대한대장항문학회

Purpose: The aim of this prospective study was to evaluate whether additional intraoperative injection of Tarasyn (ketorolac tromethamine) provided a preemptive analgesic effect that improved postoperative pain. Methods: Sixty patients scheduled<br>for<br>hemorrhoidectomy were randomly assigned to the study and control groups. For the control group (n=32), patients were treated with standard intravenous injections of Nubain (Nalbuphine hydrochloride; Jeil Pharmaceuticals Co, Seoul) per 8 hours<br>for<br>three<br>times postoperatively for pain relief. In the study group (Tarasyn group, n=28), 60 mg of Tarasyn (ketorolac tromethamine; Roche Korea, Seoul) was injected into the internal sphincter muscle and around the operative wound at the time of<br>hemorrhoidectomy as well as standard intravenous injections of Nubain .<br>Parameters were measured of pain score from 0 (no pain) to 10 (agonizing pain), painless sound sleep, additional analgesic requirements, time to first bowel movement, and postoperative urinary retention. Results: Rate of painless sound sleep was<br>75.0%<br>and 53.1% in the Tarasyn and the control groups, respectively, which was significant statically between two groups (P＜0.05). Time to first bowel movement was 2 and 3.2 days in Tarasyn and the control groups, respectively, which was also<br>significant<br>statistically (P＜0.05). Voiding difficulty developed in one case (3.5%) in the Tarasyn group and he needed catheterization. In the control group, however, the number (15 cases, 46.9%; P＜0.001) was much higher requiring more catherization (13<br>cases,<br>40.9%; P＜0.001). Mean pain scores was significant statically between two groups (P＜0.001). Conclusion: The data suggest that the use of intraoperative injection of Tarasyn is associated with a significant decrease in pain and urinary<br>complications<br>after hemorrhoidectomy.<br>