Randomized, placebo-controlled treatment of anal fissure by lidocaine, EMLA, and GTN in children

Drugs Acting on the Gut: Prokinetics, Antispasmodics, Laxatives

“…Concentrations of 0.05 and 0.1% ointments were also found to be effective for fi ssure healing after 8 weeks of treatment [ 158 ] . Results at 8 weeks of treatment were similar to results using a eutectic mixture of 5% prilocaine and 5% lidocaine (EMLA) [ 156 ] .…”

“…In children with anal fi ssures, 0.2% glyceryl trinitrate (GTN) applied topically to the distal anal canal twice a day resulted in improvement of symptoms by day 10 of treatment and higher rates of complete resolution after 8 weeks compared to placebo and topical lidocaine [ 155,156 ] . However, one study comparing GTN plus oral senna and lactulose with placebo plus oral senna and lactulose, found similar response rates, with 84% healing overall [ 157 ] .…”

Drugs Acting on the Gut: Prokinetics, Antispasmodics, Laxatives

“…Concentrations of 0.05 and 0.1 % ointments were also found to be effective for fi ssure healing after 8 weeks of treatment [ 190 ]. Results at 8 weeks of treatment were similar to results using a eutectic mixture of 5 % prilocaine and 5 % lidocaine (EMLA) [ 188 ]. Long-term treatment of chronic anal fi ssure in 31 children using 0.2 % GTN resulted in a 32 % relapse 1 year after treatment and no relapses for 4 years following initial treatment in 68 % [ 191 ].…”

Nifedipine Gel with Lidocaine in the Treatment of Anal Fissure in Children: A Pilot Study and Review of the Literature

“…After 1 month, healing rates were higher with GTN in both the acute (91.6%, GTN vs. 50%, lidocaine) and chronic (62.5%, GTN vs. 20%, lidocaine) fissure groups. A randomized, placebo-controlled treatment of anal fissure by lidocaine, EMLA, and GTN in 102 children, showed faster response rates by GTN application, and similar and high success rates by 8 weeks of EMLA treatment (Sönmez et al, 2002). The average age of patients was 3 years (range, 2.5 months to 15 years).…”