2% lidocaine gel in reducing postoperative pain following haemorrhoidectomy

Conditions: Surgery; Pain, Postoperative

Summary: the study is a randomized, double-blind, controlled trial evaluating the efficacy of 2% lidocaine gel in reducing postoperative pain and analgesic consumption after haemorrhoidectomy. 222 patients undergoing ferguson haemorrhoidectomy will be randomly assigned to receive either 2% lidocaine gel or a non-anaesthetic lubricant gel control. pain scores using a visual analog scale (vas) will be assessed at 12 and 24 hours, and 2, 3, and 7 days postoperatively. analgesic consumption will also be measured.

title: efficacy of 2% lidocaine gel in reducing postoperative pain and analgesic consumption following haemorrhoidectomy: a randomized, double-blind, controlled trial objective: to assess the effect of 2% lidocaine gel on postoperative pain intensity and analgesic consumption following haemorrhoidectomy. study design: this study is a single-center, randomized, double-blind, controlled trial. patients will be randomly assigned in a 1:1 ratio to receive either 2% lidocaine gel or a non-anaesthetic water-based lubricant gel (control) using a computer-generated randomization list. the randomization will be stratified by hemorrhoid grade (iii or iv). the study medication will be prepared by the hospital pharmacy and provided in identical, pre-filled syringes to ensure blinding of participants and investigators. intervention: the intervention group will receive 5 ml of 2% lidocaine gel, while the control group will receive 5 ml of a non-anaesthetic water-based lubricant gel. the study medication will be applied to the perianal region three times per day for 7 days following surgery. patients will be instructed on the proper application technique and will be provided with a diary to record the time and date of each application. outcome assessment: postoperative pain will be assessed using a 100 mm visual analog scale (vas), with 0 representing no pain and 100 representing the worst imaginable pain. pain scores will be recorded at 12 and 24 hours, and 2, 3, and 7 days after surgery. patients will also record their analgesic consumption in a diary, including the type, dose, and frequency of analgesics used. postoperative complications, such as bleeding, infection, or urinary retention, will be assessed by the treating surgeon at each follow-up visit. sample size: a sample size of 222 patients (111 per group) was calculated based on a power of 80%, a significance level of 0.05, and an expected difference in mean vas scores of 15 mm between the groups, with a standard deviation of 30 mm.

Eligibility criteria:
inclusion criteria: * age 18 years or older * diagnosed with grade iii or iv hemorrhoids * candidate for ferguson haemorrhoidectomy exclusion criteria: * not a candidate for ferguson haemorrhoidectomy * recurrent hemorrhoidal disease * concurrent anal pathology diagnosed preoperatively, including: * anal fistula * anal fissure * anal polyp * history of diabetes mellitus * history of liver cirrhosis * history of inflammatory bowel disease * documented neuropathy * coagulation disorders * currently on anticoagulants * documented allergy to any of the drugs included in the protocol

Keywords: hemorrhoids pain management