Opioid Prescribing Patterns After Anorectal Surgery

Leinicke, Jennifer A.; Carbajal, Valerie; Senders, Zachary J.; Patil, Nirav; Wogsland, Aric; Stein, Sharon L.; Steinhagen, Emily

doi:10.1016/j.jss.2020.05.098

Cited by 6 publications

(2 citation statements)

References 31 publications

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“…A survey study of colorectal surgeons within the American Society of Colon and Rectal Surgeons demonstrated that although 73% of surgeons report prescribing a standard quantity of opioids per anorectal procedure, nearly half of all surgeons considered subjective measures such as patient phone calls and satisfaction when prescribing. 19 Consideration of patient phone calls and satisfaction was an independent predictor of being a “high prescriber” in that study. Taken together with our finding of increasing pill prescription being significantly associated with higher pill consumption, this suggests that the onus lies on the surgeon to create a postoperative pain control plan for each patient driven by objective data.…”

Section: Discussionmentioning

confidence: 84%

Developing Opioid Prescription Guidelines After Anorectal Surgery: Do Patient-Reported Outcomes and Risk Factors Influence Consumption?

Althans

Hrebinko

Olaitan

et al. 2021

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Opioids prescribed to address postoperative pain drive opioid-related deaths in the United States. Prescribing guidelines have been developed for many general surgical procedures, which have decreased opioid prescription and consumption. The literature on opioids after anorectal surgery is lacking. OBJECTIVE:We analyzed our data on opioid prescription and consumption to create opioid-prescribing guidelines for anorectal procedures. DESIGN:We designed a prospectively collected postoperative survey given to consecutive patients undergoing anorectal surgery by colorectal surgeons.

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Section: Discussionmentioning

confidence: 84%

Developing Opioid Prescription Guidelines After Anorectal Surgery: Do Patient-Reported Outcomes and Risk Factors Influence Consumption?

Althans

Hrebinko

Olaitan

et al. 2021

Diseases of the Colon &Amp; Rectum

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“…Perianal surgery is commonly considered as a useful treatment alternative for these anorectal diseases [ 4 , 5 ]. Several patients generally complain of severe pain after perianal surgery [ 6 ]. This may be primarily owing to the dense sensory innervation of the anal canal and the proctologic procedure causing significant postoperative pain [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Patient-Controlled Caudal Epidural Analgesia and Patient-Controlled Intravenous Analgesia After Perianal Surgery: A Randomized Controlled Trial

Zhang

Long

et al. 2022

Pain Ther

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Introduction This study aimed to compare the efficacy between patient-controlled caudal epidural analgesia (PCCA) and patient-controlled intravenous analgesia (PCIA) after perianal surgery, to provide a feasible solution to postoperative pain. Methods This was a prospective, randomized controlled trial comprising 100 patients who underwent caudal epidural block on perianal surgery at Chengdu Shang Jin Nan Fu Hospital of West China Hospital at Sichuan University between April and August 2020. Patients were randomly divided into the PCCA and PCIA groups. Visual analog scale (VAS) scores were recorded at 2, 4, 6, 24, 48, and 72 h after surgery, and at the first dressing change and first defecation. The lower limb mobility in the post-anesthetic recovery room (PACU) was determined. The analgesic effect, usage amount of patient-controlled analgesia (PCA), usage amount and frequency of remedial analgesic measures, number of individuals who must be catheterized, and incidence of adverse reactions were recorded. Satisfaction of postoperative analgesic effect and convenience of PCA were also assessed. Results The patients in the PCCA group had significantly lower VAS scores at 4, 6, 24, 48, 72 h, the first dressing change, and the first defecation compared with the PCIA group. There were more patients receiving postoperative remedial analgesics in the PCIA group than in the PCCA group. The outcome of the number of PCA and catheterization rates did not differ significantly between the groups. There were two cases of sensory numbness below the S3 plane. The major postoperative complications in the PCIA group were pruritus (3/47, 6.4%), nausea, and vomiting (6/47, 12.8%) (one case combined with pruritus). Patients in the PCCA group were more satisfied with the analgesic effect, while those in the PCIA group were more satisfied with the convenience. Conclusion In the postoperative analgesia program of perianal surgery, PCCA may provide a better analgesic effect without increasing the incidence of complications. Trial Registration Chinese Clinical Trial Registry identifier, ChiCTR2000038425, September 2020, retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1007/s40122-022-00411-y.

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Effectiveness of methylene blue as a local anesthetic and analgesic in perianal operations: A prospective double-blind randomized control trial

Shareef,

AlBarznji,

Ahmed

et al. 2024

Current Problems in Surgery

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Opioid Prescribing Patterns After Anorectal Surgery

Cited by 6 publications

References 31 publications

Developing Opioid Prescription Guidelines After Anorectal Surgery: Do Patient-Reported Outcomes and Risk Factors Influence Consumption?

Developing Opioid Prescription Guidelines After Anorectal Surgery: Do Patient-Reported Outcomes and Risk Factors Influence Consumption?

Comparison of Patient-Controlled Caudal Epidural Analgesia and Patient-Controlled Intravenous Analgesia After Perianal Surgery: A Randomized Controlled Trial

Effectiveness of methylene blue as a local anesthetic and analgesic in perianal operations: A prospective double-blind randomized control trial

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