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Pain, Postoperative clinical trials

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NCT ID: NCT03715517 Recruiting - Pain, Postoperative Clinical Trials

Spinal Anesthesia For Enhanced Recovery After Liver Surgery

SAFER-L
Start date: October 4, 2018
Phase: N/A
Study type: Interventional

This project proposes to compare epidural versus spinal anesthesia in patients having liver resection surgery. The investigators hypothesize that spinal anesthesia will result in improved blood pressure control postoperatively and reduce the amount of intravenous fluids required after surgery. Spinal anesthesia is expected to provide the same pain control benefits as epidurals, with faster recovery of function. Spinal anesthesia may be a simple and effective way to improve and enhance the recovery in the increasing number of patients requiring liver resection.

NCT ID: NCT03704753 Recruiting - Postoperative Pain Clinical Trials

New Truncal Nerve Blocks for Thoracoscopic Surgery and Open Heart Surgery.

Start date: January 25, 2019
Phase: Phase 4
Study type: Interventional

This study is divided to two sub-studies. First sub-study evaluates if Serratus Anterior Plane block (SAPB) reduces opioid consumption after thoracoscopic surgery. Secondly continuous SAPB is compared to continuous intercostal blockade. Second sub-study evaluates if Subpectoral Interfascial Plane block (SIP) reduces opioid consumption after medial sternotomy.

NCT ID: NCT03697278 Recruiting - Surgery Clinical Trials

Monitoring Postoperative Patient-controlled Analgesia (PCA)

Start date: September 28, 2018
Phase: N/A
Study type: Interventional

The introduction of Acute Pain Service (APS), 1985, specialized pain management could be offered to the inpatient care. An example of this is patient-controlled analgesia (PCA), which is a technique that is used mostly after surgery. A PCA pump is an electronic pump that is prepared with pain relief medicine, usually an opioid, which is administered either epidural or intravenously. PCA pumps are programmed with medical protocols. For prevent overdose, there are blocking times between possible bolus doses and a maximum dose per hour. In a Cochrane review from 2015, PCA have shown to be more beneficial for the patient especially when it comes to patient satisfaction, compared to conventional pain relief where nurses administer pain relief on request. The authors could also demonstrate that patients experience less pain and were more satisfied with patient-controlled analgesia. However, studies have showing limitations in the ease of practice of the PCA pumps, which indicates need for further development. Today the major part of the documentation in the Swedish healthcare is computerized. Using digital systems that communicate with each other should be seen as a matter of course. Instead, a human intermediator is commonly used where documentation is performed by pencil and paper. Due to the human factor that may affect the interpretation of the information the patient safety is placed at risk. The elimination of the human intermediator could lead to a safer transfer of information. There are already studies concerning computerized PCA pumps and wireless communication by medical devices, but only studies that are conducted outside of Europe and studies with the technical aspect in focus. Studies have shown that wireless communication by medical devices in the nursing setting can provide support for prioritization and increase the patient safety. However, the field of research lacks of knowledge when it comes to the patients' and nurses' experience of using PCA pumps with wireless communication system. Due to today's research field, further studies will be needed to investigate how documentation can be safeguarded and how accessible information regarding patients' need for pain relief can be linked to prescribed treatment. This may also lead to the development of nurses' way of work with patient-controlled and epidural pain relief in the postoperative pain management.

NCT ID: NCT03695640 Recruiting - Postoperative Pain Clinical Trials

Effect of Magnesium Sulphate on Analgesia Following Knee Arthroplasty

Start date: November 1, 2018
Phase: Phase 4
Study type: Interventional

This study is designed to investigate the effect of magnesium sulfate added to levobupivacaine in continuous femoral nerve block following total knee arthroplasty.

NCT ID: NCT03685370 Recruiting - Pancreatic Cancer Clinical Trials

PERiX: Comparison of Efficacy Between Placement of Epidural Catheters X-ray Guided and LOS Technique

PERiX
Start date: March 1, 2017
Phase: N/A
Study type: Interventional

The use of epidural catheters for postoperative analgesia in pancreatic surgery is recommended by the guidelines of the ERAS society. Some studies claim it may expose to hemodynamic alterations that may compromise outcome and increase postoperative complications, attributable to a malfunction of the catheter itself, often linked to a bad positioning, since this is usually positioned with LOS technique. Our hypothesis is that a positioning made using the radiographic guide the day before the intervention can significantly reduce the number of catheter's dysfunctions.

NCT ID: NCT03674905 Recruiting - Ankle Arthritis Clinical Trials

Peripheral Nerve Block Compared to Intra-articular Injection for TAA Post-operative Pain

Start date: November 29, 2016
Phase: N/A
Study type: Interventional

Ankle arthritis is associated with debilitating pain and chronic disability. For the treatment of severe ankle arthritis, total ankle arthroplasty (TAA) is one treatment option. Postoperative pain management in joint arthroplasty is an ongoing and relevant issue. The purpose of this study is to examine if differences exist in postoperative pain control, overall patient satisfaction, and use of narcotics using an intra-articular injection in the operating room compared with a peripheral nerve block in patients undergoing TAA.

NCT ID: NCT03673163 Recruiting - Chronic Pain Clinical Trials

Lidocaine Infusion for Pain After Herniotomy

LIPAH
Start date: November 6, 2018
Phase: N/A
Study type: Interventional

This study seeks to investigate lidocaine infusion to reduce occurrence of chronic postoperative pain at 3-month after inguinal herniotomy

NCT ID: NCT03666299 Recruiting - Chronic Pain Clinical Trials

Lidocaine Infusion for Postthoracotomy Pain Syndrome

LIPPS
Start date: November 6, 2018
Phase: N/A
Study type: Interventional

This study seeks to investigate lidocaine infusion to reduce postthoractomy pain syndrome after thoracic Surgery

NCT ID: NCT03660020 Recruiting - Postoperative Pain Clinical Trials

Ultrasound Guided Erector Spinae Plane Block in Breast Surgery

Start date: May 19, 2018
Phase: N/A
Study type: Interventional

hyalorounidase will be added to local anaesthetics in patients undergoing mastectomy and effect on local anaesthetic spread will be studied under floroscope

NCT ID: NCT03646006 Recruiting - Pain, Postoperative Clinical Trials

The Effect of Pre-sacral Nerve Block on Immediate Post-operative Pain Following Laparoscopic Hysterectomy.

Start date: August 1, 2018
Phase: Phase 4
Study type: Interventional

Hysterectomy (removal of the uterus) is the most common major gynecologic surgery performed in Canada. With a focus on minimally invasive techniques and optimization of peri-operative pain control, gynaecologists have made great strides towards reducing hospital stay and accelerating post-operative recovery. These are essential achievements, both for patients and their families and for our resource-limited public healthcare system. Optimization of peri-operative pain control is multifactorial and includes, for example, administration of pre-operative analgesics, infiltration of incision sites with local anesthetic and provision of post-operative pain medications. As the understanding of pain mechanisms evolves, the incorporation of intra-operative nerve blocks has become yet another effective strategy to reduce post-operative pain. The presacral nerve plexus, which carries nerve fibers from the uterus to the brain, is an important pathway that transmits midline pelvic pain in women. Destruction of the pre-sacral nerves has been shown to provide excellent pain control in a variety of clinical settings. While transection of the presacral nerve at the time of surgery is technically challenging, instilling a presacral nerve block is surprisingly straightforward making this technique safe to perform in the hands of many gynecologists. In this technique, local anesthetic is instilled into the presacral space using a needle inserted through the abdomen. Given that the presacral nerve plexus is an integral pain pathway for the uterus, the investigators hypothesize that the addition of a presacral nerve block during laparoscopic (camera surgery) hysterectomy would confer an additional reduction in immediate post-operative pain. The proposed study therefore aims to look at the impact of presacral nerve block versus a sham (blank) block on immediate post-operative pain in a group of women scheduled to undergo laparoscopic hysterectomy.