Volume 1, Issue 3 (2022)                   GMJM 2022, 1(3): 77-80 | Back to browse issues page
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Mahdavi F, Azhough R. Effectiveness of Metronidazole Ointment on the Pain of Hemorrhoidectomy Patients. GMJM 2022; 1 (3) :77-80
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1- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
* Corresponding Author Address: Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. (r_azhough@yahoo.com)
Abstract   (1178 Views)
Aims: Recently, the use of metronidazole in reducing pain after hemorrhoids has been considered and it has been shown that the oral form of this drug can significantly reduce pain after hemorrhoidectomy; However, other studies have not confirmed the effect of oral metronidazole in reducing pain. The use of oral form has limitations compared to the local form due to its general effects. Therefore, in this study, the benefits of using metronidazole topical form in pain control after hemorrhoidectomy were evaluated.
Instrument & Methods: This descriptive cross-sectional study was performed in 2019 with the participation of 94 hemorrhoidectomy patients in Imam Reza Hospital (Tabriz Medical Sciences); For half of the participants, metronidazole topical ointment was administered three times daily and for the other group, placebo ointment was administered. Patients' pain intensity was measured using a VAS questionnaire and compared between the two groups.
Findings: Intensity in the first hours after surgery as well as the first two weeks after surgery (measured daily) in the group receiving topical metronidazole was significantly lower than in the placebo group; The dose of acetaminophen codeine in the placebo group up to day 14 was significantly higher than the group receiving metronidazole.
Conclusion: Topical metronidazole can reduce postoperative pain. In addition, the pain after defecation and the need for analgesia are significantly reduced. However, further studies are needed for the widespread use of this form of medicine in the clinic.
 
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References
1. Neogi P, Sinha A, Singh M. Is metronidazole a panacea for post-hemorrhoidectomy pain?. Int Surg J. 2018;5(11):3598-601. [Link] [DOI:10.18203/2349-2902.isj20184629]
2. Wanis KN, Emmerton-Coughlin HM, Coughlin S, Foley N, Vinden C. Systemic Metronidazole May Not Reduce Posthemorrhoidectomy Pain: A Meta-Analysis of Randomized Controlled Trials. Dis Colon Rectum. 2017;60(4):446-55. [Link] [DOI:10.1097/DCR.0000000000000792]
3. Ypsilantis E, Carapeti E, Chan S. The use of topical 10% metronidazole in the treatment of non-healing pilonidal sinus wounds after surgery. Int J Colorectal. Dis. 2016;31(3):765-7. [Link] [DOI:10.1007/s00384-015-2269-8]
4. Watson AJ, Hudson J, Wood J, Kilonzo M, Brown SR, McDonald A, et al. Comparison of stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease (eTHoS): A pragmatic, multicentre, randomised controlled trial. Lancet. 2016;388(10058):2375-85. [Link] [DOI:10.1016/S0140-6736(16)31803-7]
5. Davis BR, Lee -Kong SA, Migaly J, Feingold DL, Steele SR. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum. 2018;61(3):284-92. [Link] [DOI:10.1097/DCR.0000000000001030]
6. Rudd RA, Aleshire N, Zibbell JE, Matthew Gladden R. Increases in drug and opioid overdose deaths-United States, 2000-2014. Am J Transplant. 2016;16:1323-7. [Link] [DOI:10.1111/ajt.13776]
7. Sammour T, Barazanchi AW, Hill AG, Prospect Group (Collaborators). Evidence-based management of pain after excisional haemorrhoidectomy surgery: A prospect review update. World J Surg. 2017;41(2):603-14. [Link] [DOI:10.1007/s00268-016-3737-1]
8. Huang YJ, Chen CY, Chen RJ, Kang YN, Wei PL. Topical diltiazem ointment in post-hemorrhoidectomy pain relief: A meta-analysis of randomized controlled trial. Asian J Surg, 2018;41(5):431-7. [Link] [DOI:10.1016/j.asjsur.2017.06.002]
9. Liu JW, Lin CC, Kiu KT, Wang CY, Tam KW. Effect of Glyceryl Trinitrate Ointment on Pain Control After Hemorrhoidectomy: A Meta-analysis of Randomized Controlled Trials. World J Surg. 2016;40(1):215-24. [Link] [DOI:10.1007/s00268-015-3344-6]
10. Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. [Link] [DOI:10.1136/bmj.l4898]
11. Rodriguez-Wong U, Ocharan-Hernandez ME, Toscano-Garibay J. Topical diltiazem for pain after closed hemorrhoidectomy. Rev Gastroenterol Mex. 2016;81(2):74-9. [Link] [DOI:10.1016/j.rgmxen.2016.03.003]
12. Rodriguez-Wong U, Rodriguez-Medina U, Medina-Murillo GR. Randomized clinical trial with topical diltiazem for post-hemorrhoidectomy wound healing. Rev Gastroenterol Mex. 2019;84(1):119-22. [Link] [DOI:10.1016/j.rgmxen.2019.01.003]
13. Yadav S, Khandelwal RG, Om P, Ravindra K, Choudhary KL. A prospective randomized double-blind study of pain control by topical calcium channel blockers versus placebo after Milligan-Morgan hemorrhoidectomy. Int J Color Dis. 2018;33(7):895-9. [Link] [DOI:10.1007/s00384-018-3067-x]
14. Ala S, Alvandipour M, Saeedi M, Hamidian M, Shiva A, Rahmani N, et al. Effects of Topical Atorvastatin (2 %) on Posthemorrhoidectomy Pain and Wound Healing: A Randomized Double-Blind Placebo-Controlled Clinical Trial. World J Surg. 2017;41(2):596-602. [Link] [DOI:10.1007/s00268-016-3749-x]
15. Ala S, Alvandipour M, Saeedi M, Mansourifar M, Monajati M, Shiva A. Effect of Topical Baclofen 5% on Post-Hemorrhoidectomy Pain: Randomized Double Blind Placebo-Controlled Clinical Trial. J Gastrointest Surg. 2019;24(2):405-10. [Link] [DOI:10.1007/s11605-019-04147-7]
16. Xia W, Manning JP, Barazanchi AW, Su'a B, Hill AG. Metronidazole following excisional haemorrhoidectomy: a systematic review and meta-analysis. ANZ J Surg. 2018;88(5):408-14. [Link] [DOI:10.1111/ans.14236]
17. Davis BR, Lee-Kong SA, Migaly J, Feingold DL, Steele SR. The American society of colon and rectal surgeons clinical practice guidelines for the management of hemorrhoids. Dis Colon Rectum. 2018;61(3): 284-92. [Link] [DOI:10.1097/DCR.0000000000001030]
18. Neogi P, Sinha A, Singh M. Is metronidazole a panacea for post-hemorrhoidectomy pain?. Int Surg J. 2018;5(11):3598-601. [Link] [DOI:10.18203/2349-2902.isj20184629]
19. Ebied EF, Darweesh AA, Khalil AA, Nma SM. Assessment of oral metronidazole in pain management post Haemorrhoidectomy. Egypt. J. Hosp. Med. 2018; 73(1):5940-33. [Link] [DOI:10.21608/ejhm.2018.12064]
20. Xia W, Manning JP, Barazanchi AW, Su'a B, Hill AG. Metronidazole following excisional haemorrhoidectomy: A systematic review and meta-analysis. ANZ J Surg. 2018;88(5):408-14. [Link] [DOI:10.1111/ans.14236]