Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial

  • Syed Tatheer Abbas, Dr Dr. Akbar Niazi Teaching Hospital; Islamabad Medical and Dental College
  • Ahmad Raza, Dr Dr. Akbar Niazi Teaching Hospital; Islamabad Medical and Dental College
  • Ihtasham Muhammad Ch, Dr Al-Nafees Medical College, Islamabad
  • Tahira Hameed, Dr Dr. Akbar Niazi Teaching Hospital; Islamabad Medical and Dental College
  • Nausheen Hasham, Dr Dr. Akbar Niazi Teaching Hospital; Islamabad Medical and Dental College
  • Naveed Arshad Islamabad Medical and Dental College https://orcid.org/0000-0003-1143-8959
Keywords: Hemorrhoidectomy, Pain, Metronidazole

Abstract

Background and Objectives: Milligan Morgan Hemorrhoidectomy is one of the most commonly performed surgeries. Post-operative pain is the major cause of morbidity in post hemorrhoidectomy patients. Metronidazole has an established role in relieving post hemorrhoidectomy pain. The objective was to evaluate the pain score by using topical and oral metronidazole in post Milligan Morgan hemorrhoidectomy patients.

Methods: A prospective randomized controlled trail was done in surgical departments of Akbar Niazi Teaching Hospital, Islamabad. A total of 166 consecutive patients with 3rd and 4th degree hemorrhoids were presenting in surgical OPD and who underwent Milligan Morgan hemorrhoidectomy between July 2018 and December 2018 were included in the study. Patients allocated in two groups, Group-A received topical metronidazole 10% post hemorrhoidectomy for seven days and Group-B were given oral metronidazole 400mg for 07 days. Analgesics were given on patient’s requirement. Patients post hemorrhoidectomy pain was recorded by using VSA scale at baseline (1st day) and on 7th post-operative day. Data analysis was done by using SPSS 21. Pain calculated by compared in terms of mean, standard deviation between groups and independent sample T test was used. Association between demographic details like gender and ages of the patients with pain scale on 7th day was measured and chi-square distribution was used.

Results: Total 166 patients were included in this study. The mean ages of the patients were 44.07±10.62 years with minimum 20 and maximum 60 years. Out of 166 patients, female were 55 (33.1%) and male were 111 (66.9%). Results showed significantly lower pain in patients using topical metronidazole as compared to oral metronidazole (p=0.001). Association of pain with respect to ages was insignificant (p=0.202) whereas between genders inside the groups showed significant difference (p=0.028).

Conclusion: These results showed that topical metronidazole significantly reduces pain in post hemorrhoidectomy patients as compared to oral metronidazole overall and even when data stratified among age, gender and type of hemorrhoids.

doi: https://doi.org/10.12669/pjms.36.5.1796

How to cite this:
Abbas ST, Raza A, Chaudhry I, Hameed T, Hasham N, Arshad N. Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial. Pak J Med Sci. 2020;36(5):867-871.  doi: https://doi.org/10.12669/pjms.36.5.1796

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Syed Tatheer Abbas, Dr, Dr. Akbar Niazi Teaching Hospital; Islamabad Medical and Dental College

Senior Registrar

Ahmad Raza, Dr, Dr. Akbar Niazi Teaching Hospital; Islamabad Medical and Dental College

Associate Professor

Surgery Department

Ihtasham Muhammad Ch, Dr, Al-Nafees Medical College, Islamabad

Associate Professor

Surgery Department

Tahira Hameed, Dr, Dr. Akbar Niazi Teaching Hospital; Islamabad Medical and Dental College

Registrar

Surgery Department

Nausheen Hasham, Dr, Dr. Akbar Niazi Teaching Hospital; Islamabad Medical and Dental College

Registrar

Surgery Department

Naveed Arshad, Islamabad Medical and Dental College

Assistant Professor

Rehabilitation Department

Published
2020-06-26
How to Cite
Abbas, S., Raza, A., Ch, I., Hameed, T., Hasham, N., & Arshad, N. (2020). Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial. Pakistan Journal of Medical Sciences, 36(5). https://doi.org/10.12669/pjms.36.5.1796