Comparison of Post-Hemorrhoid Surgery Pain Profiles in Older and Younger Adults

Authors

Joseph Micheal, Department of Colorectal Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland; Xavier University School of Medicine, Oranjestad, Aruba.
Nishanthan Sothilingam, Department of Colorectal Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland; Saba University School of Medicine, Saba, Netherlands Antilles.
Nathaniel J. Schwartz, Department of Colorectal Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland; Touro College of Osteopathic Medicine, Harlem, New York.
Alperen Guver, Department of Colorectal Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland.
Christopher R. D'Adamo, Department of Colorectal Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland; Department of Epidemiology and Public Health, Department of Family and Community Medicine, University of Maryland, Baltimore, Maryland.
Sloane Lipkin, Department of Colorectal Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland.
Jasmine Demos, Department of Colorectal Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland.
Jessica Felton, Department of Colorectal Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland; George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Joshua H. Wolf, Department of Colorectal Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland; George Washington University School of Medicine and Health Sciences, Washington, District of Columbia. Electronic address: joswolf@lifebridgehealth.org.

Document Type

Journal Article

Publication Date

9-1-2024

Journal

The Journal of surgical research

Volume

301

DOI

10.1016/j.jss.2024.07.005

Keywords

Colorectal surgery; Geriatric care; Hemorrhoid surgery; Opioid crisis; Pain management; Postoperative care

Abstract

INTRODUCTION: Older and younger adults are offered similar analgesic options after hemorrhoid surgery (HS), but the differences in pain between the two populations are unknown. This study aims to compare postoperative pain outcomes after HS in older and younger individuals. METHODS: This is a retrospective analysis of electronic medical records of patients who underwent HS between 2018 and 2023. Patients were excluded if additional anorectal procedures were performed at the time of HS. Data related to pain-related outcomes were compiled: (1) need for narcotic prescription refills; (2) documentation of a pain-related phone call within 30 d; (3) urgent postoperative office visit before regular scheduled follow-up; and (4) pain-related postoperative emergency department visits. Associations between age and pain-related outcomes were tested using Fisher's exact test, chi-square test, and covariate adjusted logistic regression modeling. RESULTS: There were a total of 249 patients, 60 older adults, and 189 younger adults. Compared to younger patients, older adults demonstrated a reduced frequency of pain-related phone calls (10.3 versus 32.1%, P < 0.01) and opioid refills (0 versus 14.4%, P < 0.01). After adjusting for confounders, older age remained inversely associated with pain-related postoperative phone calls (odds ratio = 0.25, 95% confidence interval = [0.1-0.6], P = 0.003). CONCLUSIONS: Older adults had better pain outcomes after HS in comparison to younger patients. These findings suggest that the postoperative analgesic needs of older patients after HS are lower than those of younger patients. Decisions regarding opioid prescription in older adults recovering from HS should be tailored to avoid narcotic-related complications.

APA Citation

Micheal, Joseph; Sothilingam, Nishanthan; Schwartz, Nathaniel J.; Guver, Alperen; D'Adamo, Christopher R.; Lipkin, Sloane; Demos, Jasmine; Felton, Jessica; and Wolf, Joshua H., "Comparison of Post-Hemorrhoid Surgery Pain Profiles in Older and Younger Adults" (2024). GW Authored Works. Paper 5725.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5725

Department

Surgery