Background: Postoperative pain remains one of the most prevalent and clinically significant consequences of surgical intervention. It results from tissue injury–induced activation of peripheral nociceptors and subsequent release of inflammatory mediators such as prostaglandins, cytokines, and bradykinin. Inadequate postoperative pain control may delay wound healing, impair early mobilization, prolong hospital stay, and increase the risk of chronic postsurgical pain development. Multimodal analgesia strategies are increasingly recommended to improve therapeutic outcomes while minimizing adverse effects associated with opioids and non-steroidal anti-inflammatory drugs (NSAIDs). Vitex negundo, a medicinal plant traditionally used for inflammatory conditions, has demonstrated analgesic, anti-inflammatory, and antioxidant properties in preclinical studies. However, its clinical role in postoperative pain management remains underexplored.
Objective: To evaluate the clinical response and analgesic potential of orally administered Vitex negundo extract as an adjunct in postoperative pain management following pilonidal sinus excision.
Case Description: A 38-year-old male patient without systemic comorbidities underwent wide local excision of pilonidal sinus under regional anesthesia. Standard postoperative care, including intravenous antibiotic prophylaxis and gastric protection, was provided. Oral Nirgundi Ghana Vati (500 mg twice daily) was administered as adjunct therapy within a multimodal analgesic framework. Pain intensity was assessed using the Visual Analog Scale (VAS), and local inflammatory parameters such as edema, erythema, and tenderness were clinically monitored.
Results: The patient demonstrated a progressive reduction in postoperative pain intensity, as reflected by declining VAS scores during clinical observation. Associated inflammatory signs, including local swelling and tenderness, showed noticeable improvement. No gastrointestinal intolerance, hypersensitivity reactions, or systemic adverse effects were observed during therapy.
Conclusion: Adjunct systemic administration of Vitex negundo extract may contribute to postoperative pain modulation through inhibition of inflammatory mediators and antioxidant activity. Its favorable short-term safety profile and multimodal pharmacological properties suggest potential integration into postoperative pain management protocols. Further controlled clinical trials with larger sample sizes are necessary to establish definitive efficacy.
Keywords: Postoperative pain, Vitex negundo, Herbal analgesic, Multimodal analgesia, Drug delivery, Pilonidal sinus surgery.
How to cite this article: Patidar SN, Vaidya UA. Systemic herbal drug delivery of Vitex negundo as an alternate in postoperative pain management following pilonidal sinus excision: a clinical case report. Int J Drug Deliv Technol. 2026;16(7s): 442-451; DOI: 10.25258/ijddt.16.7s.47
Source of support: Nil.
Conflict of interest: None