAS  PubMed  Google Scholar 

  7. Ortiz H, Marzo J, Armendariz P, De Miguel M (2005) Stapled hemorrhoidopexy vs. diathermy excision for fourth-degree hemorrhoids: a randomized, clinical trial and review of the literature. Dis Colon Rectum 48:809–815

    Article  PubMed  Google Scholar 

  8. McQuay HJ, Poon KH, Derry S, Moore RA (2008) Acute pain: combination treatments and how we measure their efficacy. Br J Anaesth 101(1):69–76

    Article  CAS  PubMed  Google Scholar 

  9. Aida S, Baba H, Yamakura T, Taga K, Fukuda S, Shimoji K (1999) The effectiveness of preemptive analgesia varies according to the type of surgery: a randomized, double-blind study. Anesth Analg 89:711–716

    CAS  PubMed  Google Scholar 

  10. Parikh HG, Dash SK, Upasani CB (2010) Study of the effect of oral gabapentin used as preemptive analgesia to attenuate post-operative pain in patients undergoing abdominal surgery under general anesthesia. Saudi J Anaesth 4(3):137–141

    Article  PubMed Central  PubMed  Google Scholar 

  11. Dierking G, Duedahl TH, Rasmussen ML et al (2004) Effects of gabapentin on postoperative morphine consumption and pain after abdominal hysterectomy: a randomized, double-blind trial. Acta Anaesthesiol Scand 48:322–327

    Article  CAS  PubMed  Google Scholar 

  12. Kong VK, Irwin MG (2007) Gabapentin: a multimodal perioperative drug? Br J Anaesth 99:775–786

    Article  CAS  PubMed  Google Scholar 

  13. Khan ZH, Rahimi M, Makarem J, Khan RH (2011) Optimal dose of pre-incision/post-incision gabapentin for pain relief following lumbar laminectomy: a randomized study. Acta Anaesthesiol Scand 55:306–312

    Article  CAS  PubMed  Google Scholar 

  14. Al-Mujadi H, A-Refai AR, Katzarov MG, Dehrab NA, Batra YK, Al-Qattan AR (2006) Preemptive gabapentin reduces postoperative pain and opioid demand following thyroid surgery. Can J Anaesth 53(3):268–273

    Article  PubMed  Google Scholar 

  15. Pandey CK, Priye S, Singh S, Singh U, Singh RB, Singh PK (2004) Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirements in laparoscopic cholecystectomy. Can J Anaesth 51(4):358–363

    Article  PubMed  Google Scholar 

  16. Straube S, Derry S, Moore RA, Wiffen PJ, McQuay HJ (2010) Single dose oral gabapentin for established acute postoperative pain in adults. Cochrane Database Syst Rev. Issue 5

  17. Ture H, Sayin M, Karlikaya G, Bingol CA, Aykac B, Ture U (2009) The analgesic effect of gabapentin as a prophylactic anticonvulsant drug on postcraniotomy pain: a prospective randomized study. Anesth Analg 109(5):1625–1631

    Article  PubMed  Google Scholar 

  18. Lacerda-Filho A, Assuncao GM, de Oliveira TA (2009) Neuropathic pain after stapled hemorrhoidopexy. Tech Coloproctol 13(3):255–256

    Article  CAS  PubMed  Google Scholar 

  19. Marino F (2009) Gabapentin therapy for chronic proctalgia following stapled haemorrhoidopexy. Colorectal Dis 11(7):788

    Article  PubMed  Google Scholar 

  20. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381

    Article  PubMed Central  PubMed  Google Scholar 

  21. Study data were collected and managed using REDCap electronic data capture tools hosted at Beth Israel Deaconess Medical Center REDCap (Research Electronic Data Capture)

  22. Ganio E, Altomare DF, Milito G, Gabrielli F, Canuti S (2007) Long-term outcome of a multicentre randomized clinical trial of stapled haemorrhoidopexy versus Milligan–Morgan haemorrhoidectomy. Br J Surg 94:1033–1037

    Article  CAS  PubMed  Google Scholar 

  23. Ross NP, Hildebrand DR, Tiernan JP, Brown SR, Watson AJ (2012) Haemorrhoids: 21st-century management. Colorectal Dis 14(8):917–919

    Article  CAS  PubMed  Google Scholar 

  24. Gorfine SR, Onel E et al (2011) Bupivacaine extended-release liposome injection for prolonged postsurgical analgesia in patients undergoing hemorrhoidectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Dis Colon Rectum 54(12):1552–1559

    Article  PubMed  Google Scholar 

  25. Clarke H, Bonin RP, Orser BA, Englesakis M, Wijeysundera DN, Katz J (2012) The prevention of chronic postsurgical pain using gabapentin and pregabalin: a combined systematic review and meta-analysis. Anesth Analg 115(2):428–442

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Colon and Rectal Surgery, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Stoneman 9, Boston, MA, 02215, USA

    Vitaliy Poylin, Jeanne Quinn, Kristin Messer & Deborah Nagle

Authors
  1. Vitaliy Poylin
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  2. Jeanne Quinn
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  3. Kristin Messer
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  4. Deborah Nagle
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Correspondence to Vitaliy Poylin.

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Poylin, V., Quinn, J., Messer, K. et al. Gabapentin significantly decreases posthemorrhoidectomy pain: a prospective study. Int J Colorectal Dis 29, 1565–1569 (2014). https://doi.org/10.1007/s00384-014-2018-4

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  • DOI: https://doi.org/10.1007/s00384-014-2018-4

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