Meta-analysis of the use of glyceryl trinitrate ointment after haemorrhoidectomy as an analgesic and in promoting wound healing

被引：39

作者：

Ratnasingham, K. ^{[1
]}

Uzzaman, M. ^{[2
]}

Andreani, S. M. ^{[3
]}

Light, D. ^{[1
]}

Patel, B. ^{[2
]}

机构：

[1] N Tees Univ Hosp, Stockton On Tees TS19 8, England

[2] Barts & London NHS Trust, London E1 1BB, England

[3] Whipps Cross Hosp & Chest Clin, London E11 1NR, England

来源：

INTERNATIONAL JOURNAL OF SURGERY | 2010年 / 8卷 / 08期

关键词：

Haemorrhoidectomy; GTN; Analgesic; Wound healing; RANDOMIZED CONTROLLED-TRIAL; PLACEBO-CONTROLLED TRIAL; DOUBLE-BLIND TRIAL; ANAL-FISSURE; POSTHEMORRHOIDECTOMY PAIN; INTERNAL SPHINCTEROTOMY; TOPICAL METRONIDAZOLE; NITROGLYCERIN; REDUCTION;

D O I：

10.1016/j.ijsu.2010.04.012

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Introduction: Glyceryl Trinitrate (GTN) ointment has been used to treat anal fissure and pain relief in haemorrhoids, but the value of its use post-haemorrhoidectomy as an analgesic and in wound healing is unclear. The side effect of headache has often been an associated problem. Therefore, a meta-analysis of randomised controlled trials was carried out investigating the role of GTN post-haemorrhoidectomy as an analgesic, its role in would healing and the unwanted incidence of headache. Method: A structured literature search from 1966 to 2009, both paper and online, with no language barrier was carried out. 760 papers were identified and 5 randomised control trials which met the entry criteria were included in this study. Results: A total of 333 patients were included in the meta-analysis. The results revealed that GTN ointment was statistically significant in reducing pain on Day 3 and 7 compared to the placebo group. Day 3 shows a pain score of - 1.51 (p value of 0.029) and Day 7 by - 1.66 (p value of 0.014) respectively. However, it was not significant in reducing pain on Day 1. The Odds ratio for wound healing after GTN treatment at 3 weeks was 3.57 (P < 0.0001) when compared to the placebo group. Side effect of headache was not statistically significant. Conclusion: This meta-analysis has shown that GTN ointment used post-haemorrhoidectomy has a significant analgesic effect in the intermediate time period (ie. Days 3-7). It also significantly improved wound healing at 3 weeks. (C) 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

引用

页码：606 / 611

页数：6

共 37 条

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