TRANSDERMAL FENTANYL IMPROVES MANAGEMENT OF POSTOPERATIVE HEMORRHOIDECTOMY PAIN

PURPOSE: 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). CONCLUSION: 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.