A Randomized, Prospective, Double-Blind, Placebo-Controlled Trial of the Effect of Topical Diltiazem on Post-hemorrhoidectomy Pain.
Author(s): Amoli HA, Notash AY, Shahandashti FJ, Kenari AY, Ashraf H
Affiliation(s): Associate professor of surgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Publication date & source: 2009-11-14, Colorectal Dis., [Epub ahead of print]
Abstract Aim: Spasm of the internal anal sphincter plays a role in hemorrhoidal disease and may be a source of anal pain after hemorrhoid surgery. In this study, we investigated the effect of topical diltiazem on postoperative pain following Milligan-Morgan haemorrhoidectomy. Method: After hemorrhoidectomy, 33 patients were randomly assigned to receive diltiazem ointment [2%] (n = 16) or a placebo ointment (n =17). Ointments were applied to the perianal region three times daily for seven days. A Visual Analog Scale was used to assess postoperative pain. The primary endpoint was reduction in postoperative pain. Results: Patients using the diltiazem cream had significantly less pain and greater benefit than those in the placebo group throughout the first postoperative week and total and daily narcotic analgesic use was higher in the placebo group. There were no differences in morbidity between the two groups. Conclusions: Perianal application of diltiazem cream after hemorrhoidectomy significantly reduces postoperative pain and is perceived as beneficial with no increase in associated morbidity.