Topical Glyceryl Trinitrate Ointment for Pain Related to Anal Hypertonia After Stapled Hemorrhoidopexy

Objective: Anorectal pain and discomfort during transrectal ultrasound (TRUS)-guided prostate biopsy is an important issue of this procedure. Therefore present study was designed to compare whether the use of topical glyceryl trinitrate (GTN) ointment or lignocaine gel is more effective as an adjunct to periprostatic nerve block (PPNB) in reducing pain associated with transrectal ultrasound (TRUS)-guided prostate biopsy. Methods: In all, 120 consecutive patients having their first TRUS-guided prostate biopsy were randomized to receive either 0.4% GTN ointment or 2% lignocaine gel, 10 minutes or 5 minutes respectively before biopsy. All patients had a biopsy preceded by an injection with 5 ml of 2% lignocaine local anaesthesia. Results: A 100-point visual analogue score was used to record overall pain due to the presence of the probe, the biopsy itself and pain after the procedure. There was no significant difference in age, PSA level and prostate volume between the groups. There was a significantly lower mean pain score due to probe insertion, in the GTN than lignocaine group (18.32 vs 37.48, P < 0.001); pain perception was lower for the whole procedure in the GTN group (16.59 vs 35.17, P < 0.001); and was most pronounced in men aged d”65 years (21.45 vs 40.7, P < 0.001). Five patients (8.3%) in the GTN group complained of headache. Conclusion: So it can be concluded that, topical GTN ointment is safe and effective in reducing the discomfort and pain associated with TRUS-guided prostate biopsy, in particular the insertion of the ultrasound probe. It might be of maximum benefit in the younger patient(d”65years). Bangladesh Journal of Urology, Vol. 21, No. 1, January 2018 p.14-19

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Prospective, Randomised, Double-Blinded, Placebo-Controlled Trial of Glyceryl Trinitrate Ointment in the Treatment of Early Symptomatic Haemorrhoids

Endoscopy ◽

10.1055/s-2004-834525 ◽

2004 ◽

Vol 36 (10) ◽

Author(s):

M Aslam ◽

S Humadi

Keyword(s):

Glyceryl Trinitrate ◽

Controlled Trial ◽

Double Blinded ◽

Glyceryl Trinitrate Ointment

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Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099552 ◽

2018 ◽

Vol 53 (4) ◽

pp. 251-262 ◽

Cited By ~ 9

Author(s):

Dimitris Challoumas ◽

Paul D Kirwan ◽

Dmytro Borysov ◽

Christopher Clifford ◽

Michael McLean ◽

...

Keyword(s):

Systematic Review ◽

Glyceryl Trinitrate ◽

Strong Evidence ◽

Evidence Synthesis ◽

Clinical Effects ◽

Range Of Movement ◽

Level Of Evidence ◽

Moderate Evidence ◽

Best Evidence Synthesis ◽

Topical Glyceryl Trinitrate

ObjectiveTo produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate (GTN) in the treatment of tendinopathies.DesignA systematic review of published randomised controlled trials (RCTs) of the use of GTN in patients with tendinopathy.Data sourcesMEDLINE, Embase, Scopus and CINAHL from database inception to January 2018.MethodsWe examined RCTs comparing the effects of topical GTN with either placebo or other treatments on tendinopathy. Overall quality of each eligible study was determined based on a combined assessment of internal validity, external validity and precision. The level of evidence for each assessed parameter was rated based on the system by van Tulderet al.ResultsA total of 10 eligible RCTs were identified including patients with tendinopathy of the rotator cuff (n=4), wrist extensors (n=3), Achilles (n=2) and patellar (n=1) tendons. For all tendinopathies, improvements in pain were significant when comparing GTN versus placebo in the short term (<8 weeks; poor evidence). Significant improvements in midterm outcomes for treatment with GTN versus placebo included the following: patient satisfaction (strong evidence); chances of being asymptomatic with activities of daily living (strong evidence); range of movement (moderate evidence); strength (moderate evidence); pain (at night and with activity; poor evidence) and local tenderness (poor evidence). Patients treated with topical GTN reported a higher incidence of headaches than those who received placebo (moderate evidence).Conclusions and relevanceTreatment of tendinopathies with topical GTN for up to 6 months appears to be superior to placebo and may therefore be a useful adjunct to the treating healthcare professions.

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