Topical lidocaine/diltiazem significantly improves pain after Rubber Band Ligation of Hemorrhoids

A new study by Allan Kwok and team showed that topical lidocaine enhances analgesia in the short term, while a combination of lidocaine and diltiazem improves analgesia and increases patient satisfaction after hemorrhoid banding. The findings of this study were published in Diseases of the Colon & Rectum. 

Rubber band ligation of hemorrhoids produces less pain than excisional hemorrhoidectomy, however many patients still have severe post-procedure discomfort. In order to find out whether topical lidocaine, with or without diltiazem, is more efficient than a placebo for analgesia following hemorrhoid banding, this study was carried out.

This investigation was a prospective, randomized, double-blinded, placebo-controlled experiment. Patients were given a placebo, 2% lidocaine, or 2% lidocaine plus 2% diltiazem. In Australia, this study was carried out at two public teaching hospitals affiliated with universities and two private hospitals. Consecutive hemorrhoid banding patients under the age of 18 were chosen. Topical ointments were used post-procedure three times each day for five days as an intervention. The primary end measures included the visual analogue pain score, the use of opiate analgesics, and patient satisfaction.