Patients’attitudes to rectal drug administration

Abstract

SummaryOne hundred adult patients attending for day case surgery were surveyed by anonymous questionnaire in order to determine their attitudes to rectal drug administration. Fifty four patients did not want an analgesic drug (diclofenac sodium) administered rectally whilst under anaesthesia, allpreferring to take it orally ifavailable. Ninety eight patients thought that drugs administeredper rectum should always be discussed with them beforehand and a few had very strong feelings about this route of administration. We suggest that prescribers of rectal diclofenac should always discuss it with patients pre-operatively. Whilst many are happy to have suppositories, some young patients are sensitive about this and prefer to take such medication by mouth. Key words Medicolegal.Anaesthetics; rectal. Analgesics; diclofenac.Non-steroidal anti-inflammatory drugs are an important part of the anaesthetist's armamentarium in the prevention of postoperative pain following surgery [ 1-31. Diclofenac sodium is one that is commonly administered, often by rectal suppository. We have conducted a survey to explore the attitudes of patients to the administration of analgesic drugs per rectum. Some people are sensitive about this part of the anatomy [4,5] and since many patients now expect to be involved in choice of therapeutic or anaesthetic technique, this may have implications for anaesthetists. MethodsOne hundred adult patients attending for surgery at a District General Hospital Day Case Unit were asked to complete a short questionnaire to find out their views about a routine procedure in our unit. The questionnaire (Fig. 1) defined precisely what rectal drug administration involved, in this instance to be performed by a nurse after induction of general anaesthesia. It also informed the patient of the analgesic benefit of the procedure and also of the other options available, which include taking diclofenac orally. Possible side effects were outlined, namely proctitis when administered per rectum, and epigastric pain when taken orally.Patients were asked if they were happy to have a drug administered per rectum whilst they were in the operating theatre. They were asked if they would prefer to take the drug by mouth and also if they considered that rectal administration should be discussed with them beforehand.Further comments were invited. Questionnaires remained anonymous, although the patient's age, sex and the proposed surgery were recorded.

The attitudes of patients and health care personnel to rectal drug administration following day case surgery

“…A study by Vyvyan and Hanafiah (1995) examining In this study the majority of subjects questioned prepatients attitudes to rectal administration of postferred the i.v. Patients are now informed pre-operatively that a suppository may be used and verbal consent is Discussion obtained in most hospitals in Great Britain.…”

The feasibility of pain treatment at home after adenoidectomy with ketoprofen tablets in small children

“…Earlier studies have proved that not only do children dislike suppositories ( 10), but also parents prefer oral administration whenever possible ( 11). In addition, the absorption of suppositories has proved to be unreliable ( 12).…”

Patients' associations with regard to analgesic drugs and their forms for application – a pilot study

“…For postoperative pain control, oral, parenteral, and rectal routes have been compared and patients have expressed significant preference for the intravenous (74% of patients) route over rectal administration (4%) [8]. Patients' preferences for oral administration and rejection of rectal administration have been confirmed by others [18,20]. However, we did not include rectal administration in our questionnaire.…”