Postoperative Pain

Researchers are evaluating the use of transversus abdominis plane (TAP) block with different adjuvants to improve pain relief after laparotomy surgery. This study compares the addition of dexamethasone or dexmedetomidine to bupivacaine in patients aged 25 to 65 years with ASA Class I or II status. The goal is to assess which combination provides longer-lasting postoperative analgesia and reduces the need for additional pain medication. Participants will be randomly assigned to one of two groups. Group A receives a TAP block with 18ml of 0.25% bupivacaine plus 2ml of dexamethasone (8mg). Group B receives the same bupivacaine dose plus 2ml of dexmedetomidine (1µg/kg diluted in saline). The TAP block is administered bilaterally under ultrasound guidance immediately after surgery, using a needle guided between the internal oblique and transversus abdominis muscles. Patients are monitored for complications like local anesthetic toxicity or hematoma. During the 24-hour postoperative period, patients' pain levels will be measured using a Visual Analogue Scale (VAS) at several time points. If pain is insufficiently controlled (VAS ≥4), rescue analgesia with IV ketorolac will be provided and the time to first rescue dose recorded. Additional assessments include monitoring nausea, vomiting, heart rate, and blood pressure. The primary outcome is the duration until the first request for rescue analgesia, with secondary outcomes focused on pain scores over 24 hours.

This research aims to compare the effectiveness of topical lignocaine ointment versus 0.2% glyceryl trinitrate (GTN) ointment for reducing postoperative pain and promoting wound healing in patients undergoing hemorrhoidectomy. Hemorrhoids are swollen veins in the anal area, and pain after surgery can delay recovery and affect comfort. The study focuses on determining which ointment provides better pain relief and wound healing outcomes following hemorrhoid removal surgery. Patients undergoing hemorrhoidectomy will be randomly assigned to one of two groups. One group will receive lignocaine ointment applied locally to the anal wound three times daily after surgery, while the other group will receive 0.2% GTN ointment on the same schedule. Both groups will receive standard postoperative care including sitz baths, stool softeners, and paracetamol for pain relief. The study will follow participants for 3 to 6 months overall, with treatment and monitoring focused on the first month after surgery. Participants will have their pain levels assessed using a visual analog scale (VAS) at various times after surgery, including 6, 12, 24, 48, and 72 hours, as well as at 7, 14, 21, and 28 days. Wound healing time will be tracked up to one month, and patient satisfaction will be measured at 6 weeks using a 5-point scale. Additional monitoring includes recording the time to first analgesic request, analgesia amounts, and any side effects such as wound secretion, itching, bleeding, or headaches. Data will be analyzed to compare outcomes between the two ointments.

Researchers are investigating the effectiveness of the "Pontic-shield" technique in preserving the alveolar ridge after tooth extraction. This study compares this technique with two other approaches: ridge preservation using deproteinized bovine bone and a porcine collagen membrane, and no intervention after extraction (fresh socket). The trial aims to understand which method better maintains bone structure, addressing challenges in long-term dental implant success. The study is a three-arm randomized clinical trial. Participants are assigned to one of three groups: the experimental group receiving the "Pontic-shield" technique, where a 1mm thick fragment of the tooth root is left in place; the positive control group receiving ridge preservation with bovine bone and collagen membrane; and the negative control group receiving no insertion after extraction, allowing the blood clot to form naturally. A cone-beam computed tomography scan is done before extraction and again four months after to evaluate bone changes. Participants will undergo tooth extraction and assigned treatment. Their bone resorption is measured from extraction day to four months after. Satisfaction is also assessed using a visual analogue scale during the first week post-surgery. The study includes adults aged 18 to 80 who require extraction of specific teeth and agree to participate. Safety and healing are monitored throughout. Total follow-up lasts at least four months after extraction to assess outcomes.

This research aims to understand how thumb-tack needle therapy affects sleep and recovery after surgery in patients who have undergone general anesthesia for breast cancer surgery. The study focuses on improving postoperative sleep quality, preventing sleep disorders, and promoting recovery following surgery. Participants are women aged 18 to 55 years with no history of chronic insomnia or recent use of sedative-hypnotic drugs. Participants in this observational study will undergo thumb-tack needle therapy as part of their postoperative care. The therapy's impact will be monitored without assigning different treatment groups. The study will follow patients before and after anesthesia exposure to observe changes in sleep quality and recovery. During the study, researchers will assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) one or two days before anesthesia and on days 1, 3, and 7 after anesthesia. Recovery will also be evaluated with the QoR-40 questionnaire on the third day after surgery. The study monitors patient progress to explore the clinical significance of thumb-tack needle therapy in improving postoperative outcomes.

Researchers are evaluating the analgesic effect and safety of a mixed reality (MR) based cognitive distraction focus relaxation therapy for patients diagnosed with chronic moderate to severe pain. This multicenter, prospective, single-blind, randomized, and parallel controlled trial aims to assess the impact of a digital chronic pain treatment system using MR technology as part of basic clinical care for chronic pain patients. Participants are assigned to one of two groups: the pain key group receiving mixed reality pain treatment software with MR-based pain scenarios, or a control group exposed to the same content displayed on a 2D TV screen. The study compares these approaches to understand the role of MR technology in managing chronic pain. During the study, participants will be monitored using the Visual Analogue Scale (VAS) to measure pain levels over three days. Researchers will collect data on pain intensity and safety outcomes while participants follow the treatment protocols. The trial runs from October 2023 to June 2025, involving adults aged 18 to 85 years with chronic pain lasting more than three months.

Researchers are evaluating the efficacy and safety of HSK21542 injection for managing postoperative pain in patients undergoing orthopedic surgery. This is a Phase III, multi-center, randomized, double-blind, placebo and active-controlled study involving 405 participants. The trial compares HSK21542, morphine, and placebo to understand their effects on pain relief after surgery. Participants will be randomly assigned to receive either HSK21542, morphine, or a placebo. The study treatments are administered following surgery under general anesthesia, specifically for patients undergoing hip replacement. The trial monitors pain intensity and other effects over a 48-hour period post-treatment. During the study, participants will be assessed for pain relief using the Sum of Pain Intensity Differences (SPID) at 48 hours as the primary measure. Secondary measures include nausea and vomiting occurrence, additional pain assessments at shorter intervals, rescue medication use, and total morphine consumption. Safety and effectiveness will be closely monitored throughout the trial lasting until March 2026.

Researchers are studying whether a continuous intravenous lidocaine infusion after major reconstructive spinal surgery can reduce the risk and severity of postoperative delirium and lessen opioid-related side effects in elderly patients. Postoperative delirium is common after non-cardiac surgery and linked to poor outcomes, with poor pain control being a modifiable risk factor. This study is a randomized, double-blinded, placebo-controlled trial involving 60 patients undergoing major elective spine surgery involving more than three levels of instrumentation and fusion. Participants will be randomly assigned to receive either a lidocaine infusion at 1.33 mg/kg/hr based on adjusted body weight or a placebo (D5 water) intravenously for 48 hours following surgery. Anesthetic management during surgery is standardized with total intravenous anesthesia including propofol, lidocaine, magnesium, fentanyl, and sevoflurane. The lidocaine infusion or placebo begins postoperatively before discharge from the post-anesthetic care unit or upon intensive care unit arrival. During the study, participants will be monitored for the incidence and severity of postoperative delirium from 24 hours after starting the infusion to 3 days post-surgery. Researchers will also assess opioid use, pain scores, opioid-related side effects, analgesic satisfaction, functional recovery using surveys and physical therapy participation, time to discharge, and cognitive function up to 3 months. Safety and tolerability of lidocaine will be closely observed, with continuous monitoring during and after surgery. The total follow-up includes assessments up to hospital discharge and longer-term functional outcomes at 3 months.

Researchers are investigating treatments for temporomandibular disorders (TMD), which are increasingly common and affect jaw function and cause pain. This study aims to evaluate whether combining manual therapy with vagus nerve stimulation, a nerve linked to pain and jaw function, offers better relief and improved quality of life than manual therapy alone. The study involves 20 participants diagnosed with myogenic TMD, focusing on pain, jaw movement, and distress. Participants are randomly assigned to one of two groups: one receiving manual therapy combined with vagus nerve stimulation and the other receiving only manual therapy. Both groups undergo four physiotherapy sessions, one per week over a month, and are trained to continue treatment exercises at home over two months. The manual therapy includes joint manipulation and soft tissue techniques for the jaw. Throughout the study, an independent evaluator will assess participants monthly using questionnaires to measure chronic pain, jaw function, physical symptoms, range of motion, and distress. The main outcomes are changes in health status and chronic pain after two months. This double-blind, randomized study ensures unbiased results by keeping evaluators unaware of group assignments. Participant involvement spans two months of treatment and assessments.

Surgical pain after operations is a common problem that can affect recovery and treatment quality. Over 20% of patients experience chronic pain following surgery. In China, more than 70 million surgeries occur annually. This trial investigates the effects of a newly developed nerve block needle compared to a standard nerve block needle on managing both acute and chronic postoperative pain, aiming to find better methods for pain relief after surgery. The study compares two types of nerve block needles used under ultrasound guidance: an echogenic needle and a non-echogenic needle. Both procedures involve injecting 20 ml of 0.375% ropivacaine at the needle tip to help control pain. Researchers will evaluate the spread of medication, the duration of nerve blockade, the number of needle punctures, and any related complications. Participants will be randomly assigned to one of these needle groups. Participants will be monitored for acute pain immediately after surgery and up to 24 hours afterward, as well as chronic pain three months post-surgery. Additional assessments include measuring puncture operation time and tracking any complications. The study duration includes time from surgery through follow-up visits at specified intervals. All evaluations aim to understand how these needles impact pain management and patient recovery.

Researchers are conducting a first-in-human, randomized, placebo-controlled study to assess the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of TT5 given at different doses in healthy volunteers and surgical patients. This phase 1 trial includes both single and multiple ascending dose parts and involves healthy and surgical participants aged 18 to 55 years. The study aims to explore TT5's effects, including psychological responses and potential fluid biomarkers. The study consists of three parts: Part A tests single ascending intravenous doses of TT5 in healthy participants across up to five dose levels; Part B evaluates multiple ascending doses over seven days in healthy participants with up to three dose levels; and Part C administers intravenous doses on the same day to surgical patients in up to three dose levels. Both TT5 and placebo (vehicle) are given intravenously, and dosing schedules vary according to the study part. Participants will be monitored for adverse events, vital signs, physical exams, laboratory tests, and psychological responses using tools like the Bond and Lader Visual Analog Scale. Pharmacokinetic measurements will include plasma and urine analysis over specified days. Safety and tolerability will be assessed through day 8 for single doses and day 14 for multiple doses. The total study duration varies by cohort, with close follow-up during and after dosing to evaluate TT5's effects and safety.