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Topical diltiazem for pain after closed hemorrhoidectomy
U Rodríguez-Wong1, M E Ocharán-Hernández2, J Toscano-Garibay3
1Maestría en Ciencias de la Salud, Instituto Politécnico Nacional, Ciudad de México, México; Servicio de Cirugía, Hospital Juárez de México, Ciudad de México, México.
Background:
Anal sphincter spasm contributes to the appearance of postoperative pain following hemorrhoidectomy.
Aim:
To determine the efficacy of topical diltiazem in the control of post-hemorrhoidectomy pain.
Material And Methods:
A randomized, prospective, experimental, double-blind study was conducted on 2 groups of patients in the postoperative period of closed hemorrhoidectomy. Each group consisted of 17 patients. Group A received topical diltiazem in the anal region 3 times a day and group B received a placebo. Ketorolac was administered to both groups as rescue therapy.
Results:
In group A, the mean score on the visual analog scale was 2.97±1.18cm at 24h, 1.51±1.18cm at 48h, and 0.84±0.92cm at 72h. In group B, it was 6.82±1.9cm at 24h, 5.3±1.66cm at 48h, and 4.32±2.13cm at 72h (P<.001, 95% CI). The mean number of analgesic doses in group A was 2.41±0.87 at 24h, 1.11±0.85 at 48h, and 0.94±0.96 at 72h. In group B, it was 3.82±0.52 at 24h, 3.64±0.70 at 48h, and 2.88±1.26 at 72h (P<.001, 95% CI).
Conclusions:
In this study, topical administration of diltiazem resulted in a statistically significant reduction of postoperative pain in patients that underwent closed hemorrhoidectomy.
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