Sadegh Fazeli M, Safari S, Kazemeini A, Larti F, Joneidi E, Rahimi M, Meisami A,
Volume 69, Issue 8 (11-2011)
Abstract
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Background: Hemorrhoid
is among the most common anorectal diseases and patients with high-grade disease
conditions need surgical treatment. Many surgical procedures are available to
treat the disease. The aim of this study was to compare the operative time and
outcomes, (post-operative pain and complications) of LigaSure hemorrhoidectomy
with those of the open conventional method.
Methods : This randomized single-blind clinical trial included 57 patients (28 in LigaSure and 29 in the open group). The
primary variable was the operative time for the excision of a single
hemorrhoidal packet. The other variables were post-operative pain measured by
morphine doses administered to control pain, scores of visual analogue scale (VAS) used to measure pain severity,
pain during home stay measured by doses of oral ibuprofen and the mean daily VAS scores, early complications
including bleeding and urinary retention, longer-term complications and time to
return to work.
Results : The demographic data were comparatively the same between the two
groups. The average time to excise a single packet of hemorrhoid was
significantly shorter in the LigaSure group (8.91
min vs. 17.35 min, P<0.001). Post-operative pain
measurements (morphine doses and VAS scores) were lower in the LigaSure group, but the differences were
not statistically significant (P=0.055 and 0.077, respectively). Complications of the two procedures were also comparable.
Neither of the groups returned to work in a shorter time.
Conclusion: LigaSure
hemorrhoidectomy seems to be a safe method and it can reduce the operative time
significantly. It may also have a modest effect on post-operative pain.
Pourghassem J, Mahoori A, Akhbari P,
Volume 69, Issue 10 (1-2012)
Abstract
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Background: Oral
metronidazole has been previously demonstrated to decrease postoperative pain
after open hemorrhoidectomy. The aim of this study was to evaluate the effect
of topical metronidazole in reducing postoperative pain of hemorrhoidectomy.
Methods : In this double-blind, clinical trial forty 20- to 40-year old male patients were scheduled for hemorrhoidectomy under
spinal anesthesia at the Imam Khomeini Hospital in Urmia, Iran from April to
September 2010. The participants were assigned to receive topical metronidazole (n=20) or placebo (n=20). Pain intensity was assessed
using
a visual analog scale (VAS), the time of first narcotic request and morphine administrations were also
recorded.
Results : The VAS scores were lower in metronidazole than the control group but this
difference was not statistically significant, except after 24 hr post-surgically. Morphine administration
in the first 24 hr was lower in the metronidazole group (P<0.05).
Conclusion: Although metronidazole
could not prolong the time of first analgesic request, but application of
metronidazole gel is associated with lower analgesic requirement.