Botulinum Toxin Injection for Analgesic Effect after Hemorrhoidectomy: A Randomized Control Trial

Area of Science:

• Colorectal Surgery
• Pain Management
• Gastroenterology

Background:

• Hemorrhoidectomy is a common surgical procedure.
• Postoperative pain is a significant patient concern following hemorrhoidectomy.
• Multimodal pain management strategies are often required.

Purpose of the Study:

• To assess the efficacy and safety of intersphincteric botulinum toxin injection for pain relief after hemorrhoidectomy.
• To evaluate the impact of botulinum toxin on pain scores, analgesic use, hospital stay, and complications.

Main Methods:

• A randomized study involving 90 patients undergoing hemorrhoidectomy.
• 44 patients received an intersphincteric injection of 30 units of botulinum toxin (BTX).
• Postoperative data collected included Visual Analog Scale (VAS) pain scores, analgesic use, and complications.

Main Results:

• The BTX group showed significantly lower VAS pain scores at 12 and 24 hours post-surgery.
• Patients in the BTX group experienced pain-free bowel movements sooner (2 days vs. 3 days).
• No significant differences in immediate or delayed complications were observed between groups.

Conclusions:

• Intersphincteric botulinum toxin injection offers a beneficial adjunct for reducing postoperative pain following hemorrhoidectomy.
• Botulinum toxin may improve patient recovery by alleviating pain and facilitating earlier return to normal bowel function.
• Further research into multimodal pain management including botulinum toxin is warranted.