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 persons 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 evaluating the safety and effectiveness of two sedation combinations, ketamine-propofol and dexmedetomidine-propofol, in children aged 2 to 12 undergoing cardiac catheterization to close simple left-to-right heart shunts. This phase 1 clinical trial focuses on pediatric patients having elective transcatheter device closure procedures for defects such as atrial septal defect, ventricular septal defect, or patent ductus arteriosus. Participants will be randomly assigned to receive one of two sedation regimens during their procedure. One group will receive an initial IV bolus of ketamine followed by a propofol infusion, while the other group will receive a dexmedetomidine loading dose and propofol infusion. Both treatments allow additional propofol doses if sedation is inadequate. The study monitors sedation during the procedure guided by echocardiography. Throughout the trial, children will be closely monitored for respiratory complications, heart rate, blood pressure, sedation quality, and recovery time within two hours after sedation. Safety and sedation levels will be assessed continuously to compare the two sedation methods. Participation involves the procedure and related assessments, with follow-up monitoring conducted during and shortly after the intervention.

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 laparoscopicrobotic 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.

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 babys 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 mgkg, 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.

Researchers are studying how general anesthesia affects heart function and blood flow, particularly focusing on people who experience low blood pressure shortly after anesthesia is given. The goal is to better understand the changes in heart pumping and blood flow during surgery. This observational study involves adult patients who require general anesthesia and intubation for surgery, with a planned preparation time before incision. During the study, participants will receive routine anesthetic and perioperative care enhanced by echocardiography and a non-invasive blood pressure cuff to measure blood pressure at intervals of 2.5 to 5 minutes. These measurements will be taken before anesthesia induction, immediately after, and following intubation, continuing for up to 20 minutes total. This approach allows researchers to closely monitor heart function and blood flow changes in real time. Participants will undergo monitoring with echocardiography and blood pressure measurements during the anesthesia induction period. Researchers will assess the proportion of patients who experience low blood pressure within 20 minutes after anesthesia begins. The study does not involve experimental treatments, and all care follows standard surgical procedures. Participation duration includes the anesthesia induction and monitoring period during surgery preparation.

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.

Researchers are conducting a multi-center, randomized, open-label clinical study to evaluate and improve the accuracy of the target-controlled infusion TCI model for cipepofol during general anesthesia in patients undergoing elective surgery. The study aims to verify and optimize the infusion parameters to ensure precise control of drug delivery in this setting. Participants will be randomly assigned to one of two groups receiving different plasma target-controlled concentrations of cipepofol during anesthesia induction a low concentration group 0.9 bcgml and a high concentration group 1.2 bcgml. An interim analysis will be done after collecting about 5% of data from each group to evaluate key parameters like the effect-site equilibrium rate constant Ke0. During the study, participants will undergo general anesthesia with tracheal intubation for elective surgeries lasting at least one hour. Researchers will monitor vital signs, anesthesia effects, and infusion accuracy, focusing on optimizing parameters such as CeLoCCeRoC and Ke0 within two hours. The study will include screening for eligibility, informed consent, and close observation throughout surgery with ongoing assessments to ensure safety and data quality.