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Effectiveness of Metronidazole in Pain Control Posthemorrhoidectomy

Phase 3
Completed
Conditions
Hemorrhoids
Interventions
Drug: Placebo
Registration Number
NCT02328144
Lead Sponsor
Instituto Mexicano del Seguro Social
Brief Summary

Hemorrhoidal disease occurs in 50% of people over 40 years old and is the most common cause of anorectal surgery. One of the complications of hemorrhoidectomy is pain, which is a difficult symptom to appreciate and assess, by its frequent and large variations in sensitivity in each patient. Many studies have been done to reduce patient postoperative pain, but there is no ideal method. The application of both oral and topical metronidazole has shown to decrease pain following hemorrhoidectomy, but its use is not standardized.

The investigators evaluated the effect of oral administration of metronidazole versus homologated placebo in pain control after hemorrhoidectomy

Detailed Description

Objective: Evaluate the effect of oral administration of metronidazole versus homologated placebo in pain control after hemorrhoidectomy.

Material and methods: Controlled clinical trial, composed of 44 patients in a randomized manner, realized at the Coloproctology, Western Medical Center, Mexican Institute of Social Security. Referred beneficiaries adults were included, of either sex, who merited elective hemorrhoidectomy for hemorrhoidal disease grades III-IV using Ferguson's technique. They were assigned to receive metronidazole (study group) or homologated (control group) and the randomization was conducted by sealed envelopes and subsequently. We collected demographic and clinical variables. Postoperative pain was assessed by visual analog scale at 6 and 12hrs, 1, 4, 7 and 14 days; additional analgesic use; complications; return to normal activity and patient satisfaction; also were measured, in a blood sample after surgery and 12 hrs later, interleukin 6 and 10.

The statistical analysis was performed according to the nature of variables, for continuous data using measures of central tendency and dispersion and for the qualitative data with frequencies and percentages

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria
  • Hemorrhoidal disease grade III and IV
  • Informed consent
Exclusion Criteria
  • Pregnancy
  • Lactation
  • Other anorectal disease
  • Previous anorectal
  • hypersensibility to metronidazole

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlacebo22 patients received oral placebo 500mg 3 times for day for 7 days
MetronidazoleMetronidazole22 patients received oral metronidazole 500mg 3 times for day for 7 days
Primary Outcome Measures
NameTimeMethod
Pain evolution, hours and days after surgery6 and 12 hours, 1, 4, 7 and 14 days

Pain was assessed with the visual analogue scale questionnaire

Secondary Outcome Measures
NameTimeMethod
Interleukinafter surgery and 12 hours

In a blood sample, right after surgery and 12 hours later, interleukin 6 and 10 were measured by ELISA, observing if they presented alterations with the intervention, between 2 groups and between the hours the investigators took the blood sample

Analgesics6 and 12 hours, 1, 4, 7 and 14 days

Using a questionnaire if they used analgesics, which one, dose of it and how many days

Surgery complications6 and 12 hours, 1, 4, 7 and 14 days

Asking directly to participants if they presented bleeding, urinary retention or another complication. Investigators measured how many participants presented complications

Return to normal activities1, 4, 7 and 14 days

Asking to participans when they return to normal activities (to walk normally, to cook, to bath, to wear, to work) How many days were needed to recover their normal activities

Satisfaction14 day

Asking how they felt in last 14 days and what was their perception of the surgery

Trial Locations

Locations (1)

Western Medical Center, Mexican Institute of Social Security

🇲🇽

Guadalajara, Jalisco, Mexico

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