Clinical Trials

Clinical Trial – Comparison of Three Different Sitting Positions for Performing Combined Spinal-Epidural Anesthesia

In this prospective and randomized study, we aimed to compare the effect of of three sitting
positions (the traditional sitting position (TSP), the harmstring stretch position (HSP), and
the squatting position on the success rate of combined spinal epidural anesthesia in patients
undergoing total knee arhtoplasty (TKA) or total hip arthroplasty (THA) surgery.

Clinical Trial – Hyperbaric Oxygenation Treatment and Quality of Life

Osteoradionecrosis, dermal soft tissue necrosis, radiation cystitis, proctitis and sexual
dysfunctions are well-known late-effects after radiation for cancer in the pelvic area,
negatively affecting the survivors’ quality of life (QOL) and psychosocial wellbeing.
Increasing evidence and clinical practice support the use of hyperbaric oxygen treatment
(HBOT) as an effective treatment in a variety of radiation injuries, but this is still a
field with limited research and knowledge. Especially, there is a knowledge gap on how late
radiation tissue injury (LRTI) influences cancer survivors’ QOL and psychosocial health in a
longitudinal perspective (before, along and after HBOT), as well as the patients’ knowledge,
expectation and experience from this treatment. This study aims to improve knowledge on these
issues.

Clinical Trial – Influence of Injection Rate of Intrathecal Mixture of Local Anesthesia on Hypotension in Cesarean Section

Hypotension is the most common complication of neuraxial anesthesia in obstetric patients and
its prevalence in cesarean section is about 50-90%. Maternal hypotension causes unpleasant
symptoms such as nausea, vomiting, loss of consciousness, respiratory depression, and cardiac
arrest. Hypotension may reduce placental perfusion and result in fetal acidosis and
neurological injury. Several techniques have been proposed to prevent hypotension.

The recommended spinal block height to ensure patient comfort for Cesarean delivery is T4-6.
Clinically, it is desirable that the spread of local anesthetic through the cerebrospinal
fluid (CSF) achieves a sensory level no higher than the T4 dermatome to avoid extensive
sympathetic block. It is also important that the spinal block level be no lower than T6 to
avoid patient discomfort during peritoneal manipulation and uterine exteriorization. The
effect of injection speed on spread of spinal anesthesia is controversial. Several studies
have demonstrated more extensive spread with faster injection while others report either
greater spread with slower injection, or no difference. Slow injection of hyperbaric
bupivacaine 10 mg over 60 and 120 sec has been shown to reduce the incidence and severity of
hypotension during Cesarean delivery under spinal anesthesia.

Clinical Trial – Enhanced Recovery After Surgery for Emergency Caesarean Deliveries

Caesarean section (CS) constitutes a large proportion of the total surgical volume in
low-income countries. This rate comes with challenges including surgical complications,
shortage of beds, and consequently long waiting time for operations and high costs. These
have led to the adoption of ERAS in developed countries in a bid to save costs by reducing
hospital length of stay without compromising the health of the mother and her baby.

Clinical Trial – Caudal Block,Saddle Block, Anorectal Surgery

Anorectal surgery includes pilonidal sinus, hemorrhoidectomy, anal fissure, and anal fistula
operations. Various surgical and anesthetic techniques have been used to increase the level
of analgesia in perioperative period and decrease the length of stay in the hospital. In this
study, investigators investigate the effects of routinely applied anesthesia techniques
during anorectal surgery, caudal block and saddle block, on patients’ perioperative
hemodynamic values, sensory and motor block levels, and postoperative pain scores.

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