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Abstract
Objective: The research examines whether 0.2% topical glyceryl trinitrate (GTN) works better than placebo for avoiding postoperative pain and infection in patients who receive Milligan-Morgan hemorrhoidectomy at a tertiary care hospital.
Study Design: Randomized Controlled Trial. Place and Duration of Study: A six months study took place at the Department of Surgery within Jinnah Postgraduate Medical Centre (JPMC) Karachi after receiving CPSP approval.
Methodology: A total of 60 patients who fit the criteria of Grade III hemorrhoids with an ASA I or II rating between 20 and 70 years old received random distribution through a sealed opaque envelope technique into two groups. The research subjects receiving 0.2% GTN ointment followed by placebo treatment thrice daily for twelve consecutive days after surgery made up the two study groups. Two weeks following surgery Healthcare professionals examined patients for post operative pain and infection by clinical assessment and bacteriological culture testing. The research analysis occurred through SPSS version 20. Chi-square analysis served as the statistical method for determination of significance where p-values below 0.05 became significant.
Results: Postoperative pain and infection occurred in 4 patients of the GTN group (13.3%) but affected 12 patients of the placebo group (40%) (p < 0.05). The treatment effect from GTN maintained similar results regardless of patient characteristics related to diabetes, hypertension, obesity or past smoking behavior. The only Side Effects found in this study were brief temporary headaches which patients using GTN experienced.
Conclusion: Doctors should consider using topical 0.2% glyceryl trinitrate because it successfully reduces postoperative pain and infections after performing Milligan-Morgan hemorrhoidectomies. The application of GTN stands as a safe achievement-enhancing practical secondary therapy suitable for improving surgical outcomes following hemorrhoid surgery