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Effect of 0.2% nifedipine gel on anal canal pressures and postoperative pain: study following hemorrhoidectomy by open technique

INTRODUCTION: Hemorrhoids are very common and pain following their surgical treatment causes great suffering. Various alternatives have been studied for reducing postoperative pain. Among these is surgical sphincterotomy, which may in some cases cause some degree of fecal incontinence. For this reason, several studies have used chemical sphincterotomy, with nifedipine, diltiazem, glycerin trinitrate or botulinum toxin. The objective of the present study was to investigate the effects of topical nifedipine for reducing anal canal pressures and consequently reducing postoperative pain. MATERIAL AND METHOD: Topical gels of 0.2% nifedipine plus 2% lidocaine (Group 1) and 2% lidocaine alone (Group 2) were used following hemorrhoidectomy. Pressures were measured before the operation and on the first, fourth and seventh days after the operation. Pain was also evaluated on all of the first seven postoperative days using a visual analog scale. RESULTS: There were no differences in relation to anal canal pressures, but lower pain levels were reported in the group that received nifedipine. CONCLUSION: Nifedipine gel was efficient for postoperative analgesia, but did not alter anal canal pressures.

Nifedipine; Manometry; Anal canal; Hemorrhoids; Postoperative pain; operative surgical procedures


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