Anesthesia

This research aims to assess the current work situation of anaesthesiology services in Spain, 20 years after the first comprehensive record called ANESCAT 2003. It evaluates whether the increase in healthcare activity matches the growth in resources allocated to the specialty and provides objective data for future planning and demands. The study focuses on collecting data on anaesthesia activities across several areas, including surgical procedures, intensive care units, chronic pain units, and delivery rooms. This data is gathered through various questionnaires covering a 14-day activity period over the course of one year. Participants will be involved by having their anaesthesia work activity recorded during this 14-day period. Researchers will measure the extent of anaesthesia services in different clinical settings and evaluate staff activity levels, as well as the role of anaesthesiology in managing polytrauma patients and cardiorespiratory arrest. The study spans one year to capture comprehensive activity data.

Researchers are studying recovery after heart surgery for people with Complex Congenital Heart Disease (CCHD) to understand the main risk factors affecting recovery. The study also aims to build a comprehensive data platform to support CCHD care throughout a person's life and develop a China-specific quality control system to improve surgical outcomes and guide national health policies. The study includes two groups: a retrospective group of 2,494 patients who already had CCHD surgery and are in an existing national database, and a prospective group of 1,940 patients scheduled for surgery as part of related sub-studies. Data collected include pre-surgery tests, surgical details, care during and after surgery, and follow-up for up to one year. Researchers will combine data from both groups to build a new registry and quality control system. Participants will have their medical records analyzed or have data collected during their care, depending on their group. Researchers will monitor recovery and outcomes up to one year after surgery, using the combined data to identify risk factors and develop a surgical quality control system. The study spans up to 48 months, aiming to improve CCHD care across all ages in China.

Researchers are comparing two pharmacokinetic models, Eleveld and Schnider, for administering propofol sedation in mechanically ventilated patients in the intensive care unit (ICU). This observational study aims to assess which model better controls sedation depth, maintains hemodynamic stability, and supports faster recovery. The study uses sedation scales and monitoring tools like the Bispectral Index (BIS) and Riker Sedation-Agitation Scale to evaluate patient responses and safety. Participants will receive propofol through a target-controlled infusion (TCI) system guided by either the Eleveld or Schnider model. Sedation will be adjusted to maintain a Riker score between 3 and 4 and a BIS value between 60 and 80. Researchers will record hemodynamic variables, total propofol dosage, awakening time, and incidence of delirium after sedation withdrawal. No other sedatives or hypnotics will be used during sedation. During the study, patients will be monitored for sedation accuracy using BIS values for up to 72 hours. Assessments will include the proportion of time patients remain within the target sedation range. Data such as medical history, laboratory tests, and sedation depth will be collected and analyzed. The study will help identify the most reliable model for safe and effective sedation in ICU settings, with continuous monitoring of patient safety and sedation effects throughout the sedation period.

Researchers are investigating a new method to help locate a specific vein on the forearm (the distal cephalic vein) in young children undergoing surgery. This study focuses on children under six years old having elective procedures under general anesthesia. The goal is to find a simple, reliable anatomical landmark to guide the placement of a topical anesthetic patch (EMLA) to ease venipuncture, which can be challenging due to small or hard-to-see veins in young children. Ultrasound is used as a reference standard to validate the landmark's accuracy. The study has two parts: first, ultrasound is used to map and mark the vein's course on the skin during anesthesia, and photographic documentation is collected to develop the landmark. In the second part, anesthesia staff and parents apply the landmark or an EMLA patch guided by a visual instruction, and ultrasound checks if the vein lies beneath the marked or treated area. No additional needle punctures or blood samples are taken beyond routine care. Participants contribute data at one time point during their surgery preparation. Ultrasound measurements include whether the vein is under the marked area, vein depth, diameter, and course. Data are collected securely and pseudonymized. The study involves no added risks, no additional pain, and no biological samples. The main outcome is the success rate of locating the vein within the marked or EMLA-covered area during anesthesia.

Researchers are evaluating the use of local versus general anesthesia for inguinal hernia repair in Veterans aged 60 years and older. This pilot study aims to gather data to plan a larger, multisite randomized clinical trial by testing study procedures, recruiting participants, and measuring relevant outcomes. The study also seeks to identify barriers to wider use of local anesthesia and to provide training in clinical trial design and conduct. Participants are randomly assigned to one of three groups: open inguinal hernia repair with local anesthesia, open inguinal hernia repair with general anesthesia, or laparoscopic/robotic hernia repair with general anesthesia. Local anesthesia involves injecting a mix of lidocaine with epinephrine and Marcaine at the surgical site along with intravenous sedation and pain medication. General anesthesia uses inhaled and intravenous anesthesia. The laparoscopic or robotic approach is included as it cannot be performed using local anesthesia. During the 6-month study period, participants will undergo surgery and anesthesia as assigned, followed by evaluations at various time points including baseline, 48 hours, 2 weeks, and 6 months after surgery. Researchers will collect data on enrollment rates, participant retention, time to complete assessments, satisfaction, pain levels, cognitive function, delirium, postoperative complications, and recovery times. This information will help refine study instruments and inform the design of future larger trials.

Researchers are evaluating three different doses of perineural dexmedetomidine—0.67 mcg/kg, 1 mcg/kg, and 1.33 mcg/kg—as added medicines to local anesthetics for ultrasound-guided infraclavicular brachial plexus blocks in patients undergoing upper extremity surgery at or below the elbow. The study aims to see if higher doses provide longer motor block durations, which is the main measure of the drug's effect, since pain medication and surgical trauma can influence other durations like sensory and analgesic effects. In this study, 69 patients will receive ultrasound-guided infraclavicular brachial plexus blocks with a standard local anesthetic mix including lidocaine, bupivacaine, epinephrine, and dexamethasone. They will be randomly assigned to one of three groups, each receiving a different dose of perineural dexmedetomidine added to the anesthetic solution: 0.67 mcg/kg, 1 mcg/kg, or 1.33 mcg/kg. The procedure is done before surgery with careful monitoring, and the study is blinded so patients and assessors do not know which dose is given. Participants will record the time when their motor function returns after the nerve block, and data will be collected either in person or by phone on the first day after surgery. The researchers will also assess various secondary outcomes such as sensory block duration, pain intensity, block onset, and possible side effects like respiratory depression or nerve issues. The study follows patients for up to 7 days after surgery to monitor safety and effectiveness of the different doses.

Many newborn babies experience breathing difficulties that require intubation, a procedure where a tube is inserted into the windpipe to help with breathing support. This trial compares two methods used by doctors to perform intubation: the traditional direct laryngoscopy (DL), where doctors look directly into the baby's mouth with a standard laryngoscope, and video laryngoscopy (VL), which uses a camera and screen to view the windpipe. The study aims to determine if VL leads to more successful first attempts without causing drops in oxygen levels or heart rate compared to DL. The trial uses a stepped-wedge cluster randomized design across multiple hospitals. Initially, each hospital uses the standard DL method for intubation. At randomly assigned intervals, hospitals switch to using the VL device, the C-MAC video laryngoscope, which includes a monitor and special blades. Doctors receive training and practice with this device before switching. Other intubation practices, such as drug use and supplemental oxygen, remain the same throughout the study. Participants in the trial are newborn infants undergoing intubation. Researchers will collect information about intubation attempts, including success rates, oxygen levels, heart rates, and any complications like oral trauma or need for chest compressions. The main outcome is whether babies are successfully intubated on the first try without physiological instability within five minutes. Additional measures include procedure time, number of attempts, and adverse events. Data will be compared between the periods using DL and VL to assess effectiveness and safety over the course of the study, which lasts until August 2026.

Researchers are evaluating the safety and effectiveness of bupivacaine liposome injection for local pain relief in children aged 6 to 17 undergoing orthopedic surgery. This Phase 4 study focuses on real-world use of this treatment to manage acute postoperative pain. The study is sponsored by Jiangsu HengRui Medicine Co., Ltd. and aims to understand how well this analgesic works and its safety profile in pediatric patients. Participants will receive bupivacaine liposome injection at a dose of 4 mg/kg, up to a maximum of 266 mg, applied locally during surgery. The study observes patients from the time of administration through the postoperative period, monitoring pain control and the need for additional opioid pain medications. This is an interventional study without masking or placebo control. During the study, researchers will closely track adverse events related to the heart and nervous system for up to 14 days after treatment. They will measure opioid use, time to first opioid rescue medication, pain scores at rest and during movement for different age groups, and length of hospital stay up to two weeks. Participants will undergo regular assessments to evaluate pain relief and safety throughout the 72-hour postoperative period and beyond.

This research aims to understand how heart function and blood flow change in people receiving general anesthesia during surgery. The focus is on those who experience low blood pressure, known as post-induction hypotension, shortly after anesthesia is given. The study is observational and seeks to clarify how anesthesia affects heart pumping and circulation. Participants will receive standard anesthesia and perioperative care while researchers perform additional monitoring using echocardiography and Clearsight blood pressure measurements. These measurements happen before anesthesia, immediately after induction, and following intubation, continuing for 20 minutes to track changes in heart function and blood pressure. During the study, participants will undergo routine care with extra heart and blood flow assessments. Researchers will measure the proportion of patients experiencing low blood pressure within 20 minutes after anesthesia starts. The study involves monitoring vital signs and heart function with specialized equipment to gather detailed data on cardiovascular changes during surgery.

Researchers are studying the effects of Huperzine A Injection on reducing postoperative delirium in elderly patients aged 75 and older who are undergoing non-cardiac surgery. This randomized, double-blinded, placebo-controlled trial aims to observe how this treatment may influence the occurrence of delirium after surgery in this older population. Participants will be randomly assigned to receive either Huperzine A Injection or a placebo of 0.9% Sodium Chloride Injection during their non-cardiac surgical procedure. The study includes patients with an anesthesia grade of III to IV and an estimated operation time of at least 2 hours. The treatments will be administered under controlled conditions to carefully assess their effects on postoperative delirium. During the study, participants will be monitored for delirium incidence within 7 days after surgery, with additional evaluations at 24, 48, and 72 hours post-operation. Researchers will also assess the type, severity, and duration of delirium, length of hospital stay, economic costs, complications, mortality rates, and cognitive function using the Mini-mental State Examination and EuroQol scale. Follow-up assessments will continue up to 2 months after surgery, with some evaluations occurring around 30 days after discharge.