Evidence map›Paper›PMID 39917290›Full record

ArticleEuropean journal of anaesthesiology and intensive care2023

PROSPECT guideline for haemorrhoid surgery: A systematic review and procedure-specific postoperative pain management recommendations.

Alexis Bikfalvi, Charlotte Faes, Stephan M Freys, Girish P Joshi, Marc Van de Velde, Eric Albrecht

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of anaesthesiology and intensive care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07688031 (Efficacy and Safety of Topical Lidocaine 23%/Tetracaine 7% Ointment Versus Placebo for Post-Hemorrhoidectomy Pain), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07688031 phase4completednot on this map

Efficacy and Safety of Topical Lidocaine 23%/Tetracaine 7% Ointment Versus Placebo for Post-Hemorrhoidectomy Pain: A Double-Blind Randomized Controlled Trial

TypeinterventionalSponsorPontificia Universidad Catolica de ChileRan2023 to 2026Enrolled74ConditionsPain Management, Hemorrhoids Third Degree, Hemorrhoids Fourth Degree, Hemorrhoids Second DegreeArmsLidocaine 23% / Tetracaine 7% topical ointment (compounded), Placebo ointment
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Ultrasound-guidedBJA open · 2025
    Trial
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alexis BikfalviFrom the Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland (AB, EA), the Department of Cardiovascular Sciences and Department of Anaesthesia, University Hospitals of the KU Leuven, Belgium (CF, MvdV), the Department of Surgery, DIAKO Ev. Diakonie-Krankenhaus Bremen, Germany (SMF), the Department of Anaesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, USA (GPJ).
Charlotte FaesFrom the Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland (AB, EA), the Department of Cardiovascular Sciences and Department of Anaesthesia, University Hospitals of the KU Leuven, Belgium (CF, MvdV), the Department of Surgery, DIAKO Ev. Diakonie-Krankenhaus Bremen, Germany (SMF), the Department of Anaesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, USA (GPJ).
Stephan M FreysFrom the Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland (AB, EA), the Department of Cardiovascular Sciences and Department of Anaesthesia, University Hospitals of the KU Leuven, Belgium (CF, MvdV), the Department of Surgery, DIAKO Ev. Diakonie-Krankenhaus Bremen, Germany (SMF), the Department of Anaesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, USA (GPJ).
Girish P JoshiFrom the Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland (AB, EA), the Department of Cardiovascular Sciences and Department of Anaesthesia, University Hospitals of the KU Leuven, Belgium (CF, MvdV), the Department of Surgery, DIAKO Ev. Diakonie-Krankenhaus Bremen, Germany (SMF), the Department of Anaesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, USA (GPJ).
Marc Van de VeldeFrom the Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland (AB, EA), the Department of Cardiovascular Sciences and Department of Anaesthesia, University Hospitals of the KU Leuven, Belgium (CF, MvdV), the Department of Surgery, DIAKO Ev. Diakonie-Krankenhaus Bremen, Germany (SMF), the Department of Anaesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, USA (GPJ).
Eric AlbrechtFrom the Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland (AB, EA), the Department of Cardiovascular Sciences and Department of Anaesthesia, University Hospitals of the KU Leuven, Belgium (CF, MvdV), the Department of Surgery, DIAKO Ev. Diakonie-Krankenhaus Bremen, Germany (SMF), the Department of Anaesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, USA (GPJ).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHaemorrhoidectomy is associated with moderate-to-severe postoperative pain.

objectiveThe aim of this systematic review was to assess the available literature and update previous PROSPECT (procedure specific postoperative pain management) recommendations for optimal pain management after haemorrhoidectomy. DESIGN AND ELIGIBILITY CRITERIA: A systematic review utilising PROSPECT methodology was undertaken. DATA SOURCES: Randomised controlled trials published in the English language from January 1, 2016 to February 2, 2022 assessing postoperative pain using analgesic, anaesthetic, and surgical interventions were identified from MEDLINE, EMBASE and Cochrane Database.

resultsOf the 371 randomized controlled trials (RCTs) identified, 84 RCTs and 19 systematic reviews, meta-analyses met our inclusion criteria (103 publications). Interventions that improved postoperative pain relief included: paracetamol and nonsteroidal anti-inflammatory drugs or cyclo-oxygenase-2 selective inhibitors, systemic steroids, pudendal nerve block, topical metronidazole, topical diltiazem, topical sucralfate or topical glyceryl trinitrate, and intramuscular injection of botulinum toxin. DISCUSSION: This review has updated the previous recommendations written by our group. Important changes are abandoning oral metronidazole and recommending topical metronidazole, topical diltiazem, topical sucralfate, topical glyceryl trinitrate. Botulinum toxin can also be administered. Contemporary publications confirm the analgesic effect of bilateral pudendal nerve block but invalidate recommendations on perianal infiltration. The choice of the surgery is mostly left to the discretion of the surgeons based on their experience, expertise, type of haemorrhoids, and risk of relapse. That said, excisional surgery is more painful than other procedures.

Identifiers

PMID39917290
PMCPMC11783633

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.