Preemptive analgesia in anorectal surgery: results of the prospective, randomized, double-blind, placebo-controlled trial

Aim: To assess the efficiency of preemptive analgesia with Ketoprofen 100 mg 2 hours before procedure per os to decrease postoperative pain. Methods: This prospective, randomized, double-blind study was conducted in the surgical department of the Lomonosov MSU Medical Center. Patients who were diagnosed with anorectal disease without contraindication to perform subarachnoid anesthesia or other somatic diseases and underwent anorectal procedure were included. After signing the consent all participants were randomly divided: the first group got a 100 mg Ketoprofen tablet, the second one got a starch tablet 2 hours before surgery. Following the procedure the primary and secondary outcomes were evaluated: opioid administration intake, the pain at rest and during defecation, duration and frequency of other analgesics intake, readmission rate, life quality, time to return to previous lifestyle, the complications rate. Results: 134 participants were included in the study: 68 in the main group, 66 in the control one. Postoperative pain syndrome was statistically less in the main group on the 4,5,7 days (p=0,035; p=0,023; p=0,046, respectively). Opioid intake after surgery was significantly lower in the main group (p=0.174). The side effects frequency, live quality, time to return to previous lifestyle also didn’t differ in both groups. Conclusion: Preoperative analgesia is safe and effective in reducing postoperative pain in anorectal surgery, reduces the opioid usе, doesn’t increase the ketoprophen side effects frequency. It should be a part of the routine patients’ multimodal management in anorectal surgery.