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| Autori principali: | , , , , , , , , , |
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| Natura: | Artículo Open Access |
| Pubblicazione: |
Wiley
2025
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| Soggetti: | |
| Accesso online: | https://onlinelibrary.wiley.com/doi/10.1111/codi.70321 |
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Sommario:
- Topical versus oral metronidazole for post‐haemorrhoidectomy pain: A systematic review and meta‐analysis of randomized controlled trials Bernardo Fontel Pompeu Giulia Luiza Garcia Gabriel Leal Barone Isabela Oliveira Rosa Lucas Soares de Souza Pinto Guedes Lucas Monteiro Delgado Claudia Theis Leonardo de Melo Del Grande Sergio Mazzola Poli de Figueiredo Fernanda Bellotti Formiga Colorectal Disease Abstract Background Excisional haemorrhoidectomy is often associated with intense post‐operative pain and delayed recovery. Bacterial colonization may contribute to this discomfort, and metronidazole has been proposed as an analgesic adjunct. This study compared the analgesic efficacy of topical metronidazole with oral metronidazole. Methods A systematic search was conducted in PubMed, Scopus, and the Cochrane Central Register through May 2025. Randomized controlled trials comparing topical metronidazole with oral metronidazole for post‐operative pain after haemorrhoidectomy were included. Visual analogue scale (VAS) scores on post‐operative days 1, 3, and 7 were pooled. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random‐effects model. Heterogeneity was assessed with the I 2 statistic. Risk of bias (RoB 2) and certainty of evidence (GRADE) were evaluated. Results Four RCTs involving 439 patients (218 topical, 221 oral) met inclusion criteria. No significant differences were found between topical and oral metronidazole at day 1 (MD –0.1; 95% CI –0.3 to 0.2; I 2 = 25%), day 3 (MD –0.4; 95% CI –1.3 to 0.6; I 2 = 94%), or day 7 (MD –0.2; 95% CI –1.0 to 0.5; I 2 = 90%). Conclusion Topical and oral metronidazole showed similar short‐term analgesic efficacy after haemorrhoidectomy. 10.1111/codi.70321 http://creativecommons.org/licenses/by/4.0/