title: Topical diltiazem for pain after closed hemorrhoidectomy.
abstract: BACKGROUND
  Anal sphincter spasm contributes to the appearance of postoperative pain following hemorrhoidectomy.
  
  
  OBJECTIVE
  To determine the efficacy of topical diltiazem in the control of post-hemorrhoidectomy pain.
  
  
  METHODS
  A randomized, prospective, experimental, double-blind study was conducted on 2 groups of patients in the postoperative period of closed hemorrhoidectomy. Each group consisted of 17 patients. Group A received topical diltiazem in the anal region 3 times a day and group B received a placebo. Ketorolac was administered to both groups as rescue therapy.
  
  
  RESULTS
  In group A, the mean score on the visual analog scale was 2.97±1.18cm at 24h, 1.51±1.18cm at 48h, and 0.84±0.92cm at 72h. In group B, it was 6.82±1.9cm at 24h, 5.3±1.66cm at 48h, and 4.32±2.13cm at 72h (P<.001, 95% CI). The mean number of analgesic doses in group A was 2.41±0.87 at 24h, 1.11±0.85 at 48h, and 0.94±0.96 at 72h. In group B, it was 3.82±0.52 at 24h, 3.64±0.70 at 48h, and 2.88±1.26 at 72h (P<.001, 95% CI).
  
  
  CONCLUSIONS
  In this study, topical administration of diltiazem resulted in a statistically significant reduction of postoperative pain in patients that underwent closed hemorrhoidectomy.
authors.affiliation: Maestría en Ciencias de la Salud, Instituto Politécnico Nacional, Ciudad de México, México; Servicio de Cirugía, Hospital Juárez de México, Ciudad de México, México. Electronic address: ulisesromed@prodigy.net.mx.
authors.forename: U
authors.initials: U
authors.lastname: Rodríguez-Wong
authors.affiliation: Área de Investigación Clínica de la Maestría en Ciencias de la Salud, Escuela Superior de Medicina, Sección de Posgrado e Investigación, Instituto Politécnico Nacional, Ciudad de México, México.
authors.forename: M E
authors.initials: ME
authors.lastname: Ocharán-Hernández
authors.affiliation: Dirección de Investigación, Hospital Juárez de México, Ciudad de México, México.
authors.forename: J
authors.initials: J
authors.lastname: Toscano-Garibay
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology; D004110:Diltiazem / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D061865:Hemorrhoidectomy / Q000009:adverse effects*; D006484:Hemorrhoids / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D013035:Spasm / Q000188:drug therapy / Q000209:etiology; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D004110:Diltiazem
keywords: Diltiazem; Dolor postoperatorio; Hemorrhoidectomy; Hemorroidectomía; Postoperative pain; Topical; Tópico