The effects of topical metronidazole on post-hemorrhoidectomy pain: A brief report

Oral metronidazole has been previously demonstrated to decrease
postoperative pain after open hemorrhoidectomy. The aim of this study was to evaluate
the effect of topical metronidazole in reducing postoperative pain of
hemorrhoidectomy.
Methods: In this double-blind, clinical trial forty 20- to 40-year old male patients were
scheduled for hemorrhoidectomy under spinal anesthesia at the Imam Khomeini
Hospital in Urmia, Iran from April to September 2010. The participants were assigned
to receive topical metronidazole (n=20) or placebo (n=20). Pain intensity was assessed
using a visual analog scale (VAS), the time of first narcotic request and morphine
administrations were also recorded.
Results: The VAS scores were lower in metronidazole than the control group but this
difference was not statistically significant, except after 24 hr post-surgically. Morphine
administration in the first 24 hr was lower in the metronidazole group (P<0.05).
Conclusion: Although metronidazole could not prolong the time of first analgesic
request, but application of metronidazole gel is associated with lower analgesic
requirement