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Revista Brasileira de Coloproctologia
Print version ISSN 0101-9880
BASSO, Marcelo Pandolfi et al. Comparison of effect of topical metronidazole 10% associated with nifedipine 0.3% versus nifedipine 0.3% alone in postoperative hemorrhoidectomy by hybrid technique. Rev bras. colo-proctol. [online]. 2011, vol.31, n.2, pp. 131-138. ISSN 0101-9880. http://dx.doi.org/10.1590/S0101-98802011000200004.
Introduction: Hemorrhoidectomy is a frequent operation considered painful for most patients. Topical metronidazole and nifedipine have been demonstrated to decrease postoperative pain when they are applied alone. The aim of this study was to evaluate the effect of topical metronidazole and nifedipine together in reducing postoperative pain, in the evacuation, the development of inflammatory skin tags and complications. Material and methods: A double-blind, prospective, randomized study including 42 patients was performed. The group 1 used 10% metronidazole plus 0.3% nifedipine and the group 2 used 0.3% nifedipine only. Pain was assessed using a visual analog score (VAS) on postoperative hour 12 and at days 1, 4, 14 and 28. Results: Patients who used the combination of topical medications had less pain, less analgesic requirement and a lower dose ingested of analgesics, higher early defecation, lower development of inflammatory skin tags and complications than those who used topical nifedipine alone. Nevertheless, statistic differences were not significant. Conclusion: The addition of metronidazole to nifedipine in topical form did not improve the parameters evaluated in this study. However, both treatments are justified for use in postoperative hemorrhoidectomy.
Keywords : pain; postoperative; metronidazole; hemorrhoids; hemorrhoidectomy.