Randomized clinical trial of 0.2 per cent glyceryl trinitrate ointment for wound healing and pain reduction after open diathermy haemorrhoidectomy.
BACKGROUND
Open haemorrhoidectomy is associated with considerable postoperative pain and discomfort. This study assessed whether glyceryl trinitrate (GTN) ointment promotes wound healing and reduces pain after open haemorrhoidectomy.


METHODS
A randomized prospective double-blind placebo-controlled trial was conducted. Patients were randomized to either 0.2 per cent GTN ointment or placebo ointment (petroleum jelly). Patients were asked to fill in a pain diary. Complete healing was defined as complete epithelialization.


RESULTS
There were 40 patients in the GTN group and 42 in the placebo group. There were no statistically significant differences in sex, weight, type of haemorrhoid, type of surgery (emergency or elective), number of haemorrhoids excised, duration of surgery, hospital stay and complication rate between the groups. Pain scores and analgesic use were not significantly different. By week 3, however, 17 patients in the GTN group had completely epithelialized wounds compared with eight patients in the placebo group (P = 0.021). Only one patient who received GTN experienced headache requiring discontinuation of the ointment.


CONCLUSIONS
TGN 0.2 per cent ointment improved wound healing rates, but did not reduce pain in this study.
Tan
K-Y
KY
Department of General Surgery, Changi General Hospital, Singapore. kok_yang_tan@cgh.com.sg
Sng
K K
KK
Tay
K-H
KH
Lai
J-H
JH
Eu
K-W
KW
D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D003972:Diathermy / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage*; D009824:Ointments / Q000008:administration & dosage; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
D000700:Analgesics; D009824:Ointments; D005996:Nitroglycerin