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Oral Nifedipine vs Placebo for Pain and Healing After Hemorrhoidectomy (NIFEDIPINE-HD)

15. juni 2026 opdateret af: Haitham Mohammed Jowah, Sana'a University

The Effect of Oral Nifedipine Versus Placebo on Postoperative Pain and Healing Following Hemorrhoidectomy in Adult Patients: A Randomized Controlled Trial in Sana'a, Yemen

The goal of this clinical trial is to evaluate whether oral nifedipine reduces postoperative pain and improves wound healing after hemorrhoidectomy in adult patients aged 18-65 years undergoing elective surgery for grade III or IV hemorrhoids in Sana'a, Yemen.

The main questions it aims to answer are:

  • Does oral nifedipine 20 mg twice daily for 14 days reduce postoperative pain compared with placebo?
  • Does oral nifedipine improve wound healing progression and shorten time to complete healing compared with placebo?

Researchers will compare the nifedipine group to the placebo group to see if there is a significant reduction in pain scores, faster wound healing, lower analgesic consumption, and fewer complications.

Participants will:

  • Take either oral nifedipine 20 mg or an identical-looking placebo capsule twice daily for 14 consecutive days, starting 6 hours after surgery.
  • Report pain intensity using a standard 0-10 Visual Analogue Scale at multiple time points during the first 28 days.
  • Attend follow-up visits on postoperative days 7, 14, and 28 for wound healing assessment and safety monitoring.
  • Use rescue analgesia (paracetamol and/or diclofenac) as needed for breakthrough pain.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Hemorrhoidal disease affects approximately 4.4% of the global population and is one of the most common anorectal conditions. Post-hemorrhoidectomy pain remains the most significant complaint and barrier to recovery, often exceeding patient expectations and delaying return to daily activities. The pathophysiology involves tissue trauma, inflammation, and internal anal sphincter spasm, which creates a cycle of pain and impaired healing. Calcium channel blockers such as nifedipine reduce smooth muscle tone and improve local microcirculation, suggesting benefit in this context. While topical calcium channel blockers have been studied, oral nifedipine offers advantages in compliance, predictable systemic delivery, and suitability for resource-limited settings such as Yemen. This trial addresses a specific gap in evidence for oral nifedipine after hemorrhoidectomy.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

100

Fase

  • Fase 4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Dr. Kholood Ahmed AL-Subari, M.B.B.Ch
  • Telefonnummer: +967772729669
  • E-mail: drkholooda@gmail.com

Studiesteder

  • Yemen
      • Sanaa, Yemen
        • Al-Jumhouri Teaching Hospital
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Dr. Kholood Ahmed AL-Subari, M.B.B.Ch

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Adult patients aged 18-65 years
  • Scheduled for elective hemorrhoidectomy for grade III or IV hemorrhoids
  • Ability to provide written informed consent
  • Ability to understand and complete study questionnaires
  • Willingness to comply with the study protocol and follow-up visits

Exclusion Criteria:

  • Known hypersensitivity to nifedipine
  • Severe cardiovascular disease (unstable angina, recent myocardial infarction, severe heart failure)
  • Hypotension (systolic blood pressure < 90 mmHg)
  • Severe hepatic or renal impairment
  • Pregnancy or breastfeeding
  • Current use of calcium channel blockers or nitrates
  • Emergency hemorrhoidectomy
  • Concurrent inflammatory bowel disease
  • History of anorectal surgery within the past 6 months

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Nifedipine 20 mg oral capsules
Oral nifedipine 20 mg capsule twice daily (every 12 hours) for 14 consecutive days. First dose administered 6 hours after surgery.
Medicin: Nifedipine 20 Mg
Nifedipine 20 mg immediate-release oral capsule, twice daily for 14 days. First dose 6 hours after surgery. L-type calcium channel blocker causing internal anal sphincter smooth-muscle relaxation, reduced resting pressure, improved local blood flow, and potential anti-inflammatory/analgesic effects.
Placebo komparator: Placebo oral capsules
Identical-appearing placebo capsule (same color, size, taste, and packaging) twice daily for 14 days, starting 6 hours after surgery.
Medicin: Placebo
Inert placebo capsule matched to nifedipine in color, size, taste, and packaging. Administered twice daily for 14 days, starting 6 hours after surgery.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Visual Analogue Scale (VAS) Pain Score
Tidsramme: Day 1, Day 2, Day 3, Day 7, Day 14, Day 28
Pain intensity measured on a 0-10 Visual Analogue Scale. Higher scores indicate worse pain. Assessed at rest and with defecation.
Day 1, Day 2, Day 3, Day 7, Day 14, Day 28
REEDA Score (Wound Healing)
Tidsramme: Day 7, Day 14, Day 28
Redness, Edema, Ecchymosis, Discharge, Approximation score. Range 0-15; lower scores indicate better healing.
Day 7, Day 14, Day 28
Time to Complete Wound Healing
Tidsramme: Up to Day 28 (censored if not healed by Day 28)
Number of days from surgery until complete epithelialization of all surgical wounds confirmed by clinical examination.
Up to Day 28 (censored if not healed by Day 28)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Rescue Analgesic Consumption
Tidsramme: Day 0 through Day 14
Total number of paracetamol and diclofenac doses consumed during the 14-day study period.
Day 0 through Day 14
Postoperative Complications
Tidsramme: Day 7, Day 14, Day 28
Incidence of bleeding, infection, urinary retention, and anal stenosis. Binary (yes/no) for each.
Day 7, Day 14, Day 28
Return to Normal Daily Activities
Tidsramme: Day 28
Number of days until patient reports return to normal daily activities (self-reported).
Day 28
Return to Work
Tidsramme: Day 28
Number of days until return to employment or usual occupational duties (self-reported).
Day 28
Patient Satisfaction
Tidsramme: Day 28
Overall satisfaction with pain management and recovery, measured on a Likert scale or binary satisfied/dissatisfied.
Day 28
Adverse Events - Cardiovascular
Tidsramme: Throughout 14-day treatment and Day 28
Incidence of hypotension (SBP < 90 mmHg), dizziness, flushing, headache, tachycardia.
Throughout 14-day treatment and Day 28
Adverse Events - General
Tidsramme: Throughout 14-day treatment and Day 28
Incidence of any serious or non-serious adverse event, including allergic reactions, gastrointestinal symptoms.
Throughout 14-day treatment and Day 28

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Sana'a University

Efterforskere

  • Studieleder: Dr. Yasser Abdurabo Obadiel, Asssociate Professor, Faculty of Medicine and Health Sciences, Sana'a University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. august 2026

Primær færdiggørelse (Anslået)

30. december 2026

Studieafslutning (Anslået)

30. december 2026

Datoer for studieregistrering

Først indsendt

15. juni 2026

Først indsendt, der opfyldte QC-kriterier

15. juni 2026

Først opslået (Faktiske)

22. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

22. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

15. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • NIFEDIPINE-HD-2026-SANA

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

The study team does not plan to share individual participant data with other researchers. This is a single-center thesis study with limited data management infrastructure, and the dataset contains identifiable clinical information that cannot be sufficiently de-identified for broad sharing under local ethical guidelines.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Postoperativ smerte

Kliniske forsøg med Nifedipine 20 Mg

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