PROSPECT provides clinicians with supporting arguments for and against the use of various interventions in postoperative pain based on published evidence and expert opinion. Clinicians must make judgements based upon the clinical circumstances and local regulations. At all times, local prescribing information for the drugs referred to must be consulted.
Haemorrhoidectomy is associated with moderate-to-severe postoperative pain. Multiple pharmacological treatments, anaesthetic strategies and surgical techniques have been investigated for postoperative analgesia.
PROSPECT guidelines for postoperative pain management after haemorrhoidectomy were previously published in 2010 (Joshi et al) and 2017 (Sammour et al). However, many studies were published since the last recommendations, so the aim of this review (Bikfalvi et al 2023) was to update the literature and recommendations for management of pain after haemorrhoid surgery. The literature search period was January 1, 2016 to February 2, 2022.
The unique PROSPECT methodology is available at https://esraeurope.org/prospect-methodology/.
COX, cyclooxygenase; IV, intravenous; NSAIDs, non-steroidal anti-inflammatory drugs.
Analgesic interventions that are not recommended for pain management in patients undergoing haemorrhoid surgery.
COX, cyclooxygenase; NSAID, non-steroidal anti-inflammatory drug.
PROSPECT guideline for haemorrhoid surgery-infographic