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NCT Number: NCT05772351

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

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.

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Key information

Conditions

Hemorrhoids Cardiovascular Diseases Digestive System Diseases Gastrointestinal Diseases Hemorrhoid Pain Hemorrhoidal Bleeding Intestinal Diseases Rectal Diseases Vascular Diseases

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Lomonosov Moscow State University, Fundamental Medicine Faculty

Moscow, 119991, Russia

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

micronized flavonoid fraction

Drug

Patients 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.

Under spinal anesthesia appropriate surgical intervention was performed. After the surgery, the patient was given a questionnaire and a scale for assessing pain at rest and during defecation within the first 2 weeks after surgery. During the hospital stay, the nurse filled out a section on the drugs used; after discharge, the patient filled out this section for 7 days after the surgery. After 30 days, the side effects section was filled out, and the quality of life was assessed on days 7 and 30. Also, the patients indicated in a separate column on which day after the surgery they were able to return to normal living or go to work.

Primary outcomes

  1. rate of prescribing opioid analgesics

    Time frame: 7 days after surgery

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

Secondary outcomes

  1. pain at rest and during defecation

    Time frame: 15 days after surgery

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

  2. other medications use

    Time frame: 7 days after surgery

    the need for other medications after surgery

  3. readmission rate

    Time frame: 30 days after surgery

  4. The life quality rate

    Time frame: 7 and 30 days

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

  5. time from surgery to return to work

    Time frame: during 30 days after surgery

  6. complication rates

    Time frame: within 30 days after the procedure

    bleeding, urinary retention, infectious complications

Sponsors and collaborators

Lead sponsor

Center of Endourology "Endocenter"

Other

Registry information

Official study title

Preoperative Micronized Flavonoid Fraction (MFF) Use in Multimodal Anesthesia in Anorectal Surgery: Study Protocol for Prospective, Randomized, Placebo-controlled, Double-blind Study

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
Mar 16, 2023
Registry last updated
Aug 24, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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