Abstract | BACKGROUND: METHODS: A total of 91 patients with third and fourth degree hemorrhoids undergoing open hemorrhoidectomy were included in this prospective, double-blind, randomized controlled trial. The patients were randomly assigned to either cholestyramine ointment or placebo immediately after surgery, 12 h after surgery, and then every 8 h for 14 days. The primary outcomes were intensity of pain at rest and during defecation, measured with a visual analog scale, and the analgesic requirement, measured by amount of tramadol consumption. RESULTS: The cholestyramine group had less postoperative pain than the placebo group at the 24th hour (1.84 ± 2.54 vs. 4.07 ± 3.35; P = 0.001) and 48th hour (0.18 ± 0.88 vs. 3.57 ± 3.45; P < 0.001) and less pain during defecation starting at the 48th hour (2.28 ± 2.96 vs. 4.77 ± 4.09; P = 0.001). Similarly, the average tramadol consumption at hours 24 and 48 was significantly lower for the cholestyramine group (5.32 ± 21.45 vs. 43.18 ± 61.56 mg at 24 h, and 4.48 ± 16.65 vs. 57.63 ± 65.47 mg at 48 h; P < 0.001). The only adverse event was pruritus, which had a lower frequency in the cholestyramine group but the difference was not significant until postoperative week 4 (P < 0.001). CONCLUSIONS:
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Authors | Shahram Ala, Fariborz Eshghi, Reza Enayatifard, Payam Fazel, Banafsheh Rezaei, Roja Hadianamrei |
Journal | World journal of surgery
(World J Surg)
Vol. 37
Issue 3
Pg. 657-62
(Mar 2013)
ISSN: 1432-2323 [Electronic] United States |
PMID | 23229850
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anion Exchange Resins
- Ointments
- Cholestyramine Resin
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Topics |
- Administration, Topical
- Adult
- Anion Exchange Resins
(administration & dosage)
- Cholestyramine Resin
(administration & dosage)
- Defecation
- Double-Blind Method
- Female
- Follow-Up Studies
- Hemorrhoidectomy
(methods)
- Hemorrhoids
(diagnosis, surgery)
- Humans
- Male
- Middle Aged
- Ointments
(therapeutic use)
- Pain Measurement
(drug effects)
- Pain, Postoperative
(drug therapy, prevention & control)
- Prospective Studies
- Reference Values
- Severity of Illness Index
- Treatment Outcome
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