Metronidazole for Treatign the Post Hemorrhoidectomy Pain: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

TIAN Aiping ^1,2 , YANG Kehu ^1,2 , TIAN Jinhui ^1,3 ,  YAN Xiang ²

1. Evidence-based Medicine Center of Lanzhou University, Lanzhou 730000, China; 2. The First Hospital of Lanzhou Universtiy, Lanzhou 730000, China; 3. School of Basic Medical Sciences of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

YAN Xiang, Email: Yanxiang528@sohu.com

Keywords：

Metronidazole; Hemorrhoids; Hemorrhoidectomy; Pain; Systematic review

DOI：

10.7507/1672-2531.20090174

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objectives 　To evaluate the effect of metrinidazole treatment after conventional hemorrhoidectomy pain in patients with third and fourth degree hemorrhoids.
Methods 　We searched the Cochrane Library (Issue 1 2009), PubMed (1966 to March 2009), EMbase (1974 to March 2009), SCI (1974 to March 2009), CBM (1978 to March 2009), CNKI (1994 to March 2009), and VIP (1989 to March 2009) to identify randomized controlled trials or quasi- randomize controlled trials of metronidazole versus placebo for treating post hemorrhoidectomy pain. We evaluated the quality of the included studies by using the Handbook 4.2.6 recommend standards and analyzed data using the Cochrane Collaboration’s RevMan 4.2.10.
Results 　We included seven randomized controlled trials or quais-randomized controlled trials (n=553). Meta-analyses showed that there were statistical differences between metronidazole and placebo in pain after hemorrhoidectomy and the use of an additional dose of analgesia.
Conclusions 　The current evidence shows that metronidazole relieves the pain after conventional hemorrhoidectomy and reduces the additional used of analgesics. Further high quality, large sample randomized controlled trials should be carried out.

Citation： TIAN Aiping,YANG Kehu,TIAN Jinhui,YAN Xiang. Metronidazole for Treatign the Post Hemorrhoidectomy Pain: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(9): 979-984. doi: 10.7507/1672-2531.20090174 Copy

1.	李彦, 侯明晖, 陈雪莲. 高龄直肠癌患者根治术后并发症原因及分析护理. 中国肛肠病杂志, 2004, 24(8): 30.
2.	于宏, 王爱华, 范岱景. 痔的术后处理及甲硝唑的应用. 社区医学杂志, 2006, 4(2): 40-41.
3.	Higgins JPT, Green S, editors. Formulating the problem. Cochrane Handbook for Systematic Reviews of Interventions 4.2.6 [updated September 2006]; Section 4. http://www.cochrane.org/resources/ handbook/hbook.htm (accessed 6th October 2006).
4.	Review Manager (RevMan) [Computer program]. Version 4.2 for Windows. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2003.
5.	Nicholson TJ, Armstrong D. Topical Metronidazole (10 Percent) Decreases Posthemorrhoidectomy Pain and Improves Healing. Dis Colon Rectum, 2004, 47(5): 711-716.
6.	Uraiqat A. Post hemoorhoidectomy pain A randomized controlled trial. Saudi Med, 2006, 27(10): 1538-1541.
7.	Carapeti EA, Kamm MA, McDonald PJ, et al. Double-blind randomised controlled trial of effect of metronidazole on pain after day-case haemorrhoidectomy. Lancet, 1998, 351(9097): 169-172.
8.	Balfour L, Stojkovic SG, Botterill ID, et al. A Randomized, Double- Blind Trial ofthe Effect of Metronidazole on Pain After Closed Hemorrhoidectomy. Dis Colon Rectum, 2002, 45(9): 1186-1190.
9.	Ng SSM, Lee JFY, Cheung KY, et al. Pre-emptive analgesia and metronidazole on post-haemorrhoidectomy pain control. Surgical Practice, 2006, 10(3): 102-105.
10.	Wesarachawit W, Pattana-arun J. Antibiotics and Early Post Operative Complications of Closed Hemorrhoidectomy: A Retrospective Matched Pair Study. Med Assoc Thai, 2007, 90(9): 1828-1832.
11.	Ala S, Saeedi M, Eshghi F, et al. Topical Metronidazole can Reduce Pain after Surgery and Pain on Defecation in Postoperative Hemorrhoidectomy. Diseases of the Colon & Rectum, 2008, 51(2): 235-238.
12.	刘娟, 谭新玲, 刘永芳, 等. 艾炙穴位联合耳穴贴压减轻肛瘘术后疼痛的效果观察. 中华护理杂志, 2006, 41(4): 363-365.
13.	胡洪铨, 潘永梅. 混合痔术后的中西医结合治疗. 中医中药, 2007, 45(12): 70-71.
14.	吴泰相, 刘关键. 隐蔽分组(分配隐藏)和盲法的概念, 实施与报告. 中国循证医学杂志, 2007, 7(3): 222-224.
15.	Schulz Kf, Chalmers I, Hayes RI, et a1. Empirical evidence of biasdimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA, 1995, 273: 408-412.

1. 李彦, 侯明晖, 陈雪莲. 高龄直肠癌患者根治术后并发症原因及分析护理. 中国肛肠病杂志, 2004, 24(8): 30.
2. 于宏, 王爱华, 范岱景. 痔的术后处理及甲硝唑的应用. 社区医学杂志, 2006, 4(2): 40-41.
3. Higgins JPT, Green S, editors. Formulating the problem. Cochrane Handbook for Systematic Reviews of Interventions 4.2.6 [updated September 2006]; Section 4. http://www.cochrane.org/resources/ handbook/hbook.htm (accessed 6th October 2006).
4. Review Manager (RevMan) [Computer program]. Version 4.2 for Windows. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2003.
5. Nicholson TJ, Armstrong D. Topical Metronidazole (10 Percent) Decreases Posthemorrhoidectomy Pain and Improves Healing. Dis Colon Rectum, 2004, 47(5): 711-716.
6. Uraiqat A. Post hemoorhoidectomy pain A randomized controlled trial. Saudi Med, 2006, 27(10): 1538-1541.
7. Carapeti EA, Kamm MA, McDonald PJ, et al. Double-blind randomised controlled trial of effect of metronidazole on pain after day-case haemorrhoidectomy. Lancet, 1998, 351(9097): 169-172.
8. Balfour L, Stojkovic SG, Botterill ID, et al. A Randomized, Double- Blind Trial ofthe Effect of Metronidazole on Pain After Closed Hemorrhoidectomy. Dis Colon Rectum, 2002, 45(9): 1186-1190.
9. Ng SSM, Lee JFY, Cheung KY, et al. Pre-emptive analgesia and metronidazole on post-haemorrhoidectomy pain control. Surgical Practice, 2006, 10(3): 102-105.
10. Wesarachawit W, Pattana-arun J. Antibiotics and Early Post Operative Complications of Closed Hemorrhoidectomy: A Retrospective Matched Pair Study. Med Assoc Thai, 2007, 90(9): 1828-1832.
11. Ala S, Saeedi M, Eshghi F, et al. Topical Metronidazole can Reduce Pain after Surgery and Pain on Defecation in Postoperative Hemorrhoidectomy. Diseases of the Colon & Rectum, 2008, 51(2): 235-238.
12. 刘娟, 谭新玲, 刘永芳, 等. 艾炙穴位联合耳穴贴压减轻肛瘘术后疼痛的效果观察. 中华护理杂志, 2006, 41(4): 363-365.
13. 胡洪铨, 潘永梅. 混合痔术后的中西医结合治疗. 中医中药, 2007, 45(12): 70-71.
14. 吴泰相, 刘关键. 隐蔽分组(分配隐藏)和盲法的概念, 实施与报告. 中国循证医学杂志, 2007, 7(3): 222-224.
15. Schulz Kf, Chalmers I, Hayes RI, et a1. Empirical evidence of biasdimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA, 1995, 273: 408-412.

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Metronidazole for Treatign the Post Hemorrhoidectomy Pain: A Systematic Review

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