Comparative Study of Placebo Versus Metronidazole as a Role of Pain Relief Post Hemorrhoidectomy

Objective: To assess the role of metronidazole versus placebo in terms of pain relief post hemorrhoidectomy. Methodology: This randomized control trial was done at the general surgery department of PUMHS from January 2022 to July 2022. The study included adult patients of both genders, aged 18-60, who underwent surgeries for grade III and grade IV hemorrhoids. The participants were divided into two groups: a control group and an intervention group that received oral metronidazole for seven days postoperatively. Both groups received a standardized post-operative analgesic treatment. Post-operative pain and its severity were assessed using the Visual Analog Scale (VAS). Data were collected using a study proforma, and statistical analysis was performed using SPSS version 26. Results: A total of 60 cases of hemorrhoids were comparatively studied; mean age of the case group was 39.36+10.43 years and the mean age of the control group was 35.33+9.35 years (p=0.120).  The mean BMI and average disease duration was statistically insignificant according to both groups (p > 0.05). In the cases group, grade III hemorrhoids were 36.7% and grade IV hemorrhoids were 63.3%, while in the control group, grade III hemorrhoids were 46.7% and grade IV hemorrhoids were 53.3% (p=0121). The mean operative time was almost similar in both groups (p=0.515). Average VAS was significantly decreased in the case group after 2 hours, at 24 hours, at 36 hours, and at 48 hours (p=<0.05), while it was statistically insignificant according to both groups at the 7th post-operative day (p=0.091). Conclusion: The use of oral or topical metronidazole in the post-operative period concludes to be more effective in terms of clinically significant early pain relief.