Evidence-based management of pain after haemorrhoidectomy surgery

G. P. Joshi, E. A M Neugebauer

Research output: Contribution to journalReview articlepeer-review

81 Scopus citations


Background: Haemorrhoidectomy is associated with intense postoperative pain, but optimal evidencebased pain therapy has not been described. The aim of this systematic review was to evaluate the available literature on the management of pain after haemorrhoidal surgery. Methods: Randomized studies published in the English language from 1966 to June 2006, assessing analgesic and anaesthetic interventions in adult haemorrhoidal surgery, and reporting pain scores, were retrieved from the Embase and MEDLINE databases. Results: Of the 207 randomized studies identified, 106 met the inclusion criteria, with mixed methodological quality. Of these, 41 studies evaluating surgical and alternative interventions were excluded. Quantitative analyses were not performed, as there were limited numbers of trials with a sufficiently homogeneous design. Conclusion: Local anaesthetic infiltration, either as a sole technique or as an adjunct to general or regional anaesthesia, and combinations of analgesics (non-steroidal anti-inflammatory drugs, paracetamol and opiates) are recommended. If appropriate, a stapled operation may be preferable.

Original languageEnglish (US)
Pages (from-to)1155-1168
Number of pages14
JournalBritish Journal of Surgery
Issue number8
StatePublished - Aug 2010

ASJC Scopus subject areas

  • Surgery


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