Department of Surgery, Dow University OF Health Sciences, Karachi, Pakistan.
J Ayub Med Coll Abbottabad. 2021 Jan-Mar;33(1):125-128.
Hemorrhoids are one of the most common anal pathology affecting millions of people around the world. Milligan-Morgan open hemorrhoidectomy is the most effective hemorrhoidectomy method used as gold standard procedure. Post-operative pain is recognized as a distressing complication of hemorrhoidectomy leading to increase hospital stay and psychological stress to both patient and surgeon. This study is designed to determine the efficacy of diltiazem gel in relieving pain after hemorrhoidectomy caused by anal muscle spasm. This will lead to decreased hospital stay and save both patient and surgeon from stress in postoperative period.
To compare mean post-operative pain in patients undergoing hemorrhoidectomy with vs. without topical application of diltiazem gel.
Total 80 patients who were diagnosed with third- and fourth-degree hemorrhoids and undergo hemorrhoidectomy were included in the study. Patients were randomly allocated to two groups using opaque sealed envelope method. Group A and B both have 40 patients in each group. Pain score was measured on visual analogue scale (VAS) by asking the patients to fill a questionnaire or by the help of the doctor.
The patient's average age was 39.98±7.98 years. At 24 hours, mean pain score was significantly high in group B than group A [7.23±0.95 vs. 5.38±1.06; p=0.0005]. At 3rd post-operative day, mean pain score was significantly high in group B than group A [5±0.78 vs. 3.08±0.99; p=0.0005]. Seventy percent cases were observed in group B which required rescue analgesia.
It is concluded that application of diltiazem ointment at perianal area with standard treatment considerably decreases pain after haemorrhoidectomy.
痔疮是全球数百万人中最常见的肛门病理之一。Milligan-Morgan 开放式痔切除术是目前最有效的痔切除术方法，被认为是金标准。术后疼痛被认为是痔切除术的一种痛苦并发症，导致住院时间延长和患者及外科医生的心理压力增加。本研究旨在确定地尔硫卓凝胶在缓解肛门肌肉痉挛引起的痔切除术后疼痛的疗效。这将减少住院时间，并使患者和外科医生在术后都免受压力的影响。
比较痔切除术患者应用和不应用地尔硫卓凝胶局部止痛的平均术后疼痛。
共纳入 80 例诊断为三度和四度痔并接受痔切除术的患者。患者采用不透明密封信封法随机分为两组。A 组和 B 组各有 40 例患者。通过让患者填写问卷或在医生的帮助下，使用视觉模拟量表（VAS）测量疼痛评分。
患者的平均年龄为 39.98±7.98 岁。在 24 小时时，B 组的平均疼痛评分明显高于 A 组[7.23±0.95 与 5.38±1.06；p=0.0005]。在术后第 3 天，B 组的平均疼痛评分明显高于 A 组[5±0.78 与 3.08±0.99；p=0.0005]。B 组中有 70%的患者需要使用止痛剂。
在标准治疗的基础上，在肛周应用地尔硫卓软膏可显著减轻痔切除术后疼痛。
