Postoperative Pain in the Surgical Treatment of Hemorrhoids: Conventional Hemorrhoidectomy With a Monopolar Electric Scaler VS Bipolar Energy With Caiman® (Aesculap®)

Corporacion Parc Tauli27 enrolled

Overview

To demonstrate that postoperative pain secondary to Milligan and Morgan hemorrhoidectomy with Caiman® (AESCULAP®) and subsequent oral conventional analgesia is at least not greater than that generated after hemorrhoidectomy with monopolar diathermy and intravenous analgesia with care home at discharge.

In the treatment of coloproctological pathology, one of the most important problems is postoperative pain. Especially in the management of hemorrhoids treatment. There are different approaches but in all of them pain is the predominant symptom. There are some less painful techniques but the gold standard continues to be hemmorrhoidectomy, which is associated with postoperative pain. Some actions have been taken to control pain to avoid the admission of patients, but there are still problems in this regard. Our group aims to study the effect of energy change for performing hemorrhoidectomy on postoperative pain.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Hemorrhoid Pain Hemorrhoidectomy

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * All patients with 2 or 3 bundles of grade III-IV hemorrhoids (Goligher classification) clinically symptomatic and subject to outpatient hemorrhoidectomy * Voluntary participation. * ASA I-II-III. Exclusion Criteria: * Failure to meet the inclusion criteria. * ASA IV. * Allergic to Paracetamol, derivatives of morphine. * Allergic to NSAIDs. * Synchronous colorectal neoplasia. * Coagulation disorders. * Thrombosed hemorrhoid. * Inflammatory bowel disease. * Liver cirrhosis and/or portal hypertension. * Pregnant women. * Difficulty following up by phone and/or in person.

Outcomes

Primary Outcomes

Visual analogue scale (VAS)

Postoperative pain: value 0 (no pain) - 10 (maximum pain)

Time frame: 6 hours of post-operative period (before hospital discharge performed); within 2 days with telephone control; at 7 days control at external consultations; at 30 days control at external consultations

Secondary Outcomes

Wound healing time

A healed wound is considered when all post-hemorrhoidectomy wounds of 2-3 bundles are epithelialized

Time frame: 7 days postoperative control at external consultations; 30 days postoperative control at external consultations

Post-surgery satisfaction survey

Phone checklist survey

Time frame: 30 days postoperative control at external consultations

Wexner scale

Assessment of fecal incontinence o a scale from 0 (never incontinence) to 4 (always), obtaining a score between 0 and 20.

Time frame: in pre-operative visit, on the 7th and 30th postoperative clinical control

Number of emergency consultations

revision of Database

Time frame: in 30 days post-surgery

Collection of adverse effects from patients