Surgical Procedure

This observational study focuses on children under 18 years of age with tracheostomies who are followed at the Long-Term Intensive Care Unit LIVA at Karolinska University Hospital in Sweden. It aims to determine how often tracheostomy-related airway complications are asymptomatic or linked to symptoms detected through surveillance airway endoscopy. Additionally, the study evaluates how accurately caregivers and pediatricians can identify symptoms related to serious airway complications. Children scheduled for regular surveillance airway endoscopy under anesthesia as part of their follow-up at LIVA will be included. Upon admission, caregivers complete a questionnaire about possible symptoms of airway complications. The child then undergoes a physical exam and medical history review by a pediatrician following a set protocol. An ENT surgeon, unaware of the questionnaire and pediatrician exam results, performs the airway endoscopy to identify complications. During the study, researchers will compare caregiver and pediatrician reports with findings from airway endoscopy to assess symptom reliability. The main measurements include the proportion of patients with serious tracheostomy airway complications who show no symptoms before endoscopy. The study spans two years, with ongoing surveillance and the collection of data on symptoms and complications. Ethical approval has been obtained to conduct this research.

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 1gkg 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.

Spinal anesthesia-induced hypotension is a common and significant complication affecting up to 50-80% of pregnant women undergoing elective cesarean section. This trial evaluates whether a brief 5-minute mindfulness-based breathing exercise given just before spinal anesthesia can influence blood pressure changes during surgery. The study compares this breathing technique to standard care in pregnant women aged 18 to 45 years scheduled for elective cesarean delivery. Participants will be randomly assigned to either perform the mindfulness-based breathing exercise or receive standard preoperative care. The breathing exercise involves slow diaphragmatic breathing at about six breaths per minute, guided by a trained anesthesiologist or nurse, with mindful repetition of the phrase My body is relaxing as I exhale. Both groups receive spinal anesthesia with specific medications, and careful monitoring of heart rate and blood pressure is performed. During the study, participants will be closely observed for changes in systolic blood pressure and heart rate within 10 minutes after spinal anesthesia. Anxiety levels, incidence of early hypotension, and medication use to support blood pressure will also be measured. The trial includes standard monitoring such as ECG and oxygen saturation, with safety and response data collected throughout the procedure. Participants involvement includes a short breathing exercise or equivalent wait time before anesthesia, with follow-up assessments during surgery.

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 evaluate the impact of artificial intelligence AI-assisted mobilization education on patients undergoing total knee arthroplasty, focusing on reducing fear of movement kinesiophobia and improving readiness for hospital discharge. The study involves adult patients having their first total knee replacement and compares AI-assisted education with standard care. Early mobilization after surgery is important for recovery, and this study explores whether AI-based education can better prepare patients for this process. Participants are divided into two groups a control group receiving standard verbal mobilization education and an intervention group receiving an AI-assisted video-based mobilization education delivered by a nurse before the first postoperative mobilization. Both groups complete assessments of kinesiophobia using the Tampa Scale before and after education on the first day after surgery. Readiness for hospital discharge is measured by both patient and nurse assessments about four hours before discharge. During the study, participants complete personal information forms and undergo evaluations on postoperative day 1 and shortly before discharge. Researchers collect and analyze data on kinesiophobia changes and readiness for discharge using validated scales. The study includes 72 patients and is designed to provide evidence on whether AI-assisted education can support recovery and discharge preparation. Participation lasts from hospital admission through to discharge, with assessments focused around early postoperative mobilization.

This research aims to evaluate a web-based decision support tool designed to help men make informed choices about vasectomy and other birth control options. The study focuses on understanding whether the decision aid improves users knowledge about vasectomy, reduces decisional conflict, and influences interest in vasectomy compared to men who do not use the tool. The trial is randomized and compares two groups to assess these outcomes. Participants are randomly assigned to either use the Vasectomy Right for Me web-based decision aid or to complete a survey without using the decision aid. Those in the decision aid arm engage with the tool to learn about vasectomy and alternative contraception methods before answering survey questions. The control group completes the survey directly after randomization without access to the decision aid. During the study, participants will complete surveys assessing their knowledge about vasectomy, their decisional conflict regarding contraceptive choices, and their interest in vasectomy. These assessments occur up to 45 minutes after the assigned intervention or survey completion. The study is sponsored by the University of Pittsburgh and aims to better understand factors that influence mens reproductive decisions related to vasectomy.

Failure to rescue refers to preventable deaths after surgery due to delays in identifying and treating complications. This research aims to evaluate whether a quality improvement intervention called 5 Rs to Rescue can enhance monitoring and care for surgical patients in hospitals across four African countries Ethiopia, South Africa, Tanzania, and Uganda. The study uses a multi-center, cluster trial design with mixed methods to assess the interventions impact on reducing postoperative deaths. The 5 Rs to Rescue intervention focuses on five key areas assessing risk with the ASOS risk score, recognizing patient deterioration through regular vital signs and an Early Warning Score system, responding promptly using care pathways for common complications, reassessing patients after deterioration, and reflecting on care during regular meetings. This complex intervention is implemented in participating hospitals to improve patient surveillance after surgery. Participants are adults aged 18 and older who have surgery and receive postoperative care on study wards. Researchers will monitor the effectiveness of the intervention by reporting site-specific findings related to reducing in-hospital deaths within 72 hours after surgery. The study includes process evaluations and ongoing reflections to understand how the program works in practice. Participation involves routine monitoring and data collection during the postoperative period, with study completion expected by September 2026.

Researchers are evaluating whether taking tirzepatide before bariatric surgery can improve health outcomes for people with obesity and related medical conditions. This study aims to see if tirzepatide reduces inflammation in tissues and blood before surgery and how these changes relate to weight loss, metabolic improvements, and fewer complications after surgery. The trial is a Phase 4 interventional study comparing patients who take tirzepatide with those who do not before their planned surgery. Participants who are assigned to the tirzepatide group will self-inject 2.5 mg of tirzepatide once weekly for three months before surgery, following dose escalation instructions if needed. Both groups will receive education on dietary and lifestyle changes. During the three months before surgery, participants will visit the endocrine clinic monthly for drug prescription and side effect monitoring. The study continues through the surgery and post-surgery follow-up periods. Throughout the study, participants will keep a diary of drug use and side effects, and researchers will measure inflammatory markers such as C-reactive protein, interleukin 6, tumor necrosis factor, leptin, adiponectin, and RAAS at baseline, three months after drug use, and several times after surgery. Weight, blood pressure, blood sugar, cholesterol, and surgical complications will also be tracked up to one year after surgery. Participant involvement includes regular clinic visits, lab tests, and monitoring to assess the impact of tirzepatide on surgical outcomes and inflammation.

This research investigates alveolar ridge preservation after tooth extraction by examining different methods to support bone regeneration. It focuses on the use of autologous tooth root slices, bone graft materials, collagen plugs, and vitamin D3 to improve healing and bone formation in the extraction site. Advanced 2D and 3D imaging technologies are used to monitor bone regeneration without invasive biopsies. The study evaluates if combining these biological materials and treatments can increase bone formation rates and stabilize the wound more effectively than traditional methods. Participants are randomly assigned to one of four groups receiving different combinations of treatments bone graft with collagen plug alone bone graft, collagen plug, and local vitamin D3 bone graft, collagen plug, and autologous tooth root slices or bone graft, collagen plug, vitamin D3, and autologous tooth root slices. The autologous tooth root slices are placed over the extraction socket to seal it and help protect bone graft materials, while the skin flap is surgically raised to cover and stabilize the tooth root cover. This approach aims to reduce contamination and promote faster healing. Throughout the study, participants undergo imaging assessments including 3D computed tomography, periapical X-rays, and intraoral scans at the start and between weeks 12 to 16 after extraction. Implant stability is also measured between weeks 16 and 24. These evaluations help researchers observe bone regeneration progress and wound healing. The total participant involvement spans from initial tooth extraction through follow-up periods to assess treatment effects and implant stability.

Researchers are studying craniofacial deformities, which affect facial appearance and oral function, to better understand the results of autologous fat grafting, a common treatment for facial concave deformities. The study focuses on measuring how much transplanted fat remains over time, as the absorption rate of fat varies widely and affects treatment outcomes. This observational trial uses advanced 3D facial scanning technology to improve the accuracy of these measurements and explore individual factors influencing fat graft survival. Participants will undergo autologous fat grafting surgery, and their facial volume will be measured using the 3dMD face system before surgery, immediately after, and six months later. This technology captures precise three-dimensional facial images and calculates volume changes to determine fat retention rates. The study will analyze data from 100 patients to assess fat absorption and investigate how factors like age, physical health, and surgical technique affect results. During the study, participants will have 3D facial scans at three key timepoints before surgery, immediately post-surgery, and six months after. Researchers will analyze these scans to calculate the fat retention rate and assess patient satisfaction at four weeks and one year after surgery. The study aims to provide detailed, objective data to improve understanding of fat grafting outcomes and support better treatment strategies for craniofacial deformities.