Vol. 9, Issue 1, Part C (2025)

Background: Anal fissures in children cause significant discomfort, requiring effective management to alleviate symptoms and promote healing. Topical medications have been used, such as 0.4% Glyceryl Trinitrate (GTN) ointment and 2% Lidocaine gel, but their comparative efficacy remains uncertain. This study aimed to assess the outcomes of these topical treatments in pediatric anal fissures.

Methods: This prospective, comparative study was conducted in the Outpatient Department of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from March 2022 to August 2023. A total of 52 diagnosed anal fissure patients aged 3-16 years were purposively enrolled. The patients were equally divided into two groups: Group I received 0.4% GTN ointment, and Group II received 2% Lidocaine gel. The study was ethically approved, and statistical analysis was performed using SPSS version 23.0.

Results: The mean age was 6.56±3.06 years in Group I and 7.6±2.61 years in Group II. More than two- thirds (69.2%) of Group I and 57.7% of Group II were female. Symptomatic improvement and complete fissure healing occurred in 80.8% of Group I and 26.9% of Group II (p<0.05). Duration of improvement

>1 month was observed in 52.4% of Group I and 57.1% of Group II (p>0.05). Common symptoms included perianal pain (100%), P/R bleeding (50% in Group I, 38.5% in Group II), itching (65.4% in Group I, 46.2% in Group II), and constipation (88.5% in Group I, 73.1% in Group II). Side effects were noted in Group I, including headache (15.4%) and postural hypotension (7.7%).

Conclusion: 0.4% GTN ointment demonstrated superior efficacy in healing and symptom relief compared to 2% Lidocaine gel, making it a preferred option for long-term management of pediatric anal fissures.