Abstract
Background
Surgery for anorectal diseases is thought to cause significant pain postoperatively.
There is little known regarding standardized opioid-prescribing trends and patient
use following surgery for anorectal diseases. We aimed to evaluate and analyze opioid-prescribing
trends and patient use for outpatient anorectal operations.
Materials and methods
All patients who underwent outpatient anorectal surgery performed over a 1-y period
at a single institution were eligible. Procedures included hemorrhoidectomy, anal
fistula repair/seton, anal fissure treatment with sphincterotomy, and transanal excision
of rectal tumors. Demographic, operative, and postoperative data were obtained. Patients
were given a survey to determine postoperative pain control with opioid and non-narcotic
analgesia use; respondents were included in analysis.
Results
Forty-two outpatient anorectal surgery patients were included: 13 had hemorrhoidectomy,
22 had anal fistula repair/seton, one had sphincterotomy, and six had transanal excisions.
All patients had multimodality treatment with either an anal block and/or postoperative
nonopioid analgesics. Ninety percent were prescribed opioids postoperatively with
a median of 20 pills (range: 0-120 pills). Forty-three percent (18/42) did not fill
their prescription. For those who used opioids, the median number of pills taken was
four. Eighty percent of pills prescribed were not used. One patient required a refill.
Greater than 60% of respondents reported good to excellent pain control on a five-point
scale.
Conclusions
Most patients had adequate pain control after anorectal surgery with little to no
use of opioids and that more than 80% of opioid pills prescribed were not consumed.
We intend to standardize our prescribing opioid quantities for outpatient anorectal
operations to reflect this reduced use.
Keywords
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Article info
Publication history
Published online: May 08, 2018
Accepted:
April 3,
2018
Received in revised form:
March 18,
2018
Received:
November 27,
2017
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
