Study on Dynamic Multimodal Analgesia Regimen Integrated With Traditional Chinese and Western Medicine After Perianal Abscess Surgery
Study on Dynamic Multimodal Analgesia Regimen Integrated With Traditional Chinese and Western Medicine After Perianal Abscess Surgery: A Single-Center, Prospective, Open-Label Randomized Clinical Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Fujian
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Putian, Fujian, China, 351100
- The Affiliated Hospital of Putian University
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Aged between 18 and 75 years old (18 ≤ age ≤ 75);
- Diagnosed with primary perianal abscess via digital rectal examination, anorectal ultrasound or MRI, and scheduled for incision and drainage or radical surgery;
- The maximum diameter of the abscess cavity ≥ 2 cm, or with obvious abscess cavity formation;
- Patients are willing and capable of participating in the pain management protocol, fully understand the significance of pain management, and can actively cooperate with study procedures;
- No severe coagulation disorders.
Exclusion Criteria:
- Complicated with specific infectious diseases such as Crohn's disease and tuberculosis;
- Unclear source of postoperative pain, i.e., the origin of pain cannot be confirmed or the pain is unrelated to surgery;
- Presence of definite contraindications, including drug allergy or inability to tolerate any pain management measures adopted in this trial;
- Pregnant or lactating women;
- Patients unable to cooperate with the study, such as those with cognitive impairment, history of mental illness, communication barriers and other conditions;
- Patients with long-term analgesic medication use and established drug tolerance;
- Complicated with uncontrolled cardiovascular and cerebrovascular diseases (NYHA cardiac function class Ⅲ-Ⅳ), hepatic and renal insufficiency (Child-Pugh class C or eGFR < 30 mL/min/1.73 m²), etc.;
- Abscess secondary to rectal neoplasms, trauma or iatrogenic injury;
- Severe postoperative complications (such as massive hemorrhage, sepsis) or concurrent infections at other sites;
- Patients receiving only non-surgical treatments such as simple needle aspiration of pus.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Other: Western Multimodal Analgesia Group
Western multimodal analgesia.
Dynamic whole-course NRS evaluation was performed: baseline measurement preoperatively, regular rest/activity pain checks and breakthrough pain assessment postoperatively, plus follow-up reassessment after discharge.
Stepwise stratified medication was applied alongside non-pharmacological measures including potassium permanganate sitz bath, health education and psychological counseling.
A pain management team adjusted regimens individually via daily ward rounds.
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TCM sitz bath
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Experimental: Integrated Traditional Chinese and Western Medicine Multimodal Analgesia Group
integrated Chinese-Western multimodal analgesia.
All interventions of Group B were adopted, with additional TCM sitz bath and TCM nursing; assessment and Western medicine protocols remained identical to Western Multimodal Analgesia Group
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TCM sitz bath
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Numerical Rating Scale,NRS
Time Frame: Postoperative days 1, 2, 3, 4, 5, 2 weeks and 1 month
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The Numerical Rating Scale (NRS) for pain assessment ranges from 0 to 10, with higher scores indicating more severe pain and poorer outcomes.
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Postoperative days 1, 2, 3, 4, 5, 2 weeks and 1 month
|
|
total postoperative analgesic consumption
Time Frame: Postoperative days 1, 2, 3, 4, 5, 2 weeks and 1 month
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Total consumption of analgesics was converted to morphine equivalent daily dose (MEDD) for intergroup comparison.
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Postoperative days 1, 2, 3, 4, 5, 2 weeks and 1 month
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postoperative quality of life indicators
Time Frame: at day 3 and month 1 postoperatively
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The Short-Form 36 (SF-36) Health Survey was employed to evaluate quality of life, with each domain scored from 0 (minimum) to 100 (maximum), and higher scores reflecting more favorable health status and better quality of life.
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at day 3 and month 1 postoperatively
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
postoperative urinary retention
Time Frame: 24 hours postoperatively
|
Patients were placed in the supine position with a moderately full bladder.
The ultrasound probe was positioned above the pubic symphysis, and the anteroposterior, transverse, and longitudinal diameters of the bladder were measured.
The post-void residual urine volume was calculated using the formula: bladder volume (mL) ≈ 0.52 × length × width × height (cm).
A residual volume of <50 mL was considered normal, 50-200 mL indicated mild urinary retention or impaired voiding, and >200 mL was diagnostic of postoperative urinary retention.
Complete inability to void with a bladder volume of >400 mL was defined as acute urinary retention.
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24 hours postoperatively
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secondary hemorrhage
Time Frame: 24 hours postoperatively
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Active oozing from the surgical wound occurring beyond 24 hours postoperatively, with a blood loss of ≥5 mL, requiring dressing change and continuous compression hemostasis with sterile gauze; secondary suturing is indicated if bleeding cannot be controlled.
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24 hours postoperatively
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perianal edema
Time Frame: within 72 hours postoperatively
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Perianal edema was defined as visible significant soft-tissue swelling around the operative site, accompanied by local tenderness, with the edema persisting for more than 72 hours.
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within 72 hours postoperatively
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assessment of sexual function
Time Frame: assessed preoperatively and at 1 month postoperatively
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Erectile function in male patients was evaluated using the International Index of Erectile Function-5 (IIEF-5), which has a total score ranging from 5 (minimum) to 25 (maximum), with higher scores denoting better erectile function.
For female patients, sexual function was assessed using the Female Sexual Function Index (FSFI), with total scores ranging from 2 to 36, where a higher score indicates better sexual function.
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assessed preoperatively and at 1 month postoperatively
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- PutianU-0013
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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