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Topical diltiazem ointment in post-hemorrhoidectomy pain relief: A meta-analysis of randomized controlled trials.

Abstract：

BACKGROUND:Hemorrhoidectomy is commonly associated with postoperative pain. Calcium channel blockers are known to cause relaxation of gastrointestinal smooth muscle and oral diltiazem has also been shown to reduce the resting anal pressure. OBJECTIVE:We attempted to analyze efficacy and side effects of topical diltiazem oint. in post-operative pain control. METHODS:This is a meta-analysis of patients who underwent hemorrhoidectomy using topical diltiazem oint. versus placebo (Vaseline) for pain control. Patients with third or fourth degree hemorrhoids undergoing traditional hemorrhoidectomy were included. Procedures took place in the colorectal division of a hospital in 5 countries. Five randomized control trials (RCTs) published between 2005 and 2016 including 227 patients were included our meta-analysis (Diltiazem (calcium channel block) group = 137; Placebo (Vaseline) group = 90). Pain assessment was performed using a standardized Visual Analogue Scale. Any side effects of surgery or medication use, which were noted by the patient or the surgeon, also were recorded. RESULTS:A total of 227 patients were included in the meta-analysis. The results revealed that Diltiazem ointment was statistically significant in reducing pain within 48 h, at 72 h, and more than 96 h after operation compared to the placebo group. Regarding overall complications (including headache), there was no statistical significance between diltiazem and placebo group. CONCLUSIONS:Topical application of diltiazem effectively relieves pain after hemorrhoidectomy with minimal side effects. Further large studies are needed to substantiate its value in clinical practice.

journal_name

Asian J Surg

journal_title

Asian journal of surgery

authors

Huang YJ,Chen CY,Chen RJ,Kang YN,Wei PL

doi

10.1016/j.asjsur.2017.06.002

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

431-437

issue

5

eissn

1015-9584

issn

0219-3108

pii

S1015-9584(17)30149-5

journal_volume

41

pub_type

杂志文章,meta分析

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