A Randomized, Prospective, Double-Blind, Placebo-Controlled Trial of the Effect of a Calcium Channel Blocker Ointment on Pain After Hemorrhoidectomy

Silverman, Ralph; Bendick, Phillip J.; Wasvary, Harry

doi:10.1007/s10350-005-0135-4

Cited by 66 publications

(51 citation statements)

References 14 publications

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“…In animal models, NMDA receptor antagonists have been shown to have analgesic properties in pain conditions, with similar effects also observed in humans (20,21). Conversely, calcium has been shown to be associated with the release of neurotransmitters and substances implicated in nociceptive response (22), thus the blockage of calcium channels may initiate the pain relief process (23).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intra-articular magnesium for postoperative analgesia in total hip arthroplasty

Wen

et al. 2017

Biomedical Reports

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Abstract. The aim of the present study was to compare the efficacy of intra-articular magnesium sulphate and a saline placebo for postoperative pain control following total hip arthroplasty (THA). Sixty patients underwent THA and were randomly allocated into two groups to receive intra-articular injections of either 10 ml magnesium sulphate (100 mg/ml; magnesium group, n=30) or 10 ml normal saline solution (control group, n=30). Postoperative analgesia was maintained by intravenous morphine injection. The outcome measurements were visual analogue score (VAS), morphine consumption and Harris hip score (HHS). The two groups were well matched. The outcome of VAS at rest was significantly lower at postoperative hours 6 and 12 in the magnesium group as compared with the control group, although the difference was insignificant preoperatively and at postoperative hours 2, 4, 24 and 48, and days 3, 7 and 14. This indicator during activity was also lower in the magnesium group at postoperative hour 24 than that of the control group, although the difference was insignificant preoperatively and at hour 48, and days 7 and 14. The consumption of morphine (the total quantity) at 0-6, 6-12 and 0-48 h in the magnesium group was significantly lower than in the control group, although no significant differences were observed at 12-24 and 24-48 h between the groups. The improvements of HHS from preoperative to postoperative scores were statistically significant, however, no significant differences were identified between groups. Thus, the findings indicate that intra-articular magnesium sulphate injections provided improved pain control and reduced the need for morphine when compared with a saline placebo following THA.

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Section: Discussionmentioning

confidence: 99%

Efficacy of intra-articular magnesium for postoperative analgesia in total hip arthroplasty

Wen

et al. 2017

Biomedical Reports

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“…In the proctology field, it is used in combination with other antibiotics against infections by anaerobic bacteria, according to the extent and severity of the injury. Considering that bacterial colonization is inevitable after hemorrhoidectomy, it is not surprising that antibiotics such as metronidazole help reduce bacterial proliferation, inflammation, and postoperative pain (18,22).…”

Section: Discussionmentioning

confidence: 99%

“…There are many approaches and treatments for postoperative pain management after hemorrhoidectomy, including local treatments such as the use of nitrates, anion exchange resins (cholestyramine), complex aluminum sucrose sulfates (sucralfate), topical anesthetics, analgesics, and calcium channel blockers (such as nifedipine and diltiazem) (8,(14)(15)(16)(17)(18)(19)(20). Metronidazole was discovered in 1950 and synthesized in 1957.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of metronidazole versus placebo in pain control after hemorrhoidectomy. Results of a controlled clinical trial

Solorio-López

Ur²,

Je³

et al. 2015

Rev Esp Enferm Dig

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Introduction: Hemorrhoidal disease occurs in 50% of people aged > 40 years and is the most common reason for anorectal surgery. Pain is the main complication. Multiple topical and systemic drugs have been investigated for pain control, but there is no ideal treatment. Metronidazole has been shown to decrease postoperative pain but is not used widely.Objective: To evaluate the effect of oral metronidazole versus placebo and to assess postoperative pain following hemorrhoidectomy.Material and methods: Controlled clinical trial in adult patients who underwent elective hemorrhoidectomy for grade III/IV hemorrhoids. Patients were assigned to receive metronidazole (500 mg q8 h orally; study group, SG) or placebo (control group, CG) for 7 days after surgery. Pain was assessed using a visual analog scale after surgery. Analgesic administration (time and use of analgesics) and resumption of daily life activities were also assessed.Results: Forty-four patients were included, 22 in each group. Postoperative pain differed significantly between the SG and CG at 6 h

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“…Its efficacy in reducing postoperative pain was demonstrated in two randomized trials either with respect to placebo [23] or bupivacaine HCl [24]. Topical diltiazem showed a marginal benefit in reducing pain after surgery [25][26][27]. Glyceryl trinitrate ointment improved wound healing and reduced postoperative pain [28].…”

Section: Complicationsmentioning

confidence: 99%

Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review

Picchio¹,

Greco²,

Filippo

et al. 2014

Indian J Surg

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Surgical therapy guaranties satisfactory results, which are significantly better than those obtained with conservative therapies, especially for Grade III and IV hemorrhoids. In this review, we present and discuss the results of the most diffuse surgical techniques for hemorrhoids. Traditional surgery for hemorrhoids aims to remove the hemorrhoids, with closure (Fergusson's technique) or without closure (Milligan-Morgan procedure) of the ensuing defect. This traditional approach is effective, but causes a significant postoperative pain because of wide external wounds in the innervated perianal skin. Stapled hemorrhoidopexy, proposed by Longo, has gained a vast acceptance because of less postoperative pain and faster return to normal activities. In the recent literature, a significant incidence of recurrence after stapled hemorrhoidopexy was reported, when compared with conventional hemorrhoidectomy. Double stapler hemorrhoidopexy may be an alternative to simple stapled hemorrhoidopexy to reduce the recurrence in advanced hemorrhoidal prolapse. Transanal hemorrhoidal deartertialization was showed to be as effective as stapled hemorrhoidopexy in terms of treatment success, complications, and incidence recurrence. However, further high-quality trials are recommended to assess the efficacy and safety of this technique.

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A Randomized, Prospective, Double-Blind, Placebo-Controlled Trial of the Effect of a Calcium Channel Blocker Ointment on Pain After Hemorrhoidectomy

Cited by 66 publications

References 14 publications

Efficacy of intra-articular magnesium for postoperative analgesia in total hip arthroplasty

Efficacy of intra-articular magnesium for postoperative analgesia in total hip arthroplasty

Efficacy of metronidazole versus placebo in pain control after hemorrhoidectomy. Results of a controlled clinical trial

Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review

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