Sunil Suchdev, Muhammad Ghayassuddin, Syed Muneeb Younus, Abdul Jabbar Mirani, Nighat Ghias, Aamna Qazi, Altaf Jatoi, Saqib Bakhshi, Qazi Jalaluddin Ahmed.
Calcium Channel Blockers for pain relief after Haemorrhoidectomy; a randomized controlled trial from Karachi, Pakistan.
Pak J Surg Jan ;30(2):187-92.

Background: Spasm of internal anal sphincter is responsible for pain aft er haemorrhoid surgery (haemorrhoidectomy). Topical use of a calcium channel blocker, 2% Diltiazem (DTZ), may be eff ective in reducing pain aft er haemorrhoidectomy. Objectives: To evaluate the mean pain scores on visual analogue scale on second post operative day aft er haemorrhoidectomy in patients using 2% DTZ versus patients using placebo ointment along with standard treatment for pain relief. Methodology: Th is was a randomized control trial conducted at Kulsoom Bi Valika Social Security (K.V.S.S.) SITE Hospital, Karachi, for a period of six months from 01st August 2011 to 31st January 2012 . Eighty patients, who had undergone Milligan Morgan haemorrhoidectomy, were randomly assigned to receive 2% DTZ ointment (group D - study group) or a placebo ointment (group P - control group) post-operatively. Forty patients were included in each group. Mean postoperative pain scores were recorded using aisual analogue score on second postoperative day. SPSS version 16 was used for statistical analysis. Results: Mean age was 38.79±14.86 years. Sixty fi ve (81.3%) patients were male whereas fi ft een (18.7%) were female, with male to female ratio being 4:1. Patients using 2% DTZ ointment had signifi cantly less pain aft er surgery. Mean postoperative pain score in those using 2% DTZ was 4.20±1.09, while in placebo group it was 7.53±0.81, on the second postoperative day (p<0.0001). Conclusion: Perianal application of 2% DTZ ointment aft er haemorrhoidectomy is eff ective in reducing pain on second postoperative day.

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