Identification of Patients More Susceptible to Severe Anal Pain after Colonoscopy and Effect of Topical Treatment of Lidocaine Gel in Reducing the Anal Pain: A Prospective, Randomized, Controlled Study (Identification and Management of Patients Susceptible to Severe Anal Pain after Colonoscopy)

Korean J Gastrointest Endosc > Volume 27(6); 2003 > Article

Korean Journal of Gastrointestinal Endoscopy 2003;27(6): 521-526.

대장내시경 후 항문통이 심한 환자군의 선별과 리도카인 겔의 국소 도포 효과

김성은·정성애·심기남·조유경·권정미·전정현·신정은·유 권

이화여자대학교 의과대학 내과학교실

Identification of Patients More Susceptible to Severe Anal Pain after Colonoscopy and Effect of Topical Treatment of Lidocaine Gel in Reducing the Anal Pain: A Prospective, Randomized, Controlled Study (Identification and Management of Patients Susceptible to Severe Anal Pain after Colonoscopy)

Seong-Eun Kim, M.D., Sung-Ae Jung, M.D., Ki-Nam Shim, M.D., Yu Kyung Cho, M.D., Jung Mi Kwon, M.D., Chung Hyun Chun, M.D., Jeong Eun Shin, M.D. and Kwon Yoo, M.D.

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea

Abstract

Background/Aims:
The aim of this study was to identify which patients are more susceptible to severe anal pain after colonoscopy and to determine the usefulness of lidocaine gel in reducing the anal pain.
Methods:
A prospective trial was performed with 150 consecutive outpatients who underwent a colonoscopic examination. The patients were randomized into three groups: they received topical treatment of lidocaine gel (n=48) or lubricant gel (chlorhexidine gluconate) (n=48), or no treatment (n=54) just after the procedure. Data regarding the procedures were collected and the patients were phone-interviewed on the next day.
Results:
Seventy of 150 (46.7%) had moderate to severe pain (VAS score≥4). A multiple regression analysis found that the presence of hemorrhoid was significantly (p＜0.05) associated with severe anal pain after colonoscopy. Among three groups, there was no significant difference of the pain scores on the procedure day on the next day. However, patients' subjective evaluation about the usefulness of the gel was significantly better in the lidocaine group than in the placebo group in patients who had moderate to severe pain (79.2% vs. 43.5%, p＜0.05).
Conclusions:
A palliative management is more required for patients who complain moderate to severe pain just after colonoscopy or those with hemorrhoid (Korean J Gastrointest Endosc 2003;27:521⁣526)

Key Words: Colonoscopy, Anal pain, Lidocaine gel

주요어: 대장내시경, 항문통, 리도카인 겔