The Effects of Using Liposomal Bupivacaine and Aloe Vera Cream after Haemorrhoidectomy on Postoperative Pain, Need for Analgesics, Hospitalisation Period and Return to Work and Social Life

Abstract

Aim:Post-haemorrhoidectomy pain adversely affects the patients’ comfort, length of hospitalisation and return to work/school and social life. We investigated the effect of liposomal bupivacaine (LB) and aloe vera 2% cream (AVC) on post-haemorrhoidectomy pain and wound healing.Method:We established four treatment groups: G1, G2, G3 and G4. Then, we applied perianal submucosal 300 mg LB to 20 patients in G1 intraoperatively; perianal 300 mg LB + local AVC to 20 patients in G2, 3 times a day, postoperatively; perianal AVC to 20 patients in G3 3 times a day, postoperatively and perianal placebo cream to 32 patients in G4 3 times a day, postoperatively. Patients’ pain at rest at the 12th, 24th and 36th hours and the during defaecation at the 36th hour were scored using the visual analogue scale, “0” indicating “no pain” and “10” indicating “unbearable pain”. We recorded their needs for narcotic analgesics within postoperative 12 and 24 hours and for NSAID within 36 hours, as well as their return to social life and work and full recovery periods.Results:The difference was significant between the following groups: G1-G4 (p=0.042) & G2-G4 (p=0.002) in the need for narcotic analgesics within the first 24 hours, G2-G4 (p=0.002) in pain score at the 12th hour, G2-G4 (p<0.001) in pain score at the 24th hour, G2-G4 (p<0.001) & G3-G4 (p=0.001) in pain score at the 36th hour, G2-G4 (p<0.001) in pain score during defaecation at the 36th hour and G2-G4 (p<0.001) in the return to work and social life.Conclusion:We recommend the combined use of LB and AVC after haemorrhoidectomy.

Keywords

• haemorrhoidectomy
• liposomal bupivacaine
• aloe vera cream
• pain
• return to work
• need for analgesics