The Effect of Metronidazole on Hemorrhoidectomy Pains

Background and Topical metronidazole (10 percent) has been previously demonstrated to decrease post operative pain after hemorrhoidectomy. The aim of this study was to evaluate the effect of topical metronidazole (10 percent) on postoperative and after defecation pains of hemorrhoidectomy. A double-blind randomized trial was conducted to compare post- hemorrhoidectomy pain using topical metronidazole (10 percent) to. placebo carrier applied to surgical site. Forty-seven patients were randomly selected to receive metronidazole (n=25) or placebo (n=22). Pain was assessed using a visual analog scale (VAS) preoperatively as well as on postoperative hours 6 and 12, and on days 1, 2, 7, and 14. The use of narcotic, additional analgesics and complications were recorded. (Pain scores were calculated and compared with baseline values and control group (t-test, SPSS ver.10). Patients in the topical metronidazole group had significantly less postoperative pain than those in the placebo group by the day 14 (P≤0.04). There was no significant difference in narcotic analgesic requirements between groups, except for hour 12 (P<0.05). In the metronidazole group, after defecation, pain was ranked significantly lower on day 2 (P=0.016) and patients required fewer additional analgesics postoperatively on days 2 and 7 (P≤0.04). These finding indicate that topical 10 percent metronidazole significantly reduce post- hemorrhoidectomy discomfort and postoperative defecation pain is reduced compared with that of the placebo control group.