For a study, researchers sought to evaluate the effectiveness of infusing triamcinolone acetonide and bupivacaine hydrochloride into surgical incisions after a Milligan-Morgan hemorrhoidectomy to relieve postoperative discomfort. A double-blind randomized controlled clinical trial was conducted between May 2105 and June 2019. Patients with grade third to fourth hemorrhoids who underwent an elective Milligan–Morgan hemorrhoidectomy met the inclusion criteria. Patients in the intervention group had a single injection of bupivacaine and triamcinolone, while those in the control group did not get any treatment. The primary outcome metric was the median of the maximum amount of pain recorded over the course of a 48-hour hospital stay using a visual analog scale. Secondary end goals were pain during follow-up, pain during urination, the need for analgesics, the rate of wound healing, and complications. Overall, 128 patients were distributed at random (64 in each group). At 48 hours, the maximum pain score in the intervention group was 3 points, whereas it was 6 points in the control group. This change met the criteria for statistical significance (P<0.05). No changes were seen with regard to discomfort during defecation. The intervention group required considerably fewer doses overall and had lower opiate requirements (6.3% vs. 21.9% patients; P=0.01; 5 vs. 23 cumulative doses). Comparison of the complications rates and wound healing were comparable. In the clinical trial comparing the intervention group to the “control group,” the use of a placebo was not taken into account. The median of values was used to convey data on pain or other problems forty-eight hours after surgery.

Source: journals.lww.com/dcrjournal/Abstract/2022/08000/Infiltration_of_Bupivacaine_and_Triamcinolone_in.14.aspx