Abstract：
BACKGROUND: Older and younger adults are offered similar analgesic options after hemorrhoid surgery (HS), but the differences in pain between the two populations are unknown. This study aims to compare postoperative pain outcomes after HS in older and younger individuals.
METHODS: This is a retrospective analysis of electronic medical records of patients who underwent HS between 2018 and 2023. Patients were excluded if additional anorectal procedures were performed at the time of HS. Data related to pain-related outcomes were compiled: (1) need for narcotic prescription refills; (2) documentation of a pain-related phone call within 30 d; (3) urgent postoperative office visit before regular scheduled follow-up; and (4) pain-related postoperative emergency department visits. Associations between age and pain-related outcomes were tested using Fisher\'s exact test, chi-square test, and covariate adjusted logistic regression modeling.
RESULTS: There were a total of 249 patients, 60 older adults, and 189 younger adults. Compared to younger patients, older adults demonstrated a reduced frequency of pain-related phone calls (10.3 versus 32.1%, P < 0.01) and opioid refills (0 versus 14.4%, P < 0.01). After adjusting for confounders, older age remained inversely associated with pain-related postoperative phone calls (odds ratio = 0.25, 95% confidence interval = [0.1-0.6], P = 0.003).
CONCLUSIONS: Older adults had better pain outcomes after HS in comparison to younger patients. These findings suggest that the postoperative analgesic needs of older patients after HS are lower than those of younger patients. Decisions regarding opioid prescription in older adults recovering from HS should be tailored to avoid narcotic-related complications.
METHODS: This is a retrospective analysis of electronic medical records of patients who underwent HS between 2018 and 2023. Patients were excluded if additional anorectal procedures were performed at the time of HS. Data related to pain-related outcomes were compiled: (1) need for narcotic prescription refills; (2) documentation of a pain-related phone call within 30 d; (3) urgent postoperative office visit before regular scheduled follow-up; and (4) pain-related postoperative emergency department visits. Associations between age and pain-related outcomes were tested using Fisher\'s exact test, chi-square test, and covariate adjusted logistic regression modeling.
RESULTS: There were a total of 249 patients, 60 older adults, and 189 younger adults. Compared to younger patients, older adults demonstrated a reduced frequency of pain-related phone calls (10.3 versus 32.1%, P < 0.01) and opioid refills (0 versus 14.4%, P < 0.01). After adjusting for confounders, older age remained inversely associated with pain-related postoperative phone calls (odds ratio = 0.25, 95% confidence interval = [0.1-0.6], P = 0.003).
CONCLUSIONS: Older adults had better pain outcomes after HS in comparison to younger patients. These findings suggest that the postoperative analgesic needs of older patients after HS are lower than those of younger patients. Decisions regarding opioid prescription in older adults recovering from HS should be tailored to avoid narcotic-related complications.
摘要：
背景：老年人和年轻人在痔疮手术（HS）后可提供类似的镇痛选择，但这两种人群的疼痛差异尚不清楚。这项研究旨在比较老年人和年轻人在HS后的术后疼痛结果。
方法：这是对2018年至2023年期间接受HS的患者的电子病历的回顾性分析。如果在HS时进行其他肛门直肠手术，则排除患者。收集了与疼痛相关结果相关的数据：（1）需要补充麻醉性处方；（2）记录30天内与疼痛相关的电话；（3）在定期定期随访之前进行紧急术后就诊；（4）与疼痛相关的术后急诊就诊。使用Fisher精确检验检验年龄和疼痛相关结局之间的关联，卡方检验,和协变量调整逻辑回归模型。
结果：共有249名患者，60名老年人，189名年轻人。与年轻患者相比，老年人显示疼痛相关电话的频率降低(10.3对32.1%，P<0.01）和阿片类药物补充（0对14.4%，P<0.01)。在调整了混杂因素后，年龄与疼痛相关的术后电话呈负相关(比值比=0.25,95%置信区间=[0.1-0.6],P=0.003)。
结论：与年轻患者相比，老年人在HS后的疼痛结局更好。这些发现表明，老年患者HS后的术后镇痛需求低于年轻患者。关于从HS恢复的老年人的阿片类药物处方的决定应量身定制，以避免麻醉相关的并发症。
方法：这是对2018年至2023年期间接受HS的患者的电子病历的回顾性分析。如果在HS时进行其他肛门直肠手术，则排除患者。收集了与疼痛相关结果相关的数据：（1）需要补充麻醉性处方；（2）记录30天内与疼痛相关的电话；（3）在定期定期随访之前进行紧急术后就诊；（4）与疼痛相关的术后急诊就诊。使用Fisher精确检验检验年龄和疼痛相关结局之间的关联，卡方检验,和协变量调整逻辑回归模型。
结果：共有249名患者，60名老年人，189名年轻人。与年轻患者相比，老年人显示疼痛相关电话的频率降低(10.3对32.1%，P<0.01）和阿片类药物补充（0对14.4%，P<0.01)。在调整了混杂因素后，年龄与疼痛相关的术后电话呈负相关(比值比=0.25,95%置信区间=[0.1-0.6],P=0.003)。
结论：与年轻患者相比，老年人在HS后的疼痛结局更好。这些发现表明，老年患者HS后的术后镇痛需求低于年轻患者。关于从HS恢复的老年人的阿片类药物处方的决定应量身定制，以避免麻醉相关的并发症。
