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NCT07105527
From an anesthesiological perspective, carotid endarterectomy (CEA) is an operation that is increasingly being performed with locoregional techniques and sedation. The aim of this observational study was to compare dexmedetomidine with midazolam and fentanyl during CEA in terms of perioperative adverse events, patient, anesthetist, and surgeon satisfaction, as well as the possible reduction in clamping time and the number of times additional local anaesthesia is needed. Sixty patients listed for CEA were enrolled and two types of sedation were used, both protocols widely used in our hospital, resulting in the formation of two groups of patients. Both the intermediate and superficial cervical plexus blocks were administered, and the patients in Group 1 were sedated with midazolam and fentanyl, and Group 2 was sedated with dexmedetomidine. The investigators examined comorbidities, surgical time and clamping, and possible intraoperative use of local anaesthetics and intraprocedural complications, and follow-up at 180 days to observe any residual deficits. The data were analysed with Statistical Package for Social Science (SPSS) Statistics 25 (IBM).
NCT04908553
Research objective: To explore the safety and dose exploration of Remimazolam Tosilate for Injection for induction and maintenance of general anesthesia in elective short-term surgery in adults. Main research indicators:(1)Success rate of sedation during induction and maintenance of general anesthesia with remazolam tosylate;(2)The incidence and severity of hypotension in the induction and maintenance phases Study design: Multi-center, randomized, double-blind clinical study. Subject population: patients undergoing elective short-term surgery. Research data collection period: The subject signs the consent form until discharge or death in the hospital or withdrawal from the research. Number of research centers/sample size: It is planned to enroll 600 patients from 11 hospitals. Research process: The researchers will include patients who meet the enrollment criteria and agree to participate in the investigation of the support laryngoscope surgery and minor head and neck surgery patients from the elective surgery patients.
NCT06080178
Adequate free flap perfusion during Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction surgery requires maintaining blood pressure above 100 mmHg and avoiding excessive fluid administration. This study aims to determine whether the use of a measurement of preload dependency (Pulse Pressure Variation = PPV), can guide fluid therapy and if it decreases the risk of flap oedema. For this purpose, two fluid management strategies will be compared: * Static intraoperative fluid management: Administration of crystalloid fluids is limited to 5ml/kg/h * Dynamic intraoperative fluid management: Crystalloid fluids are only administered if PPV exceeds 12% The purpose of this study is to compare the static and dynamic (= targeted) fluid strategy and to evaluate the effect on flap oedema and flap perfusion.
NCT06347211
The study will investigate whether the use of Goal Directed Hemodynamic Therapy implemented with the HPI algorithm using a treatment algorithm will reduce the incidence of hypotension and improve treatment of hypotension.
NCT06679933
In geriatric anesthesia, hand grip strength is used as an important biomarker to evaluate the general health status of elderly patients. Hand grip strength is considered an indicator of various factors, such as muscle function, physical endurance, nutritional status, and frailty, and can be helpful in geriatric anesthesia practice to predict patients' response to anesthesia and determine their risk. Hand grip strength is used as an important parameter in the pre-anesthesia evaluation of elderly patients. Low grip strength has been associated with postoperative complications (e.g., infection, pulmonary complications, prolonged hospitalization) and worse outcomes.Weak hand grip strength is related to the patient's degree of frailty. Frail patients may be less resistant to stress and respond more negatively to anesthesia. One of the most important of these responses is intraoperative hypotension, and it is especially common in elderly patients. Since hypotension has possible adverse effects in the postoperative period, it is necessary to evaluate elderly patients in more detail during the preoperative evaluation in order to predict this and take the necessary precautions. Hand grip strength has been found to be associated with cardiovascular system health. With this study, the investigators wanted to evaluate whether measuring hand grip strength during preoperative evaluation would help evaluate the risk of intraoperative hypotension.
NCT06238973
Controlled hypotension application is a commonly preferred anesthesia practice during surgical procedures, particularly in regions with rich tissue perfusion, aiming to reduce bleeding, enhance surgical field visibility, and mitigate potential complications. Preserving blood flow, especially to the brain, heart, and kidneys, is vital during this method. Previous studies on the subject have primarily focused on short-term effects regarding cognitive impairments, with limited research on the long-term impacts. In our study, we aim to investigate how controlled hypotension application, administered to patients undergoing rhinoplasty or septoplasty surgery, specifically affects cerebral blood flow and its potential consequences on the development of short-term/medium-term/long-term cognitive impairments or delirium in the postoperative period.
NCT05724095
The parturients may suffer from hypotension after spinal anesthesia and the incidence could be as high as 70-80% when pharmacological prophylaxis is not used. Acupuncture was reported to treat hypotension both in human and animal studies. Possible mechanisms include modulating cardiovascular and sympathetic system. In this prospective, double-blinded, randomized clinical trial, we tend to investigate the effect of transcutaneous electric acupoint stimulation (TEAS) on hypotension in parturients undergoing cesarean section.