Topical diltiazem for pain after closed hemorrhoidectomy

Area of Science:

• Colorectal Surgery
• Pharmacology
• Pain Management

Background:

• Anal sphincter spasm is a significant contributor to postoperative pain after hemorrhoidectomy.
• Effective pain management strategies are crucial for patient recovery and satisfaction following this procedure.

Purpose of the Study:

• To evaluate the effectiveness of topical diltiazem in alleviating pain experienced by patients post-hemorrhoidectomy.
• To compare the pain scores and analgesic requirements between patients receiving topical diltiazem and those receiving a placebo.

Main Methods:

• A randomized, double-blind, placebo-controlled study involving 34 patients undergoing closed hemorrhoidectomy.
• Patients were divided into two groups: one received topical diltiazem, the other a placebo, applied three times daily.
• Both groups received ketorolac as rescue analgesia.

Main Results:

• Patients treated with topical diltiazem reported significantly lower visual analog scale pain scores at 24, 48, and 72 hours post-surgery compared to the placebo group (P<.001).
• The diltiazem group required fewer doses of rescue analgesic (ketorolac) over the 72-hour postoperative period compared to the placebo group (P<.001).

Conclusions:

• Topical diltiazem demonstrates statistically significant efficacy in reducing postoperative pain following closed hemorrhoidectomy.
• This finding suggests topical diltiazem is a valuable therapeutic option for managing pain associated with this surgical procedure.