- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT07659665
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.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
Studietyp
Inskrivning (Beräknad)
Fas
- Fas 4
Kontakter och platser
Studiekontakt
- Namn: Dr. Kholood Ahmed AL-Subari, M.B.B.Ch
- Telefonnummer: +967772729669
- E-post: drkholooda@gmail.com
Studieorter
-
-
-
Sanaa, Jemen
- Al-Jumhouri Teaching Hospital
-
Kontakt:
- Dr. Kholood Ahmed AL-Subari, M.B.B.Ch
- Telefonnummer: +967772729669
- E-post: drkholooda@gmail.com
-
Huvudutredare:
- Dr. Kholood Ahmed AL-Subari, M.B.B.Ch
-
Kontakt:
- Dr. Yasser Abdurabo Obadiel, Associate Professor
- E-post: Yasser.Obadiel@su.edu.ye
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Beskrivning
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
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Fyrdubbla
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: 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-jämförare: 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.
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Visual Analogue Scale (VAS) Pain Score
Tidsram: 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
Tidsram: 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
Tidsram: 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
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Rescue Analgesic Consumption
Tidsram: 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
Tidsram: 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
Tidsram: Day 28
|
Number of days until patient reports return to normal daily activities (self-reported).
|
Day 28
|
|
Return to Work
Tidsram: Day 28
|
Number of days until return to employment or usual occupational duties (self-reported).
|
Day 28
|
|
Patient Satisfaction
Tidsram: Day 28
|
Overall satisfaction with pain management and recovery, measured on a Likert scale or binary satisfied/dissatisfied.
|
Day 28
|
|
Adverse Events - General
Tidsram: 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
Tidsram: 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
|
Samarbetspartners och utredare
Sponsor
Utredare
- Studierektor: Dr. Yasser Abdurabo Obadiel, Associate Professor, Faculty of Medicine and Health Sciences, Sana'a University
Publikationer och användbara länkar
Allmänna publikationer
- 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.
Studieavstämningsdatum
Studera stora datum
Studiestart (Beräknad)
Primärt slutförande (Beräknad)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
- Smärta
- Neurologiska manifestationer
- Sjukdomar i nervsystemet
- Kärlsjukdomar
- Hjärt-kärlsjukdomar
- Postoperativa komplikationer
- Patologiska processer
- Tarmsjukdomar
- Matsmältningssystemets sjukdomar
- Gastrointestinala sjukdomar
- Neurobehavioral manifestationer
- Rektala sjukdomar
- Perceptuella störningar
- Patologiska tillstånd, tecken och symtom
- Tecken och symtom
- Smärta, postoperativt
- Agnosia
- Hemorrojder
- Pyridiner
- Heterocykliska föreningar, 1-ring
- Heterocykliska föreningar
- Dihydropyridiner
- Nifedipin
Andra studie-ID-nummer
- NIFEDIPINE-HD-2026-SANA
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
IPD-planbeskrivning
Läkemedels- och apparatinformation, studiedokument
Studerar en amerikansk FDA-reglerad läkemedelsprodukt
Studerar en amerikansk FDA-reglerad produktprodukt
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