• Mojgan Rahimi, Ali Reza Kazemeini, Nasim Pourtabatabaei, and Amir Reza Honarmand.
• Department of Anesthesiology, Imam Hospital, Tehran University of Medical Sciences, Keshavarz Blvd, Vali Asr Square, Tehran, Iran. mrahimi_anesth@yahoo.com
• Surg. Today. 2012 Dec 1;42(12):1201-5.

PurposeWe compared the efficacy and side effects of diclofenac and a topical eutectic mixture of local anesthetics (EMLA) for pain relief after hemorrhoidectomy.MethodsNinety patients, nominated for elective hemorrhoidectomy, were recruited for this randomized clinical trial and were randomly categorized into three groups (30 patients in each group). After surgery, the patients in the first group received one 100 mg diclofenac suppository, those in the second group received 5 g of EMLA, and those in the third group received 5 g of petrolatum ointment (control group). The pain intensity was measured using a visual analog scale (VAS). Twenty-five mg of intramuscular pethidine was administered upon the patient's request. Pain measurements were performed on the patient's transfer to the recovery ward, 2 h after surgery, the evening and the morning after surgery.ResultsThe EMLA group yielded the lowest VAS score on transfer to recovery and at 2 h after surgery (p < 0.05). The diclofenac group reported the lowest VAS score in the evening and the morning after surgery (p < 0.05).ConclusionsTopical use of an EMLA cream is appropriate for short-term pain control following hemorrhoidectomy, while diclofenac yields a more sustainable pain control.

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