Treatment of anal fissures using a combination of minoxidil and lignocaine: a randomized, double-blind trial.
OBJECTIVE
Anal fissures are associated with hypertonia of the internal anal sphincter and pain. We evaluated the efficacy of local application of a combination of minoxidil and lignocaine in healing anal fissures.


METHODS
In this prospective, randomized, double-blind study, 90 patients with anal fissure were recruited. Patients received local applications of ointments containing 5% lignocaine (n=28), 0.5% minoxidil (n=36), or both (n=26). Healing of anal fissure at 6 weeks was used as the primary end-point.


RESULTS
Rates of complete healing of fissure were similar in the three groups (lignocaine alone 8/27, minoxidil alone 10/34, combination 7/22; p=ns). Mean (SD) time taken for complete healing with combination treatment [1.9 (0.6) weeks] was significantly shorter than that with minoxidil alone (3.1 [1.7] weeks; p=0.001) or with lignocaine alone (3.3 [0.8] weeks; p=0.002). Rates of pain relief were similar in the three groups. Stoppage of bleeding occurred more often with combination treatment than with lignocaine alone. No patient had systemic or local side effects.


CONCLUSIONS
Combination treatment with minoxidil and lignocaine helps in faster healing of anal fissures and provides better symptomatic relief than either drug alone.
Muthukumarassamy
Rajakannu
R
Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605 006, India. muthukumarassamy@yahoo.com
Robinson
Smile S
SS
Sarath
Sistla Chandra
SC
Raveendran
R
R
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008914:Minoxidil / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000779:Anesthetics, Local; D014665:Vasodilator Agents; D008914:Minoxidil; D008012:Lidocaine