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NCT06986109
General Anaesthesia (GA) is a medical state of controlled unconsciousness that inhibits two dimensions of consciousness: the content and the level of consciousness. This state is achieved using various anaesthetic agents, with propofol being one of the most commonly used intravenous anaesthetics. Propofol is a gamma amino butyric acid (GABAA) receptor agonist, which affects both the content and level of anaesthesia. In some cases, anaesthesiologists may choose to use an adjuvant drug, ketamine, in subanaesthetic doses during inhalation GA and propofol total intravenous anaesthesia (TIVA). Ketamine is an N-methyl D-aspartate (NMDA) receptor antagonist and is primarily employed for its analgesic properties. Unlike propofol, ketamine selectively affects only the content of consciousness. The combination of propofol and ketamine appears to have dual effects on the dimensions of consciousness, with propofol affecting both content and level, and ketamine affecting only the content. This combination is likely to complement and improve the consistency of intraoperative anaesthesia depth. However, studies have shown that the administration of ketamine with propofol TIVA, delivered through an automated anaesthesia delivery system using electroencephalogram (EEG) feedback signals from NeuroSENSE processed electroencephalogram (pEEG) monitor, has not demonstrated any significant benefit over the use of propofol alone. Till now, the only study on propofol-ketamine co-administration used an uncommon NeuroSENSE pEEG monitoring system. Closed loop anaesthesia delivery system (CLADS) is a more precise, efficient, and robust mechanism to facilitate automated administration of propofol TIVA which employs the standard bispectral index (BIS) pEEG monitoring to control propofol TIVA delivery. Further evidence is desirable on depth of anaesthesia consistency when ketamine is co-administered with propofol TIVA, using CLADS This randomised controlled study will compare the effect of subanaesthetic dose of ketamine versus placebo (normal saline) on anaesthesia depth consistency in patients undergoing elective laparoscopic surgery under automated propofol TIVA using CLADS. All patients undergoing elective laparoscopic surgery will be screened, and those found eligible will be enrolled. Enrolled patients will receive CLADS-controlled propofol TIVA as standard. In intervention are, patients will additionally receive subanaesthetic dose of ketamine (0.25-mg/kg bolus followed by maintenance infusion 0.25-mg/kg/h) (ketamine group); in control arm, patients will receive normal saline as placebo in addition to propofol TIVA (placebo group).
NCT07517809
The aim of the study is to compare the onset time of the costoclavicular approach of brachial plexus block with that of the lateral-sagittal infraclavicular approach in adults distal upper limb surgeries.
NCT07663877
This prospective, single-center, randomized controlled trial aims to compare remimazolam anesthesia with planned flumazenil reversal and sevoflurane-based balanced anesthesia in adult women undergoing ambulatory hysteroscopic surgery. Participants will be randomly assigned in a 1:1 ratio to receive either remimazolam for induction and maintenance followed by flumazenil reversal or propofol induction followed by sevoflurane-based balanced anesthesia. The primary outcome is anesthesia-controlled time, defined as the sum of induction time and emergence time. Secondary outcomes include recovery profiles, postoperative symptoms, quality of recovery, hemodynamic stability, and the incidence of re-sedation. The study will evaluate whether a remimazolam-flumazenil strategy can improve operating room efficiency while maintaining recovery quality and safety comparable to conventional sevoflurane-based anesthesia in the ambulatory surgery setting.
NCT07663149
This study aims to evaluate the effectiveness of continuous phenylephrine infusion at 50 mcg/min in preventing shivering after spinal anesthesia in cesarean section. This study was an open-label randomized clinical trial involving patients undergoing cesarean section under spinal anesthesia. Subjects were allocated into two groups: without phenylephrine and continuous phenylephrine infusion at 50 mcg/min. The primary outcome was the incidence of shivering during observation, assessed using the Crossley and Mahajan scale. Secondary outcomes included hypotension, ephedrine requirement, hemodynamic adverse events, and nausea vomiting.
NCT00775879
Sevoflurane is widely used for induction of anaesthesia. Several studies showed EEG abnormalities during mask induction with sevoflurane. The aim of our study was to test the induction target concentration of sevoflurane on the spikes wave occurrence.
NCT07173894
This study will compare two different types of anesthesia used for shoulder surgery. The first method, called an interscalene block, is commonly performed by anesthesiologists and is effective for pain control but may cause side effects such as breathing problems, arm weakness, or discomfort. The second method, called a shoulder field block, is a newer technique performed by orthopedic surgeons that numbs the nerves around the shoulder without affecting breathing. Patients scheduled for shoulder surgery will be randomly assigned to receive either the interscalene block or the shoulder field block. The main goal of the study is to find out whether the shoulder field block provides pain relief that is as effective as the interscalene block, but with fewer side effects. Pain levels, patient satisfaction, length of hospital stay, need for pain medication, and any complications will be recorded and compared between the two groups. The results may help identify a safe and effective alternative anesthesia option for patients undergoing shoulder surgery.
NCT07646093
\*\*Brief Summary\*\* This study aimed to develop and conduct a preliminary clinical evaluation of a novel weight-adjusted gelatin-based diclofenac potassium medicated lollipop for the management of postoperative pain following adenotonsillectomy in children. The formulation was designed to improve analgesic adherence by providing a palatable and child-friendly dosage form suitable for oral transmucosal administration. Fifty paediatric patients aged 4 to 12 years undergoing elective adenotonsillectomy received one of three weight-adjusted diclofenac potassium lollipop doses (15 mg, 20 mg, or 30 mg) every 8 hours during the first 24 postoperative hours. The study assessed postoperative pain intensity, product acceptability, rescue analgesic use, and safety. In parallel, the formulation underwent pharmaceutical characterization, including physicochemical and microbiological quality evaluation.
NCT06889870
Breast cancer is the malignant neoplasm with the highest incidence in women in Brazil, with the exception of non-melanoma skin tumors. Breast cancer surgery is an important part of treatment and post-operative pain needs to be adequately prevented and treated. This prospective, randomized, double-blind clinical study aims to evaluate the efficacy of interfascial pectoral nerve block (PECS II) compared to local anesthetic infiltration at the surgical site in patients undergoing breast cancer surgery in terms of pain and nausea. Data collection will be carried out at the Nossa Senhora das Dores Hospital with 133 patients, who will be divided into two groups: the PEC group will undergo PECS II blockade and the LOC group will undergo local anesthetic infiltration at the surgical site. Both interventions will be performed after the induction of opioid-free/sparing balanced general anesthesia. At the end of surgery, the patients will be taken to the post-anesthetic recovery room (PACU), where post-operative pain will be monitored on arrival and at 30-minute intervals up to two hours after surgery, and before the patient is discharged the following day. A visual analog scale (VAS) will be used, and PONVs will also be recorded. After a 2-hour stay in the PACU, they will be transferred to the ward, and after 24 hours, they will be reassessed using the same parameters. Opioid consumption will be recorded in the PACU and during hospitalization, as well as the occurrence of nausea or vomiting and compared between the groups, and side effects and complications will be monitored.
NCT04226495
Randomized single blind controlled clinical trial to test the benefit of sufentanil infusion over bolus dosing to reduce time to extubation and reduced length of ICU stay.
NCT06702631
The purpose of this study is to determine the effects of acute pain on long-term memory and conditioned physiologic responses in the presence and absence of low dose nitrous oxide. Functional magnetic resonance imaging will be used to identify the neural correlates of these phenomena. The study will occur over 2 visits and involves no long-term follow up.
NCT07628231
Driven by industry demands and the need for anesthesia that consumes fewer resources ("green anesthesia"), manufacturers of anesthesia ventilators have developed closed-circuit ventilators. In a closed-circuit system, during the exhalation phase, gases are not released outside the ventilator into the atmosphere but are injected into the inspiratory limb of the circuit after being warmed and having CO2 removed. It is a closed loop. However, the loop is not completely closed because a very small stream of air is additionally injected into the inspiratory limb to limit the risk of hypoxia. This small stream of air is called "Fresh Gas Flow" or FGF. To optimize this closed-loop recirculation, manufacturers have designed machines capable of minimizing the fresh gas flow. In the 2000s, machines operated with FGFs of 2 L/min, dropping to flows as low as 0.5 L/min by 2010. This low-flow regime allows for an 80% reduction in halogenated gas (sevoflurane) consumption while maintaining the same efficiency. Recently, even more sophisticated machines have been designed with FGFs of 0.3 L/min. Some of these new machines will be commercially available on a large scale in 2026. As part of an industrial partnership, the Nîmes University Hospital has validated the post-CE marking of these machines for certain manufacturers (including General Electric); the post-CE marking allows the manufacturer to have access to usage data Given that this product has only recently been introduced to the market, very little data has been published on the use of sevoflurane in daily practice at very low FGF flow rates (0.3 to 0.5 L/min). For the past four months, the Nîmes University Hospital has had two CE-marked machines (GE, CS 850) capable of ventilating at flow rates of 0.3 L/min. These machines are connected to software (Carestation Insight) that allows all anonymized ventilator data to be recorded independently of the users. This software has been in continuous use in 12 operating rooms since 2024 within our institution and has been the subject of numerous publications (see Ref. 19). All ventilation and sevoflurane data are continuously recorded and stored in a secure, anonymous cloud (Ref. 19). The objective of this retrospective study is to analyze the database of sevoflurane consumption derived from the Carestation Insight software for patients who underwent general anesthesia with ventilation at FGF flow rates of 0.3 L/min and to compare these data with our database of patients under anesthesia at flow rates of 0.5 to 2 L/min, also derived from this same cloud.
NCT07608276
The objective of this study is to evaluate the clinical impact of the NOL nociception level index monitoring on intraoperative and post operative patient outcomes and institutional metrics when used to guide intraoperative analgesia dosing in patients undergoing spine surgery under general anesthesia when compared to a case controlled retrospective cohort.
NCT07042893
Lung resection is associated with high postoperative morbidity and mortality and leads to a significant long-term decrease in functional capacity, particularly due to cardiorespiratory complications. One of the contributing factors to this functional decline is the postoperative reduction in right ventricular function. Due to the anatomical proximity and interactions, right ventricular function is evaluated by echocardiography following lung resection. The pulmonary artery pressure (PAP)/tricuspid annular plane systolic excursion (TAPSE) ratio is a parameter that provides a more comprehensive assessment of right heart function by evaluating both right ventricular systolic function and pulmonary artery pressure. In this study, investigators aimed to evaluate changes in right heart function by performing preoperative and postoperative echocardiographic assessments in participants undergoing lung resection, focusing on PAP/TAPSE ratios.
NCT07603622
Over 300 million surgeries are performed globally every year. Complications after surgery - infections, cardiovascular conditions, postoperative pulmonary complications and renal impairment - affect survival and quality of life. Age and co-morbidity are unmodifiable factors, contributing to increased risk of these perioperative complications. However, a modifiable risk factor is physical activity. This study aims to test if self reported physical activity has added predicted value, beyond established risk factors, for predicting perioperative morbidity and mortality.
NCT07601854
This study will try to elucidate the neural responses of neonatal patients to surgery-level propofol infusions during induction and maintenance of anesthesia. The main objective is to elucidate the EEG patterns of neural activity that can reliably reflect the level of hypnotic depth in full term neonates undergoing propofol anesthesia based on the classification of EEG into states and the characterization of discrete neonatal EEG events.
NCT07603765
This prospective observational clinical study aims to evaluate the clinical utility of Pressure Recording Analytical Method (PRAM)-based minimally invasive hemodynamic monitoring in patients undergoing cardiac ablation procedures. The study will be conducted in the cardiac catheterization laboratory of Istanbul University-Cerrahpaşa Cardiology Institute and will include 27 adult patients scheduled for catheter ablation. Written informed consent will be obtained from all participants, and the study will adhere to the principles of the Declaration of Helsinki.
NCT07321041
The goal of this observational study is to evaluate the effect of neonatal delivery time on umbilical cord blood gas parameters in pregnant women undergoing elective cesarean section under general or spinal anesthesia. The study population consists of adult pregnant women aged 18-40 years with singleton term pregnancies scheduled for elective cesarean delivery. The main questions it aims to answer are: Is neonatal delivery time associated with changes in umbilical artery pH values under general and spinal anesthesia? Is neonatal delivery time associated with changes in umbilical artery base excess under general and spinal anesthesia? Researchers will compare cesarean sections performed under general anesthesia with those performed under spinal anesthesia to determine whether the relationship between delivery time and umbilical cord blood gas parameters differs between anesthesia techniques. Participants will: Undergo elective cesarean delivery under general or spinal anesthesia as part of routine clinical care Have neonatal delivery time recorded intraoperatively Have umbilical artery blood gas parameters (pH and base excess) measured immediately after birth as part of standard neonatal assessment
NCT07592832
The main aim of this study is to compare the effects of two different anesthesia methods-(1) general anesthesia alone and (2) combination of general anesthesia with cervical plexus block-on postoperative inflammatory process and amino acid metabolism in patients undergoing thyroidectomy.
NCT07589010
Splints are often used in neonatal intensive care units (NICUs) to immobilize the limb and stabilize the catheter, theoretically reducing complications by minimizing movement at the catheter site. Unfortunately, not much local data exist on the effectiveness of splints for peripheral intravenous line securement (PIVC). This study aimed to compare the dwell time of PIVCs with and without splints in neonates admitted to the NICU.
NCT06834243
This retrospective study evaluates the effects of two different administration methods of the Pericapsular Nerve Group (PENG) Block on postoperative pain control, opioid consumption, and recovery in patients undergoing hip surgery. All patients in the study received: * PENG block via a catheter * Patient-Controlled Analgesia (PCA) with tramadol * Multimodal analgesia, including IV paracetamol and nonsteroidal anti inflammatory drugs (NSAIDs) as rescue analgesia The study compares two groups: 1. Intermittent Bolus Group: A researcher administered 20 mL of 0.25% bupivacaine every 4 hours. 2. Continuous Infusion Group: A pump delivered 5 mL/hour of 0.25% bupivacaine continuously. Both groups received the same total volume of local anesthetic over 24 hours. All PENG blocks were performed under ultrasound guidance at the end of surgery. This study aims to determine whether intermittent bolus or continuous infusion PENG block administration leads to better pain control, lower opioid consumption, and improved recovery outcomes.