Montreal Est

Researchers are evaluating the effects of esmolol, a short-acting beta-blocker, on pain management during general anesthesia in adults aged 18 to 65 undergoing laparoscopic or lower abdominal surgery. The study aims to see how esmolol impacts the amount of remifentanil, an opioid, given during surgery and the level of postoperative pain experienced in the recovery room. This research responds to challenges with opioid use, including side effects and opioid-related problems, by exploring alternative pain control methods combined with nociception monitoring. Participants will be randomly assigned to receive either esmolol or a saline placebo during their surgery. Esmolol will be given as a bolus dose at anesthesia induction followed by a continuous infusion until the end of the procedure. General anesthesia will be induced with propofol and remifentanil, with nociception levels monitored to guide remifentanil dosing. Hypnosis will be maintained with sevoflurane, aiming for specific brain activity and anesthetic concentration levels. The control group will receive saline under the same conditions. During the study, researchers will monitor the amount of remifentanil used during surgery as the primary outcome. They will also assess variations in nociception levels, heart rate, blood pressure, doses of other medications, and the timing of any low blood pressure or slow heart rate episodes. After surgery, pain intensity and the need for pain relief medication will be recorded in the Post-Anesthesia Care Unit. The study is expected to last 12 months and includes safety monitoring for side effects related to esmolol.

Researchers are evaluating the new LithoVue Elite disposable flexible ureteroscope in adults with kidney stones undergoing ureteroscopy and laser lithotripsy. This multicenter, single-arm prospective trial involves 150 participants across 6 institutions. The study aims to compare the new scope's performance to standard ureteroscopes, focusing on stone clearance rates, intraoperative parameters, and postoperative outcomes such as pain, quality of life, and infection rates. The study also measures changes in specific urine biomarkers related to kidney injury. Participants will undergo ureteroscopy using the LithoVue Elite device. The procedure details, including use of safety guidewires, ureteral access sheath, laser settings, and irrigation, are determined by the surgeon. Intraoperative pressure readings from the device will be recorded. Postoperative care, including stent placement and medication, follows standard practices. Follow-up visits occur at 1-2 weeks for stent removal and 4-8 weeks for imaging to assess stone clearance. During the study, participants complete questionnaires on pain and quality of life at baseline, immediately after surgery, and during follow-ups. Clinical data, laboratory tests including urine biomarker NGAL, and imaging results are collected. Data is securely managed using electronic tools and stored for 10 years. Safety monitoring includes assessment of vital signs and complications. Participation lasts approximately 4-8 weeks after surgery.