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

27. juni 2026 oppdatert av: 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.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Detaljert 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.

Studietype

Intervensjonell

Registrering (Antatt)

100

Fase

  • Fase 4

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

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

Studiesteder

  • Jemen
      • Sanaa, Jemen
        • Al-Jumhouri Teaching Hospital
        • Ta kontakt med:
        • Hovedetterforsker:
          • Dr. Kholood Ahmed AL-Subari, M.B.B.Ch
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Firemannsrom

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Legemiddel: 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.
Legemiddel: Placebo
Inert placebo capsule matched to nifedipine in color, size, taste, and packaging. Administered twice daily for 14 days, starting 6 hours after surgery.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
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)
Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) Score
Tidsramme: Day 7, Day 14, Day 28
Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) score. Range 0-15; lower scores indicate better healing.
Day 7, Day 14, Day 28

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
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 - 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
Adverse Events - Cardiovascular
Tidsramme: Throughout 14-day treatment and Day 28
Incidence of hypotension (systolic blood pressure [SBP] < 90 mmHg), dizziness, flushing, headache, tachycardia.
Throughout 14-day treatment and Day 28

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Sana'a University

Etterforskere

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

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. august 2026

Primær fullføring (Antatt)

30. desember 2026

Studiet fullført (Antatt)

30. desember 2026

Datoer for studieregistrering

Først innsendt

15. juni 2026

Først innsendt som oppfylte QC-kriteriene

15. juni 2026

Først lagt ut (Faktiske)

22. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

1. juli 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

27. juni 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • NIFEDIPINE-HD-2026-SANA

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

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.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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