A painless treatment undergoing Milligan-Morgan hemorrhoidectomy

Background: Postoperative pain associated with Milligan Morgan haemorrhoidectomy (MMIf) remains problematic. Most patients complaint a severe pain on defecation and in the 1st postoperative week because of secondary infection a fid sphincter spasm. We studied the effect of metronida zole, lactulose and glyceryl-trinitrate on pain after MMH. Method: Thirty patients were randomly assigned to two groups. The 1st received a treatment with oral laxative (lac- tulose 66,7%) metronidazole and a topical glyceryl-trinitrate ointment at 0,2% both pre and postoperative; the 2nd received a placebo at the same dosage. The amount of pain in the 1st week and at the time of two defecation, postoperative analgesic requirement ana time to return to normal activities were documented. Results: A significant differences in the score pain on 2nd and 3rd day and on the 1st two defecation were observed among group. Analgesic consumption was highest in the pla-cebo group. Conclusion: The treatment with lactulose, metronidazole and topic glyceryl-trinitrate in patients undergoing MMH, seems to reduce secondary pain and increase patients satisfaction and earlier return to work with improvement of cost and benefit.