Effect of Topical Baclofen 5% on Post-Hemorrhoidectomy Pain: Randomized Double Blind Placebo-Controlled Clinical Trial

Baclofen is an agonist for a subtype of gamma-amino butyric acid (GABA-B) receptors and traditionally been used
for the systemic treatment of spasticity. Topical application of baclofen has been shown to reduce pain in patients with localized
neuropathic pain.
Objectives In this study, we investigate the efficacy of baclofen cream (5%) in reducing postoperative pain and analgesic
requirement after open hemorrhoidectomy.
Design The patients were randomly assigned to either baclofen (5%) cream or placebo immediately after surgery and then every
12 h for 14 days.
Patients A total of 66 patients with third- and fourth-degree hemorrhoids undergoing open hemorrhoidectomy were randomly
assigned to this trial.
Setting This study was conducted at a single educational hospital.
Primary and Secondary Outcome Measures The primary outcomes were intensity of pain, measured with a visual analog scale,
and the analgesic requirement, measured by the amount of the acetaminophen consumption.
Results No significant difference was found in baseline characteristics between the two groups. Postoperative pain score of the
baclofen group was significantly lower on week 1 (P = 0.01) and week 2 (P = 0.02) than the placebo group. Similarly, patients in
the baclofen group consumed significantly less analgesic medication on week 1 (P = 0.025) and week 2 (P = 0.024) than the
control group.
Conclusion Topical application of baclofen effectively relieves pain after hemorrhoidectomy with minimal side effects