PURPOSE: @entity158 after hemorrhoidectomy appears to be multifactorial and dependent on individual @entity158 tolerance, mode of anesthesia, @entity86 , and surgical technique. Spasm of the internal sphincter is believed to play an important role. The aim of this study was to assess the role of botulinum toxin in reducing @entity158 after Milligan-Morgan hemorrhoidectomy. METHODS: This was a double-blind study of 50 consecutive @entity1 undergoing Milligan-Morgan hemorrhoidectomy and assigned to an internal sphincter injection of 0.4 ml of solution containing either botulinum toxin (20 U; Botox) or normal saline. @entity1 were managed according to standardized perioperative analgesic and laxative regimens. @entity158 was assessed by use of daily visual analog scores and analgesia requirements for the first seven postoperative days. RESULTS: @entity1 randomized to receive botulinum toxin had lower daily average and maximal visual analog scores throughout the study period. The difference reached significance on both Day 6 (P < 0.05) and Day 7 (P < 0.05). There was no significant difference (P = 0.12) in @entity1286 requirements in the first 24 hours (botulinum group, 16 (range, 6-27) mg; placebo arm, 22 (range, 13-41) mg). @entity1 who received Botox used 19 (range, 8-36) @entity44669 tablets in the first seven days after surgery compared with 23 (range, 10-40) in the placebo arm (P = 0.63). CONCLUSIONS: Those @entity1 who had botulinum toxin had significantly less @entity158 toward the end of the first week after surgery. Reduction in @entity2473 within the internal sphincter is the presumed mechanism of action. This is the first reported randomized, controlled trial using botulinum toxin in hemorrhoidectomy.

Botulinum toxin (botox) reduces XXXX after hemorrhoidectomy: results of a double-blind, randomized study.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity2473 :: ('MESH:D013035', 'Disease') :: ['spasm'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative analgesia'] @entity1286 :: ('MESH:D009020', 'Chemical') :: ['morphine'] @entity158 :: ('MESH:D010146', 'Disease') :: ['Pain', 'pain'] @entity44669 :: ('MESH:C011800', 'Chemical') :: ['coproxamol']
@entity158 :: (MESH:D010146,Disease) :: ['pain']
