Diseases of the colon and rectum
-
Randomized Controlled Trial Comparative Study
Topical metronidazole can reduce pain after surgery and pain on defecation in postoperative hemorrhoidectomy.
Topical metronidazole (10 percent) has been previously demonstrated to decrease postoperative pain after hemorrhoidectomy. The aim of this study was to evaluate the effect of topical metronidazole (10 percent) in reducing postoperative and after-defecation pain of hemorrhoidectomy. ⋯ These finding indicate that topical 10 percent metronidazole significantly reduce posthemorrhoidectomy discomfort, and postoperative defecation pain is reduced compared with that of the placebo control group.
-
Randomized Controlled Trial Comparative Study
Continuous wound infusion of local anesthetic for the control of pain after elective abdominal colorectal surgery.
Local anesthetic wound infusion has been investigated in recent years as a potential alternative to standard analgesic regimens after major surgery. This study investigates the efficacy of a continuous wound infusion of ropivacaine in conjunction with best practice postoperative analgesia after midline laparotomy for abdominal colorectal surgery. ⋯ Management of pain after major abdominal colorectal surgery is best achieved through adopting a multimodal approach to analgesia. Delivery of ropivacaine to midline laparotomy wounds via a Painbuster Soaker device is safe, but we have not demonstrated any significant clinical advantage over current best practice.
-
Randomized Controlled Trial
Pudendal block with bupivacaine for postoperative pain relief.
Postoperative pain after hemorrhoidectomy is very intense, and the pain at the first postoperative defecation is very intense. Based on our pilot initial results that reflected reduced postoperative pain, we conducted a prospective, randomized, double-blind study to investigate whether the analgesia produced by bilateral pudendal nerve block using a nerve-stimulator could provide better postoperative pain relief compared with the routine technique in use in the Department of Anesthesia. ⋯ In this controlled study, bilateral pudendal nerve block oriented by nerve stimulator provided excellent analgesia with low need for opioids, without local or systemic complications, and without urinary retention.
-
Randomized Controlled Trial
Comparison of outcomes in Z-plasty and delayed healing by secondary intention of the wound after excision of the sacral pilonidal sinus: results of a randomized, clinical trial.
Pilonidal sinus is a common disease, mostly among young males. Although the conventional surgery, secondary repair of the wound after wide excision with or without curettage, is not technically difficult, it takes a long time, weeks or months, for a wound to heal. In this study, we compared outcomes and complications of Z-plasty repair with outcomes and complications of delayed healing by secondary intention (conventional surgery). ⋯ Healing was considerably faster in patients who were treated with Z-plasty technique of wound closure. This procedure can be used as a desirable treatment for pilonidal sinus, which is a noncomplex method without increased rate of complications. Nonetheless, it might slightly increase the duration of hospitalization.
-
Randomized Controlled Trial Comparative Study
Randomized clinical trial of botulinum toxin plus glyceryl trinitrate vs. botulinum toxin alone for medically resistant chronic anal fissure: overall poor healing rates.
This study was designed to assess whether addition of glyceryl trinitrate to botulinum toxin improves the healing rate of glyceryl trinitrate-resistant fissures over that achieved with botulinum toxin alone. ⋯ There is some evidence to suggest that combining glyceryl trinitrate with botulinum toxin is superior to the use of botulinum toxin alone for glyceryl trinitrate-resistant anal fissure. The poor healing rate may reflect the fact that many of the patients did not have significant anal spasm at trial entry.