TO COMPARE THE EFFICACY OF INTERNAL SPHINCTEROTOMY WITH TOPICAL 0.2% GLYCERYL TRINITRATE OINTMENT AFTER HEMORRHOIDECTOMY FOR PAIN RELIEF

Topical 0.2% Glyceryl Trinitrate Ointment for Pain Relief

Abstract

Objective: To compare the efficacy of internal sphincterotomy with topical 0.2% glyceryl trinitrate ointment after hemorrhoidectomy for pain relief.

Study Design: Randomized controlled trial. 

Place and Duration of Study: Department of surgery, Combined Military Hospital Rawalpindi.

Material and Methods: Individual patients undergoing hemorrhoidectomy were randomized to either undergo internal sphincterotomy (Group A) or apply 0.2% glyceryl trinitrate (Group B). internal sphincter was divided up to dentate line through one of hemorrhoidectomy incisions. For 2^nd group the first dose of 0.2% GTN ointment was applied at the end of hemorrhoidectomy. They were advised sitz bath 4 times daily and stool softener. Post operative pain was measured using visual analogue scale (VAS) on 1^st, 2^nd post op day and after a week and the average score was noted. VAS of pain far last visit was compared between the groups.

Results:  Post operative pain was comparatively less in group A as compared to group B (p = 0.014).

Conclusion: In patients undergoing hemorrhoidectomy, addition of surgical internal sphincterotomy results in lesser pain in the postoperative period as compared to those receiving topical application of 0.2% glyceryltrinitrate ointment.