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Preoperative Micronized Flavonoid Fraction (MFF) Use in Multimodal Anesthesia in Anorectal Surgery

Not Applicable
Completed
Conditions
Hemorrhoids
Hemorrhoidal Bleeding
Hemorrhoid Pain
Interventions
Drug: micronized flavonoid fraction
Registration Number
NCT05772351
Lead Sponsor
Center of Endourology "Endocenter"
Brief Summary

Aim: To assess the efficiency of the micro-flavonoid fraction (MMF) administration prior to anorectal surgery with spinal anesthesia on postoperative pain severity reduction.

Methods: Patients who meet the following criteria are included: participants must be diagnosed with surgical treatment of anorectal diseases. All participants are randomly divided into 2 groups: the first one gets a tablet with 1000 mg MFF (Detralex®), the second one gets a tablet containing starch per os 14 days before surgery (72 participants per arm). Then patients of each group will continue MFF administration for 30 days after surgery. Patients of both arms receive spinal anesthesia and undergo surgery. Following the procedure the primary and secondary outcomes are evaluated: frequency of the opioid drugs intake, the severity of the postoperative pain syndrome, duration and frequency of other drugs intake, readmission rate, overall quality of life, time from the procedure to returning to work and the complications rate, C-reactive protein level.

Discussion: the MFF intake allows reducing the severity of the hemorrhoidal disease symptoms during conservative treatment. In addition, the Detralex® efficacy has been proven in postoperative pain reduction for patients diagnosed with varicose veins of the lower extremities. The investigators intend to evaluate the feasibility of the preoperative MFF administration for the postoperative pain reduction and the decrease of the postoperative complications in patients with hemorrhoidal disease.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
182
Inclusion Criteria
  • Stage 2-4 hemorrhoidal disease;
  • Presence of indications for elective surgery (open hemorrhoidectomy) using mono or bipolar coagulation possibly combined with other minimally invasive methods: hemorrhoidopexy and mucopexy, Ligasure hemorrhoidectomy;
  • Absence of other diseases that cause pain;
  • Class I, II ASA anesthesia risk;
Exclusion Criteria
  • The presence of the following diseases: paraproctitis, inflammatory bowel disease, metabolic or endocrine disorders, alcoholism, drug use, blood clotting disorders, and history of diseases in the anorectal region;
  • Contraindicated or technically impossible subarachnoid anesthesia;
  • Patients who refused to participate;
  • Pregnant women.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Experimental groupmicronized flavonoid fractionPatients of the experimental group received Detralex® 1000 mg QD for 15 days before the operation, 3000 mg starting from day 1 after the surgery for 4 days, then 2000 mg for the next 3 days and 1000 mg till day 30 after surgery
Primary Outcome Measures
NameTimeMethod
rate of prescribing opioid analgesics7 days after surgery

the rate of prescribing opioid analgesics to prevent the pain from rising above VAS 5 after surgery

Secondary Outcome Measures
NameTimeMethod
other medications use7 days after surgery

the need for other medications after surgery

complication rateswithin 30 days after the procedure

bleeding, urinary retention, infectious complications

pain at rest and during defecation15 days after surgery

The pain was assessed using a visual analogue scale (VAS, 0 to 10 points, where 10 is the maximum score).

readmission rate30 days after surgery
The life quality rate7 and 30 days

The overall quality of life was assessed using the EQ-5D patient questionnaire.

time from surgery to return to workduring 30 days after surgery

Trial Locations

Locations (1)

Lomonosov Moscow State University, Fundamental Medicine Faculty

🇷🇺

Moscow, Russian Federation

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