SynthesisBMC surgery2025
Efficacy of metronidazole in reducing pain after hemorrhoidectomy: a meta-analysis of randomized controlled trials.
Synthesis in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePain is a significant issue in post-hemorrhoidectomy. Metronidazole is being explored as an adjunctive pain management option. This meta-analysis of randomized controlled trials (RCTs) assesses metronidazole's effectiveness and safety compared to a placebo post-hemorrhoidectomy, aiming to provide evidence-based pain management guidance.
methodWe conducted a systematic search of the Cochrane Library, Embase, PubMed, Web of Science, and ClinicalTrials.gov for RCTs comparing metronidazole to placebo after hemorrhoidectomy, covering the period from database inception to July 21, 2024. After screening per inclusion/exclusion criteria, study quality was assessed using Cochrane Handbook's risk of bias tool (version 5.1.0). The meta-analysis was conducted using RevMan 5.3 software, the quality of outcome indicators was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, and trial sequential analysis (TSA) was employed to verify the adequacy of the sample size.
resultsA total of 9 RCTs were included. The meta-analysis results showed that the pain scores on the first day post-operation [MD=-1.07, 95% CI (-1.85, -0.30), P = 0.006], the second day post-operation [MD=-1.72, 95% CI (-2.62, -0.81), P = 0.0002], the seventh day post-operation [MD=-1.73, 95% CI (-2.70, -0.76), P = 0.0005], and the fourteenth day post-operation [MD=-1.80, 95% CI (-2.67, -0.94), P < 0.0001] in the metronidazole group were lower than those in the placebo group. Additionally, the rate of additional analgesia was reduced [RR = 0.48, 95% CI (0.27, 0.84), P = 0.01]. No statistically significant differences were found between the metronidazole and placebo groups in terms of the overall incidence of complications [RR = 0.69, 95% CI (0.41, 1.16), P = 0.16] and time to return to normal activities [MD=-1.69, 95% CI (-6.58, 3.20), P = 0.50]. Sensitivity analysis indicated that the results for pain scores on the first day post-operation were unstable. High heterogeneity was observed in pain scores on the first, second, seventh, and fourteenth days post-operation, as well as in the time to return to normal activities. The TSA indicated that the sample size for the primary outcome measures had achieved the required information size (RIS), supporting the strength and dependability of the meta-analysis findings.
conclusionMetronidazole may be effective and safe in reducing postoperative pain in patients undergoing hemorrhoidectomy. However, due to the limitations of this study, further verification is needed from future large-sample, multi-center, well-designed high-quality RCTs. CLINICAL TRIAL NUMBER: Not applicable.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.