A randomized, prospective, double-blind, placebo-controlled trial of the effect of topical diltiazem on posthaemorrhoidectomy pain

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
H A AmoliH Ashraf

Abstract

Spasm of the internal anal sphincter plays a role in haemorrhoidal disease and may be a source of anal pain after haemorrhoid surgery. In this study, we investigated the effect of topical diltiazem (DTZ) on postoperative pain following Milligan-Morgan haemorrhoidectomy. After haemorrhoidectomy, 33 patients were randomly assigned to receive DTZ ointment (2%; n = 16) or a placebo ointment (n = 17). Ointments were applied to the perianal region three times daily for 7 days. A Visual Analogue Scale was used to assess postoperative pain. The primary end-point was reduction in postoperative pain. Patients using the DTZ cream had significantly less pain and greater benefit than those in the placebo group throughout the first postoperative week, and total and daily narcotic analgesic use was higher in the placebo group. There were no differences in morbidity between the two groups. Perianal application of DTZ cream after haemorrhoidectomy significantly reduces postoperative pain and is perceived as beneficial, with no increase in associated morbidity.

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Citations

Jan 8, 2011·International Journal of Colorectal Disease·Muhammad Rafay Sameem SiddiquiAl Mutaz Abulafi
Mar 25, 2016·The Indian Journal of Surgery·Marcello PicchioErasmo Spaziani
Nov 13, 2015·Postgraduate Medical Journal·J R F Hollingshead, R K S Phillips
Jul 15, 2015·Anesthesiology and Pain Medicine·Farsad ImaniSeyed Reza Hosseini
May 29, 2016·International Journal of Colorectal Disease·Sameh Hany EmileMohamed Farid
Feb 9, 2018·Diseases of the Colon and Rectum·Bradley R DavisScott R Steele
Jul 24, 2012·Gastrointestinal Endoscopy·Sumanth R DaramShou-jiang Tang

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