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Oral Nifedipine Versus Placebo for Pain and Healing After Hemorrhoidectomy (NIFEDIPINE-HD)
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.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Inschrijving (Geschat)
Fase
- Fase 4
Contacten en locaties
Studiecontact
- Naam: Dr. Kholood Ahmed AL-Subari, M.B.B.Ch
- Telefoonnummer: +967772729669
- E-mail: drkholooda@gmail.com
Studie Locaties
-
-
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Sanaa, Jemen
- Al-Jumhouri Teaching Hospital
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Contact:
- Dr. Kholood Ahmed AL-Subari, M.B.B.Ch
- Telefoonnummer: +967772729669
- E-mail: drkholooda@gmail.com
-
Hoofdonderzoeker:
- Dr. Kholood Ahmed AL-Subari, M.B.B.Ch
-
Contact:
- Dr. Yasser Abdurabo Obadiel, Associate Professor
- E-mail: Yasser.Obadiel@su.edu.ye
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-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: 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.
|
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-vergelijker: Placebo oral capsules
Identical-appearing placebo capsule (same color, size, taste, and packaging) twice daily for 14 days, starting 6 hours after surgery.
|
Inert placebo capsule matched to nifedipine in color, size, taste, and packaging.
Administered twice daily for 14 days, starting 6 hours after surgery.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Visual Analogue Scale (VAS) Pain Score
Tijdsspanne: 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.
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Day 1, Day 2, Day 3, Day 7, Day 14, Day 28
|
|
Time to Complete Wound Healing
Tijdsspanne: 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.
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Up to Day 28 (censored if not healed by Day 28)
|
|
Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) Score
Tijdsspanne: Day 7, Day 14, Day 28
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Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) score.
Range 0-15; lower scores indicate better healing.
|
Day 7, Day 14, Day 28
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Rescue Analgesic Consumption
Tijdsspanne: Day 0 through Day 14
|
Total number of paracetamol and diclofenac doses consumed during the 14-day study period.
|
Day 0 through Day 14
|
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Postoperative Complications
Tijdsspanne: Day 7, Day 14, Day 28
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Incidence of bleeding, infection, urinary retention, and anal stenosis.
Binary (yes/no) for each.
|
Day 7, Day 14, Day 28
|
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Return to Normal Daily Activities
Tijdsspanne: Day 28
|
Number of days until patient reports return to normal daily activities (self-reported).
|
Day 28
|
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Return to Work
Tijdsspanne: Day 28
|
Number of days until return to employment or usual occupational duties (self-reported).
|
Day 28
|
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Patient Satisfaction
Tijdsspanne: Day 28
|
Overall satisfaction with pain management and recovery, measured on a Likert scale or binary satisfied/dissatisfied.
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Day 28
|
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Adverse Events - General
Tijdsspanne: Throughout 14-day treatment and Day 28
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Incidence of any serious or non-serious adverse event, including allergic reactions, gastrointestinal symptoms.
|
Throughout 14-day treatment and Day 28
|
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Adverse Events - Cardiovascular
Tijdsspanne: Throughout 14-day treatment and Day 28
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Incidence of hypotension (systolic blood pressure [SBP] < 90 mmHg), dizziness, flushing, headache, tachycardia.
|
Throughout 14-day treatment and Day 28
|
Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Studie directeur: Dr. Yasser Abdurabo Obadiel, Associate Professor, Faculty of Medicine and Health Sciences, Sana'a University
Publicaties en nuttige links
Algemene publicaties
- Jin J, Unasa H, Bahl P, Mauiliu-Wallis M, Svirskis D, Hill A. Can Targeting Sphincter Spasm Reduce Post-Haemorrhoidectomy Pain? A Systematic Review and Meta-Analysis. World J Surg. 2023 Feb;47(2):520-533. doi: 10.1007/s00268-022-06807-3. Epub 2022 Nov 10.
- Golfam F, Golfam P, Golfam B, Pahlevani P. Comparison of topical nifedipine with oral nifedipine for treatment of anal fissure: a randomized controlled trial. Iran Red Crescent Med J. 2014 Aug;16(8):e13592. doi: 10.5812/ircmj.13592. Epub 2014 Aug 5.
- Perrotti P, Dominici P, Grossi E, Cerutti R, Antropoli C. Topical nifedipine with lidocaine ointment versus active control for pain after hemorrhoidectomy: results of a multicentre, prospective, randomized, double-blind study. Can J Surg. 2010 Feb;53(1):17-24.
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Pijn
- Neurologische manifestaties
- Ziekten van het zenuwstelsel
- Vaatziekten
- Hart-en vaatziekten
- Postoperatieve complicaties
- Pathologische processen
- Darmziekten
- Ziekten van het spijsverteringsstelsel
- Gastro-intestinale aandoeningen
- Neurologische gedragsmanifestaties
- Rectale ziekten
- Perceptuele stoornissen
- Pathologische aandoeningen, tekenen en symptomen
- Tekenen en symptomen
- Pijn, postoperatief
- Agnosie
- Aambeien
- Pyridines
- Heterocyclische verbindingen, 1-ring
- Heterocyclische verbindingen
- Dihydropyridines
- Nifedipine
Andere studie-ID-nummers
- NIFEDIPINE-HD-2026-SANA
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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