Comparative Study of Topical 0.3% Nifedipine- Lignocaine Versus 7% Sucralfate-Lignocaine in the Management of Acute Anal Fissure: A Prospective Study

Background: Acute anal fissure is a common benign anorectal condition characterized by severe pain after defecation, bleeding per rectum, and sphincter spasm. Pathophysiology of Anal Fissure is hypertonia of internal anal sphincter, elevated resting anal pressure which contributes to reduced anodermal blood flow and relative ischemia. The mainstay of contemporary non-operative management involves Topical pharmacological agents aimed at reducing internal anal sphincter tone and promoting healing remains the first-line treatment. This study compares the effectiveness of Topical 0.3% Nifedipine- lignocaine and Topical 7% Sucralfate- lignocaine in the management of acute anal fissure. Aims and objectives: The study evaluated and compared the effectiveness of Topical 0.3% Nifedipine-Lignocaine and Topical 7% Sucralfate-Lignocaine in Patients with Acute anal fissure. Materials and Methods: Total 200 Patients of Acute Anal Fissure were studied. They were randomly divided into two groups of 100 Patients each. In one group, Patients undergone treatment with Topical Nifedipine (0.3%)- Lignocaine (1.5%) ointment and in second group, Topical Sucralfate (7%)- Lignocaine (4%) Ointment. The Patients were instructed to apply Ointment locally into anal canal twice daily for 3 weeks after passing stools. Patients were assessed for Pain after defecation, Bleeding per rectum, Fissure healing and any side effects at 1st , 2nd and 3rd week of follow up. Results: Pain scores reduced significantly in both groups, with greater reduction in the nifedipine group by 3rd week (Mean VAS ~1.8 vs ~2.4). Fissure healing rates were higher in Group A (?86%) compared to Group B (?70%). Bleeding control was also better in the nifedipine group. Conclusion: Topical nifedipine?lignocaine is more effective than sucralfate?lignocaine in reducing pain after defecation, Bleeding per rectum and improving fissure healing in acute anal fissure.