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Anesthesia clinical trials

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NCT ID: NCT05648279 Recruiting - Surgery Clinical Trials

Personalized Hemodynamic Management in High-risk Major Abdominal Surgery

PELICAN
Start date: October 8, 2023
Phase: N/A
Study type: Interventional

Postoperative mortality within 30 days after surgery is around 2% in patients having major noncardiac surgery in Europe and the USA. In fact, if the first 30 days after surgery were considered a disease, it would be the third leading cause of death globally. Postoperative deaths are a consequence of postoperative organ injury and complications - including acute myocardial injury, acute kidney injury, and severe infectious complications. To avoid postoperative deaths, it is thus crucial to reduce postoperative organ injury and complications. To reduce postoperative organ injury and complications, modifiable risk factors need to be addressed. These modifiable risk factors for postoperative organ injury include low blood flow states and intraoperative hypotension. Optimizing blood flow (i.e., cardiac index) during surgery may thus be effective in reducing postoperative organ injury and complications. However, the optimal hemodynamic treatment strategy for high-risk surgical patients remains unclear. Cardiac index varies substantially between individuals. However, current intraoperative hemodynamic treatment strategies mainly aim to maximize cardiac index instead of using personalized cardiac index targets for each individual patient. A single-center pilot trial suggests that using individualized cardiac index targets during surgery may reduce postoperative organ injury and complications compared to routine hemodynamic management. However, large robust trials investigating the effect of personalized hemodynamic management targeting preoperative baseline cardiac index on postoperative complications are missing. The investigators, therefore, propose a multicenter randomized trial to test the hypothesis that personalized hemodynamic management targeting preoperative baseline cardiac index reduces the incidence of a composite outcome of acute kidney injury, acute myocardial injury, non-fatal cardiac arrest, severe infectious complications, and death within 7 days after surgery compared to routine hemodynamic management in high-risk patients having major abdominal surgery.

NCT ID: NCT05618405 Recruiting - Anesthesia Clinical Trials

Changes in Circadian Rhythm After Anaesthesia in Children

CLOCKSkids
Start date: March 16, 2022
Phase:
Study type: Observational

In this study the investigators will examine the effect of general anesthesia and surgery on sleep duration and sleep quality in children, using questionnaires and a sleep diary.

NCT ID: NCT05601427 Recruiting - Anesthesia Clinical Trials

Intra-Operative Adductor Canal Blocks

Start date: March 22, 2023
Phase: N/A
Study type: Interventional

Adductor canal blocks (ACB) have been recommended in total knee arthroplasty (TKA) to provide better control of post-operative pain, facilitate early ambulation, and reduce length of stay in the hospital. ACB is typically done before surgery by an anesthesiologist, which may increase time per case, cost, and requires the specialized skills of an anesthesiologist trained in regional anesthesia. Recent studies have suggested that surgeons can safely and reliably administer the adductor canal blocks (sACB) during surgery. However, there is currently very limited data on the clinical efficacy of such sACBs, and no studies assessing this technique in the context TKA that are discharged the same day. As such, this randomized control trial (RCT) is being done to compare sACBs to conventional anesthesiologist-performed adductor canal blocks (aACB).

NCT ID: NCT05590312 Recruiting - Anesthesia Clinical Trials

Comparison of Total Oxidant and Total Antioxidant Capacities in Low-Flow and High-Flow General Anesthesia

Start date: August 1, 2022
Phase:
Study type: Observational

The goal of this observational study is to determine whether low-flow anesthesia has a positive contribution to the total oxidant/antioxidant balance.

NCT ID: NCT05570682 Recruiting - Anesthesia Clinical Trials

Manually Controlled Infusion vs Target Controlled Infusion for StrokeThrombectomy

HASTE
Start date: October 9, 2022
Phase: N/A
Study type: Interventional

The goal of this randomized controlled trial is to compare manual general anesthesia induction to general anesthesia induction guided by target controlled infusion system in cerebral ischemic stroke The main questions it aims to answer are: - Does target controlled infusion has a more favorauble hemodynamic profile than manual general anesthesia induction? - Do patients receiving general anesthesia with target controlled infusion system have a more favourable outcome? Participants will receive general anesthesia induction with a target controlled infusion system and will be compared to patients receiving manual general anesthesia induction.

NCT ID: NCT05569460 Recruiting - Anesthesia Clinical Trials

Construction of Perioperative Medical Data Platform and Its Typical Practice to Predict Postoperative Acute Moderate to Severe Pain With Machine Learning Models

Start date: October 2022
Phase:
Study type: Observational

Data intelligence platform was widely used to facilitate the process of clinical research. However, a platform that integrates natural language processing (NLP) and machine learning (ML) algorithms has not been reported in perioperative medical management.

NCT ID: NCT05563025 Recruiting - Anesthesia Clinical Trials

Comparison of Time and Cost Efficiency in Arthroscopic Shoulder Surgery Under Regional Anesthesia vs General Anesthesia

vs
Start date: December 16, 2022
Phase:
Study type: Observational

Arthroscopic Shoulder surgery can be done not only under general anesthesia but also regional technics. In this study we aimed to compare the cost and time effectiveness of regional anesthesia and general anesthesia.

NCT ID: NCT05558826 Recruiting - Anesthesia Clinical Trials

Pressure Analysis of Trendelenburg Position Effect on Indices From Arterial Pressure

Start date: October 1, 2022
Phase:
Study type: Observational

Intraoperative fluid management is key component of care for patients undergoing surgery. Hypovolemia and hypervolemia both associate with increased morbidity, length of stay in the intensive care unit and mortality. Thus, maintaining adequate intravascular volume yet avoiding fluid overload is crucial to achieve optimal outcomes. Goal-directed fluid therapy based on arterial pressure waveform analysis is widely used for intraoperative fluid management and have been shown to improve surgical outcomes compared with conventional clinical assessment in several studies. However, dynamic indices of arterial pressure waveform analysis such as pulse pressure variation (PPV) and stroke volume variation (SVV) are altered by certain situations including elevated intra-abdominal pressure and Trendelenburg position. Intravascular fluid status might thus be misinterpreted. Carbon dioxide pneumoperitoneum with increased intra-abdominal pressure and Trendelenburg position are commonly seen in laparoscopic surgeries including colorectal, gynecological, and genitourinary procedures. Understanding how dynamic indices change in these clinical situations are essential for achieving appropriate intraoperative fluid management. This study focus on identifying the effects of different levels of intra-abdominal pressure and angles of Trendelenburg position on dynamic indices of arterial pressure waveform.

NCT ID: NCT05541588 Recruiting - Anesthesia Clinical Trials

Erector Spinae Plane Block Versus Quadratus Lumborum Block For Postoperative Analgesia After Abdominal Hysterectomy

Start date: July 7, 2022
Phase: N/A
Study type: Interventional

The aim of this study is to compare the analgesic efficacy of erector spinae plane block and quadratus lumborum block after abdominal hysterectomy surgery and postoperative opioid consumption.

NCT ID: NCT05525104 Recruiting - Anesthesia Clinical Trials

The Effect of DSA on Recovery of Anaesthesia in Children (Het Effect Van DSA op Het Herstel na Anesthesie Bij Kinderen).

DSA-RCT-1
Start date: September 5, 2022
Phase: N/A
Study type: Interventional

In this randomised, blinded study, we will investigate the influence of DSA on recovery from general anaesthesia. DSA monitoring provides continuous information on depth of hypnosis. Based on DSA monitoring dose adjustments of sevoflurane can be made. We expect that this will lead to a faster speed of emergence and recovery.