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Trial registered on ANZCTR
Registration number
ACTRN12619000492156p
Ethics application status
Submitted, not yet approved
Date submitted
11/03/2019
Date registered
26/03/2019
Date last updated
26/03/2019
Date data sharing statement initially provided
26/03/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
The Role of Oral Metronidazole in the Management of Post Haemorrhoidectomy Pain
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Scientific title
The Effect of Oral Metronidazole on Post Open Haemorrhoidectomy Pain
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Secondary ID [1]
297693
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None
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Universal Trial Number (UTN)
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Trial acronym
POHM trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Haemorrhoidal disease
311977
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Condition category
Condition code
Surgery
310546
310546
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0
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Other surgery
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Oral and Gastrointestinal
310709
310709
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention group: will take one 400mg metronidazole tablet, three times per day for 7 days after the patient has had their haemorrhoidectomy. This will commence in the evening (if the procedure was performed in the morning) or the following morning (if the procedure was performed in the afternoon).
Adherence to the intervention will be assessed by bottle returns.
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Intervention code [1]
313923
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Treatment: Drugs
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Comparator / control treatment
o Control group: will take a placebo tablet (identical in appearance to the metronidazole tablets): one tablet, three times per day for 7 days.
The placebo will be PROSOLV® EASYtab SP. This consists of the following four ingredients: Microcrystalline Cellulose, Colloidal Silicon Dioxide, Sodium Starch Glycolate, Sodium Stearyl Fumarate.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Post-operative pain days 1-7. This be assessed by using a Visual Analogue Score (VAS) ranging from 0-10 at each of these time points.
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Assessment method [1]
319410
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Timepoint [1]
319410
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Days 1-7 post operation (this will be assessed daily during this time period).
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Secondary outcome [1]
368043
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Post-operative pain weeks 2-6. This be assessed by using a Visual Analogue Score (VAS) ranging from 0-10 at each of these time points.
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Assessment method [1]
368043
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Timepoint [1]
368043
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This will be assessed weekly from weeks 2-6 post operation.
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Secondary outcome [2]
368044
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Return to work/normal daily activities. This will be assessed by asking the patient the date they returned to work. If the patient does not return to work, then the date they were able to complete their basic household chores.
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Assessment method [2]
368044
0
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Timepoint [2]
368044
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6 weeks
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Secondary outcome [3]
368045
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Post-operative delayed wound healing. This will be assessed via clinical examination in the surgeon's rooms at 6 weeks post-operation. If the wound is still "open" (that is, the edges have not completely healed), then this will be considered delayed wound healing.
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Assessment method [3]
368045
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Timepoint [3]
368045
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6 weeks
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Secondary outcome [4]
368046
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Post-operative complications: This outcome will be assessed at the time of 6 week post-operation follow-up in the surgeon's rooms. This information will be obtained from both the patient as well as the hospital medical records, to see if the following had occurred post-operation:
• bleeding (Defined as bleeding requiring re-admission to hospital and/or blood transfusion)
• urinary retention
• constipation
• re-admission to hospital
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Assessment method [4]
368046
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Timepoint [4]
368046
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6 weeks
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Eligibility
Key inclusion criteria
o Age greater than or equal to 18 years old
o Patient with grade III/IV internal haemorrhoids and/or external haemorrhoids, presenting for elective excisional open haemorrhoidectomy
o Patient capable of participating in informed consent for the study
o Patient willing to complete follow-up over the study period (6 weeks)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
o Patient unable or not willing to consent to procedure
o Patient allergy to metronidazole
o Patients who are immune suppressed
o If patient receives any antibiotics during the 6-week trial period
o Chronic kidney disease
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Double-blinded.
Allocation will be performed by the pharmaceutical company producing the placebo and intervention tablets (PPI), which will be concealed from the study investigators. The placebo and intervention medications will be contained in numbered containers.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3 / Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/06/2019
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
302217
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Hospital
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Name [1]
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Westmead Hospital, Colorectal Surgery Department
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Address [1]
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Corner of Darcy Rd and Hawkesbury Rd
Westmead NSW, 2145
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Country [1]
302217
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Australia
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Primary sponsor type
Individual
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Name
Dr Grahame Ctercteko
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Address
Westmead Hospital
Corner of Darcy Rd and Hawkesbury Rd
Westmead NSW, 2145
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Country
Australia
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Secondary sponsor category [1]
302066
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None
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Name [1]
302066
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Address [1]
302066
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Country [1]
302066
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
302896
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Western Sydney Local Health District Human Research Ethics Committee
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Ethics committee address [1]
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Westmead Hospital Corner of Darcy Rd and Hawkesbury Rd Westmead NSW 2145
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Ethics committee country [1]
302896
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Australia
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Date submitted for ethics approval [1]
302896
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10/03/2019
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Approval date [1]
302896
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Ethics approval number [1]
302896
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Summary
Brief summary
We are planning on performing a double-blinded randomised controlled trial (RCT), investigating the role of oral metronidazole in the management of Post Open Haemorrhoidectomy pain. Haemorrhoidal disease is a common benign condition, with conventional open haemorrhoidectomy remaining the gold standard for treatment. The main post-operative complaint is pain. Various methods have been used to optimise analgesia post-haemorrhoidectomy. The most widely used pharmacological agent is metronidazole, typically administered orally. However, the overall quality of previous studies investigating this have been few in number and generally of poor quality. It is common practice however, for the majority of surgeons both nationally and internationally to administer a prophylactic course of oral metronidazole to decrease post haemorrhoidectomy pain. We hope to run our own RCT, double blinded, to assess whether oral metronidazole really does decrease post-operative pain. Patient will be either randomised to a seven day course of oral metronidazole (400mg TDS) or placebo. Patients will be followed up for 6 weeks, with the use of a 10-point Visual Analogue Scale (VAS) to assess their pain at various time intervals post-operatively.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Grahame Ctercteko
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Address
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Westmead Hospital
Corner Darcy Rd and Hawkesbury Rd
Westmead, NSW, 2145
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Country
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Australia
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Phone
91770
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+61 288905555
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Fax
91770
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Email
91770
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[email protected]
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Contact person for public queries
Name
91771
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Grahame Ctercteko
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Address
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Westmead Hospital
Corner Darcy Rd and Hawkesbury Rd
Westmead, NSW, 2145
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Country
91771
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Australia
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Phone
91771
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+61 288905555
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Fax
91771
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Email
91771
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[email protected]
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Contact person for scientific queries
Name
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Grahame Ctercteko
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Address
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Westmead Hospital
Corner Darcy Rd and Hawkesbury Rd
Westmead, NSW, 2145
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Country
91772
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Australia
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Phone
91772
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+61 288905555
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Fax
91772
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Email
91772
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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