Comparison the effect of gelatin sponge and epinephrine-soaked gauze for hemostasis and pain control after hemorrhoidal surgery

Abstract

Abstract Post-operative pain and bleeding are the main complications after hemorrhoidal surgery. The purpose of this study was to investigate whether an absorbable gelatin sponge is a superior hemostatic and analgesic agent to gauze soaked in epinephrine after hemorrhoidal surgery. A retrospective study was conducted using data from a single institute. Data were collected from the electronic medical record database and outpatient patient questionnaire archive. This study included 132 patients for whom gauze soaked in epinephrine was used as the hemostatic agent after hemorrhoidal surgery and 139 patients for whom an absorbable gelatin sponge was employed. The primary outcome measurements were postoperative pain score, oral analgesic dosage, length of hospital stay, and complications. Patients in the absorbable gelatin sponge group had significantly lower pain scores from the day they underwent hemorrhoidal surgery (postoperative day 0) until postoperative day 2. Average pain scores in the absorbable gelatin sponge group and gauze soaked in epinephrine group were 5.33 ± 3.2 and 6.18 ± 3.2 (p = 0.029) on postoperative day 0, respectively; 4.69 ± 3.0 and 5.77 ± 2.9 (p = 0.003) on postoperative day 1, respectively; and 4.44 ± 2.8 and 5.33 ± 2.9 (p = 0.010) on postoperative day 2, respectively. No significant differences were discovered in postoperative recovery or complication rate between the groups. Absorbable gelatin sponges provide patients with more effective pain relief than gauze soaked in epinephrine for the first couple of days after hemorrhoidal surgery. Moreover, absorbable gelatin sponges had no negative effect on patient outcomes. Therefore, absorbable gelatin sponges are recommended as a replacement for gauze soaked in epinephrine following hemorrhoidal surgery.