To compare the efficacy of internal sphincterotomy with topical 0.2% glyceryl trinitrate ointment after hemorrhoidectomy for pain relief

ABSTRACT

To compare the efficacy of internal sphincterotomy with topical 0.2% glyceryl trinitrate ointment after hemorrhoidectomy for pain relief. Randomized controlled trial. Department of surgery, Combined Military Hospital Rawalpindi. Individual patients undergoing hemorrhoidectomy were randomized to either undergo internal sphincterotomy [Group A] or apply 0.2% glyceryl trinitrate [Group B]. internal sphincter was divided up to dentate line through one of hemorrhoidectomy incisions. For 2[nd] group the first dose of 0.2% GTN ointment was applied at the end of hemorrhoidectomy. They were advised sitz bath 4 times daily and stool softener. Post operative pain was measured using visual analogue scale [VAS] on 1[st], 2[nd] post op day and after a week and the average score was noted. VAS of pain far last visit was compared between the groups. Post operative pain was comparatively less in group A as compared to group B [p = 0.014]. In patients undergoing hemorrhoidectomy, addition of surgical internal sphincterotomy results in lesser pain in the postoperative period as compared to those receiving topical application of 0.2% glyceryltrinitrate ointment