Ala Shahram, Saeedi Majid, Eshghi Fariborz, Mirzabeygi Parastou
Faculty of Pharmacy, Clinical Pharmacy, Mazandaran University of Medical Sciences, P.O. Box 48175-861, Sari, Mazandaran Province, Iran.
Dis Colon Rectum. 2008 Feb;51(2):235-8. doi: 10.1007/s10350-007-9174-3. Epub 2008 Jan 4.
Topical metronidazole (10 percent) has been previously demonstrated to decrease postoperative pain after hemorrhoidectomy. The aim of this study was to evaluate the effect of topical metronidazole (10 percent) in reducing postoperative and after-defecation pain of hemorrhoidectomy.
A double-blind, randomized trial was conducted to compare posthemorrhoidectomy pain with use of topical metronidazole (10 percent) vs. placebo carrier, applied to surgical site. Forty-seven patients were randomly allocated to receive metronidazole (n=25) or placebo (n=22). Pain was assessed using a visual analog scale preoperatively and on postoperative hours 6 and 12 and at days 1, 2, 7, and 14. The use of narcotic, additional analgesics, and complications were recorded. (Pain scores were calculated and compared with baseline values and control group (t test, SPSS ver.10).
Patients in the topical metronidazole group had significantly less postoperative pain than those in the placebo group up to day 14 (P <or= 0.04). There was no significant difference in narcotic analgesic requirements between groups, except on hour 12 (P<0.05). In the metronidazole group, after-defecation pain was ranked significantly lower at day 2 (P=0.016) and patients required fewer additional analgesics postoperatively on days 2 and 7 (P <or= 0.04).
These finding indicate that topical 10 percent metronidazole significantly reduce posthemorrhoidectomy discomfort, and postoperative defecation pain is reduced compared with that of the placebo control group.
先前已证明局部使用甲硝唑（10%）可减轻痔切除术后疼痛。本研究的目的是评估局部使用甲硝唑（10%）对减轻痔切除术后及排便后疼痛的效果。
进行了一项双盲随机试验，比较局部使用甲硝唑（10%）与安慰剂载体用于手术部位时痔切除术后的疼痛情况。47例患者被随机分配接受甲硝唑治疗（n = 25）或安慰剂治疗（n = 22）。术前以及术后6小时、12小时、1天、2天、7天和14天使用视觉模拟量表评估疼痛。记录麻醉剂、额外镇痛药的使用情况及并发症。（计算疼痛评分并与基线值及对照组进行比较（t检验，SPSS 10.0版））。
直到第14天，局部使用甲硝唑组患者的术后疼痛明显少于安慰剂组（P≤0.04）。除了第12小时外，两组之间麻醉性镇痛药的需求量无显著差异（P<0.05）。在甲硝唑组，排便后疼痛在第2天的评分显著更低（P = 0.016），并且患者在术后第2天和第7天需要的额外镇痛药更少（P≤0.04）。
这些发现表明局部使用10%的甲硝唑可显著减轻痔切除术后的不适，与安慰剂对照组相比，术后排便疼痛减轻。
