Details
Category: Volume 06 Issue 11 November 2018
Hits: 1092

Title: Effectiveness of 0.2 percent glyceryl trinitrate ointment for pain reduction after open Hemorrhoidectomy

Authors: Dr Guljar Ahmed, Dr Rawshan Jahan, Mamun Ibn Munim, Dr Anup Kumar Mazumder, Dr Md Monirul Ahsan

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i11.92

Abstract

Open haemorrhoidectomy is associated with significant postoperative agony and inconvenience. The main cause of postoperative pain is the haemorrhoidectomy wounds, which cause reflex spasm of the involuntary internal anal sphincter and the voluntary external sphincter.

Objective: The porpoise of this study is to evaluate effectiveness of 0.2 percent glyceryl trinitrate ointment for pain reduction after open hemorrhoidectomy.

Method: During study a planned clinical preliminary was directed. Patients were dispensed to either test gathering (GTN-gathering) or Non-GTN gathering. Complete healing was defined as complete epithelialization.  There were 32 patients in the GTN gathering and 37 in Non-GTN gathering. There were no factually huge contrasts in sex, weight, kind of haemorrhoid, sort of medical procedure (emergency or elective), number of hemorrhoids excised, term of medical procedure, and doctor's facility remain and intricacy rate between the gatherings.

Result: Pain scores and pain-relieving use were not essentially unique. By week 3, be that as it may, 21 patients in the GTN amass had totally epithelialized wounds contrasted and 9 patients in the Non-GTN gathering (P = 0•006). Just a single patient who got GTN experienced headache requiring suspension of the salve. GTN 0•2 for each penny balm enhanced injury recuperating rates and diminish postoperative torment in this investigation.

Conclusion: Post-operative pain was significantly less in GTN-Group in this study. Further study is need for better outcome.

Keyword: Haemorrhoidectomy, sphincter, glyceryl trinitrate ointment.

References

  1. Asfar, Sami K., Taleb H. Juma, and Tareef Ala-Edeen. 1988. “Hemorrhoidectomy and Sphincterotomy - A Prospective Study Comparing the Effectiveness of Anal Stretch and Sphincterotomy in Reducing Pain after Hemorrhoidectomy.” Diseases of the Colon & Rectum 31(3):181–85.
  2. Cheetham, M. J. and R. K. S. Phillips. 2001. “Evidence-Based Practice in Haemorrhoidectomy.” Colorectal Disease 3(2):126–34.
  3. Fazila Hashmi, Faisal G Siddiqui, Akmal Jamal. 2008. “Role of Topical Glyceryl Trinitrate As an Adjunct Following Milligan Morgan S Haemorrhoidectomy.”
  4. Hwang, Do Yeon, Seo Gue Yoon, Hyun Shig Kim, Jong Kyun Lee, and Kwang Yun Kim. 2003. “Effect of 0.2 Percent Glyceryl Trinitrate Ointment on Wound Healing after a Hemorrhoidectomy: Results of a Randomized, Prospective, Double-Blind, Placebo-Controlled Trial.” Diseases of the Colon and Rectum46 (7):950–54.
  5. Karanlik, Hasan, Remzi Akturk, Hakan Camlica, and Oktar Asoglu. 2009. “The Effect of Glyceryl Trinitrate Ointment on Posthemorrhoidectomy Pain and Wound Healing: Results of a Randomized, Double-Blind, Placebo-Controlled Study.” Diseases of the Colon and Rectum 52(2):280–85.
  6. Kennedy ML,Sowter S, Nguyen H, Lubowski DZ. 1996. “Glyceryl Trinitrate Ointment for the Treatment of Chronic Anal Fissure.” 1000–1006.
  7. Lund, Correspondence J. N. 1996. “Use of Glyceryl Trinitrate Ointment in the Treatment.” 776–77.
  8. Mathai, V., B. C. Ong, and Y. H. Ho. 1996. “Randomized Controlled Trial of Lateral Internal Sphincterotomy with Haemorrhoidectomy.” British Journal of Surgery 83(3):380–82.
  9. PARKS, A. G. 1956. “THE SURGICAL TREATMENT OF HEMORRHOIDS.” XLIII.
  10. Soltany, Setareh, Jafar A. Toussy, and Mohamad Foruzesh Fard. 2009. “The Effect of 0 . 2 % Glyceryl Trinitrate Ointment on Pain and Wound Healing after Hemorrhoidectomy.” 4(1):8–12.
  11. Speakman, C. T. M., S. J. D. Burnett, M. A. Kamm, and C. I. Bartram. 1991. “Sphincter Injury after Anal Dilatation Demonstrated by Anal Endosonography.” British Journal of Surgery 78(12):1429–30.
  12. Tan, K. Y., K. K. Sng, K. H. Tay, J. H. Lai, and K. W. Eu. 2006. “Randomized Clinical Trial of 0.2 per Cent Glyceryl Trinitrate Ointment for Wound Healing and Pain Reduction after Open Diathermy Haemorrhoidectomy.” British Journal of Surgery 93(12):1464–68.
  13. Wasvary, HJ, J. Hain, M. Mosed-Vogel, and P. Bendick. 2001. “Randomized, Prospective, Double-Blind, Placebo-Controlled Trial of Effect of Nitroglycerin Ointment on Pain after Hemorrhoidectomy.” Diseases of the Colon & Di(5):1069–70.

Corresponding Author

Dr Guljar Ahmed

Associate Professor, Dept. of General Surgery, North East Medical College, Sylhet, Bangladesh