Total hip replacement is one of major orthopedic surgery which result in severe postoperative
pain especially at first 24 hours. Ultrasound guided regional anesthesia has become a part of
multimodal analgesia.Ultrasound guided supra-inguinal fascia iliaca block is a new technique
which can consistently cover femoral and lateral femoral cutaneous nerve. And with large
volume (40ml), it may cover obturator nerve. This technique already proved to be useful for
acute pain control in hip fracture or postoperative control in dynamic hip screw or nail
insertion operation. However, it has not been compared with intrathecal morphine for total
hip replacement yet.
Clinical Trials
Clinical Trial – Intrathecal Bupivacaine-fentanyl and Bupivacaine-dexmedetomidine for Elective Low Segment Caesarean Section
the primary objective of the study is to compare the onset and recovery times of sensory and
motor blockade of the two study drugs intrathecally with low dose bupivacaine The secondary
objectives of the study are to observe hemodynamics, side effects profile, and duration of
postoperative analgesia
Clinical Trial – Acute Hyperbaric Oxygen (HBO) Treatment Increases Hepatic Insulin Sensitivity and Muscle Reactive Oxygen Species in Type 2 Diabetes
Diabetes mellitus type 2 (T2D) is characterized by insulin resistance of liver and skeletal
muscle, which is at least partly due to impaired muscle mitochondrial function. Long-term HBO
therapy, as applied for treating the diabetic foot syndrome, has been shown to improve blood
glucose concentrations. To study the underlying mechanisms, we want to examin the short-term
effect of HBO treatment on insulin sensitivity and mitochondrial oxidative capacity and
production of reactive oxygen species (ROS) in a randomized, double blinded,
placebo-controlled cross-over trial.
Clinical Trial – Height Versus Height and Weight Based Spinal Bupivacaine on Maternal Haemodynamics for Elective Cesarean in Short Stature Patients
Doses of intrathecal bupivacaine based on patients either height or height and weight has
shown to lower the risk of maternal hypotension with similar quality of anesthesia compared
to conventional doses.
In clinical practice there is a tendency of reducing the dose of bupivacaine as either low
fixed dose or using the doses based on either height and weight or height (0.06mg/cm) alone
in parturient with short stature. However, there is lack of evidence regarding the
appropriate dose required in this group of patients. Therefore, our aim is to compare the
height versus height and weight based intrathecal bupivacaine dose for elective caesarean on
maternal haemodynamics in short stature patients.
Clinical Trial – Enhanced Recovery After Laparoscopic Colorectal Surgery Study
The study will assess the impact on quality of care after implementation of the ERAS
(Enhanced Recovery After Surgery) protocol for laparoscopic colorectal surgery in Vilnius
University Hospital Santaros klinikos. The primary goal of this study is to compare efficacy
of two different types of anaesthesia – general and combined (spinal and general), efficacy
of multimodal analgesia in both groups, need for rescue analgetics, time to bowel movement,
time to ambulation. We also aim to study overall patient satisfaction and measure
health-related quality of life, from date of randomisation until the date of hospital
discharge, 30 days, 3 months and 6 months post-discharge.
Clinical Trial – Use of Hyperbaric Oxygen Therapy for the Treatment of Crush Injuries
The purpose of this study is to determine whether using hyperbaric oxygen (HBO) improves
wound healing for patients who have a crush injury. The comparison of the prospective
intervention group to the retrospective matched cohort aims to show that HBO can improve
wound healing and decrease poor outcomes for patients with crush injuries. The information
gained from this small study will serve as a basis for a follow-up prospective, randomized
control trial to further delineate the role of HBO in a larger patient population.
Clinical Trial – Hyperbaric Oxygen for Carbon Monoxide Induced Chronic Encephalopathy
in some patients, a few days or weeks after they recover from carbon monoxide poisoning they
develop new symptoms. These can affect mood, ability to think or remember clearly, and
movements. Some people develop movement problems that are similar to Parkinson’s disease.
This damage to brain tissue is called "encephalopathy," and this study will look at the
effect of pressurized oxygen therapy on long term, or chronic, encephalopathy.
Clinical Trial – Plethysmographic Variability Index in Post Spinal Anesthesia Hypotension in Cesarean Section
– Full term pregnant female patients presented for elective C.S for single viable fetus
will be included in this study.
– Before anesthesia, the patient will be attached to a monitor of: ECG , heart rate, non
invasive blood pressure, pulse taximeter applied on the index finger of the limb not
attached to the blood pressure cuff, pulse oximetry and plethysmographic variability
index (PVI) and perfusion index (PI) will be taken by (Massimo radical 7, Massimo corp.
USA). Measures will be recorded every 5 minutes preoperative.
– Patients with PVI <15 will be excluded from the study.
- Patients with PVI > 15 are started on intravenous infusion of warm ringer lactate
solution via suitable pore intravenous cannula to reach target of PVI <15 or a total 1
liter of ringer lactate.
- The patients in which the PVI is corrected by fluid to level below 15 will be Group (C)
or corrected group. Patients in which intravenous fluid administration did not result
any change in PVI or changed but still higher than 15 will be Group (NC) or non
corrected group.
After preoperative preparation patient is shifted to operating theater, with all monitors
applied. She will receive spinal block at lumbar 3-4 space with hyperbaric bupivacaine 8 mg
plus 25 mic fentanyl. After giving anesthesia and positioning for surgery with a left lateral
tilt of 15 degrees,
Clinical Trial – Erector Spinae Plane Block for Postoperative Pain Control in Hip Replacement Surgeries
ESP block advantages include its simplicity, easy identifiable ultrasonographic landmarks and
low risk for serious complications as injection is into tissue plane that is distant from
pleura, major blood vessels and discrete nerves. Coupled with the fact that the erector
spinae muscle and ESP extend down to the lumbar spine, ESP block was hypothesized to be
performed at the level of L4. In a recent case report, ultrasound guided ESP block was
successfully performed at L4 transverse process level for postoperative analgesia after total
hip arthroplasty. However, confirmation of the efficacy of ESP block in hip replacement
surgeries needed more investigation.
Clinical Trial – Quadratus Lumborum Block Versus Fascia Iliaca Block for Hip Arthroplasty
Quadratus lumborum block is a newly developed block with good performance in lower abdominal
surgery. In a cadaveric study, the spread of local anesthetic in the anterior approach of QL
block (QL3) was reported to cover nerve roots from T10 to L3. Thus, it was hypothesized that
this approach could be used in hip surgeries with minimal motor affection.
This study aims to compare QL3 block and suprainguinal Fascia Iliaca block in the duration of
postoperative analgesia, pain scores, motor power in quadriceps muscle, and side effects.