Evidence map›Paper›PMID 31897645›Full record

SynthesisInternational journal of colorectal disease2020

Topical analgesia following excisional haemorrhoidectomy: a systematic review and meta-analysis of randomised controlled trials.

Weisi Xia, Brittany Park, Bacil F Otutaha, Wiremu S MacFater, Andrew D MacCormick, Tarik Sammour, Andrew G Hill

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07688031 (Efficacy and Safety of Topical Lidocaine 23%/Tetracaine 7% Ointment Versus Placebo for Post-Hemorrhoidectomy Pain), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07688031 phase4completednot on this mapstarted 2023, after this paper: background citation

Efficacy and Safety of Topical Lidocaine 23%/Tetracaine 7% Ointment Versus Placebo for Post-Hemorrhoidectomy Pain: A Double-Blind Randomized Controlled Trial

TypeinterventionalSponsorPontificia Universidad Catolica de ChileRan2023 to 2026Enrolled74ConditionsPain Management, Hemorrhoids Third Degree, Hemorrhoids Fourth Degree, Hemorrhoids Second DegreeArmsLidocaine 23% / Tetracaine 7% topical ointment (compounded), Placebo ointment
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Weisi XiaSouth Auckland Clinical Campus, Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland, New Zealand. w.xia@auckland.ac.nz.ORCID https://orcid.org/0000-0003-0250-4942
Brittany ParkDepartment of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand.
Bacil F OtutahaDepartment of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand.
Wiremu S MacFaterDepartment of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand.
Andrew D MacCormickDepartment of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand.
Tarik SammourDepartment of Surgery, Colorectal Unit, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia.
Andrew G HillDepartment of Surgery, South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand.
University of Auckland · NZMiddlemore Hospital · NZRoyal Adelaide Hospital · AU

Funding

Health Research Council of New Zealand 18/013Health Research Council of New Zealand 19/004
6 · The paper itself

Abstract

purposePost-operative pain following excisional haemorrhoidectomy poses a particular challenge for patient recovery, as well as a burden on hospital resources. There appears to be an increasing role for topical agents to improve this pain, but their efficacy and safety have not been fully assessed. This systematic review aims to assess all topical agents used for pain following excisional haemorrhoidectomy.

methodsThe study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two authors independently assessed MEDLINE, EMBASE, and CENTRAL databases to 27 June 2019. All randomised controlled trials (RCTs) in English that investigated topical agents following excisional haemorrhoidectomy were included. Meta-analysis was performed using Review Manager, version 5.3.

resultsA total of 3639 records were identified. A final 32 RCTs were included in the qualitative analysis. Meta-analysis was performed on 9 RCTs that investigated glyceryl trinitrate (GTN) (5 for diltiazem, 2 for metronidazole and 2 for sucralfate). There were mixed significant changes in pain for GTN compared with placebo. Diltiazem resulted in significant reduction of pain on post-operative days 1, 2, 3 and 7 (p < 0.00001). Metronidazole resulted in significant reduction of pain on days 1 (p = 0.009), 7 (p = 0.002) and 14 (p < 0.00001). Sucralfate resulted in signification reduction of pain on days 7 and 14 (both p < 0.00001).

conclusionTopical diltiazem, metronidazole and sucralfate appear to significantly reduce pain at various timepoints following excisional haemorrhoidectomy. GTN had mixed evidence. Several single trials identified other promising topical analgesics.

Indexed as

Pain ManagementAdministration, TopicalAnalgesicsHemorrhoidectomyHumansPostoperative PainRandomized Controlled Trials as TopicRisk FactorsTreatment OutcomeAnalgesicsAnalgesiaHaemorrhoidectomyHaemorrhoidsMeta-analysisTopical

Identifiers

PMID31897645
OpenAlexW2997474477

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.