Efficacy of combination of 0.2% GTN and lignocaine ointments in wound healing and pain relief after Milligan Morgan hemorrhoidectomy--a comparison with lignocaine and 0.2% GTN ointments separately.
OBJECTIVE
To compare the analgesic efficacy and rate of wound healing of combination of 0.2% Glyceryl Trinitrate and 2% lignocaine ointments with 0.2% Glyceryl Trinitrate and 2% lignocaine ointment separately after Milligan Morgan hemorrhoidectomy.


METHODS
Randomized control trial.


METHODS
Combined Military Hospital, Kharian, Malir and Bannu. November 2007 to August 2011.


METHODS
Patients undergoing Milligan Morgan hemorrhoidectomy were randomized into 3 groups by using computer generated table. Group A received combination of 0.2% Glyceryl Trinitrate and 2% lignocaine ointment, Group B 2% lignocaine and Group C received 0.2% Glyceryl Trinitrate ointment. These ointments were given on twice daily basis. Pain scores were measured on a 100 mm Visual Analog Scale. Pain scores and quantity of oral analgesics used were compared daily until the 7th post-operative day. The time required for complete healing (in weeks) was also compared.


RESULTS
Out of 210 patients, 192 (67 Group A, 64 Group B and 61 Group C) completed the study. Demographic data were comparable in all three groups. There were statistically significant reductions in pain scores and quantity of analgesics used from the first to the fourth post-operative days in Group A. The time required for complete healing was also significantly reduced in the combination group. There were no significant side effects in any group.


CONCLUSIONS
The combination of 0.2% GTN and 2% lignocaine showed better pain relief resulting in less use of oral analgesics and faster healing of the wound after Milligan Morgan hemorrhoidectomy.
Buraidah Central Hospital, Buraidah, Saudi Arabia. Electronic address: khizarikhan@yahoo.com.
Khizar Ishtiaque
KI
Khan
HIT Hospital, Taxilla, Pakistan.
Ahmed
A
Waqas
CMH, Lahore, Pakistan.
Muhammad
M
Akmal
CMH, Malir, Pakistan.
Shahid
S
Mahmood
CMH, Bannu, Pakistan.
Afaq
A
Iqbal
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D061865:Hemorrhoidectomy / Q000009:adverse effects / Q000379:methods*; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage*; D009824:Ointments / Q000008:administration & dosage; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D014945:Wound Healing / Q000187:drug effects
D000779:Anesthetics, Local; D009824:Ointments; D008012:Lidocaine; D005996:Nitroglycerin
GTN; Lignocaine; Milligan Morgan hemorrhoidectomy