Evaluation of Analgesic Effect of Panchtikta Ghrita as an Adjuvant Therapy in Patients of Fissurectomy- The Study Protocol

Abstract

Background: Postoperative pain has always been a sensitive factor in patients of anorectal diseases. NSAIDs and other anti-inflammatory drugs are helpful but have gastric and renal adverse effects. Application of ancient principle of pre and postoperative Shaman Snehapana along with allopathic medicines for analgesia can have an add-on effect on pain and surgical outcome of patient. Objectives: To assess and compare severity of pain and dose of analgesia required for fissurectomy pain in standard treated controlled group and Panchatikta Ghrita intervention group. Methodology: Each group will have 47 patients. 1. Experimental group:  Panchtikta Ghrita 40 ml will be given 3 days prior to surgery daily. On 4^th day under appropriate anesthesia patient will be operated for fissurectomy excision of sentinel piles along with lateral internal sphincterotomy. Severity of postoperative pain will be assessed on VAS. For pain Inj. Diclofenac 75mg IV diluted will be given SOS. From 5^th day again, Snehapana of Panchtikta Ghrita will be started till 7 days post operatively. 2. Control Group: Placebo drug 40 ml will be given 3 days prior to surgery and then 7 days postoperatively. Apart from Snehapana by Panchtikta Ghrita rest of the treatment protocol will be same in control group viz. local application of Panchatikta Ghrita on fissurectomy wound, antibiotics, IV fluids, and light diet. Expected Results: As vitiation of Vata is the foundation of pain and Sneha being the best treatment for vitiation of Vata, pre and postoperative Snehapana may result in early recovery of patient along with reduced dose and duration of anti-inflammatory medication. Conclusion: Pre and postoperative Snehapana might play a pivotal role in the postoperative pain management.