Randomized controlled trial of trimebutine (anal sphincter relaxant) for pain after haemorrhoidectomy.
BACKGROUND
Anal sphincter spasm may aggravate pain after haemorrhoidectomy. The aims of this study were to investigate whether a trimebutine suppository (Proctolog) reduced anal resting pressure and, subsequently, to test its efficacy in relieving pain after haemorrhoidectomy.


METHODS
Ten patients underwent anal manometry before and 4 h after Proctolog application. A controlled randomized trial was then conducted on 160 consecutive patients. A standard haemorrhoidectomy was performed. Eighty patients were then randomized to receive an application of Proctolog immediately after the procedure (group 1). The remaining 80 did not receive a suppository (controls, group 2). An independent, blinded observer determined the pain scores.


RESULTS
Proctolog resulted in a mean 35 per cent reduction in resting anal pressure (P < 0.001). However, there were no differences in the pain score at 4 h after haemorrhoidectomy, maximum pain during the first 24 h, maximum pain during the second postoperative day, ketoprofen requirement or need for intramuscular pethidine injections between groups 1 and 2.


CONCLUSIONS
Although Proctolog reduced mean resting anal pressure at 4 h after application, this did not affect pain after haemorrhoidectomy.
Ho
Y H
YH
Department of Colorectal Surgery, Singapore General Hospital, Singapore.
Seow-Choen
F
F
Low
J Y
JY
Tan
M
M
Leong
A P
AP
D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008365:Manometry; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010276:Parasympatholytics / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D013488:Suppositories; D014287:Trimebutine / Q000008:administration & dosage / Q000627:therapeutic use*
D010276:Parasympatholytics; D013488:Suppositories; D014287:Trimebutine