Al Arab

Spinal anesthesia is commonly used for lower limb orthopedic surgeries due to its cost-effectiveness and ease of application, but its effectiveness is limited by the short duration of action of local anesthetics like 0.5% heavy bupivacaine. To improve this, researchers are studying adjuvants such as dexmedetomidine and fentanyl, which are added to local anesthetics to enhance their effects, speed onset, prolong the block duration, and reduce the required anesthetic dose while potentially decreasing side effects. This phase 4 study compares the effects of intrathecal dexmedetomidine and fentanyl as additions to heavy bupivacaine in these surgeries, focusing on hemodynamic stability and motor block characteristics. Participants receive spinal anesthesia with either 3 mL of 0.5% hyperbaric bupivacaine plus 4 µg dexmedetomidine diluted in 0.5 mL normal saline or 3 mL of 0.5% hyperbaric bupivacaine with 25 µg fentanyl intrathecally. Before administration, patients are preloaded with fluids and monitored closely throughout surgery with non-invasive blood pressure, heart rate, ECG, and oxygen saturation measurements. The motor block onset and duration are assessed using the Modified Bromage scale. Intraoperative complications such as nausea, vomiting, pruritus, hypotension, bradycardia, and respiratory depression are observed and treated as needed. Participants, aged 20 to 60 years with ASA physical status 1 or 2 and scheduled for elective lower limb orthopedic surgery, are monitored continuously during surgery. Vital signs are recorded frequently for up to 90 minutes after spinal injection. The main outcomes measured include the duration and onset of motor block, mean blood pressure, and heart rate. Safety is carefully evaluated by tracking side effects and managing any complications. Total participation covers preoperative assessment, anesthesia administration, intraoperative monitoring, and postoperative observation to assess both effectiveness and safety.

Researchers are investigating the prevalence of primary and secondary bloodstream infections associated with central line catheters in patients admitted to the Cardiovascular Unit of a tertiary care hospital. This study focuses on patients diagnosed with sepsis, aiming to identify the microorganisms responsible and the factors that predispose patients to these infections. The study uses microbiological diagnosis and culture sensitivity tests to analyze blood samples and determine antibiotic resistance patterns of isolated organisms. The study involves collecting venous blood samples from patients suspected of sepsis or bacteremia. These samples undergo automated culture using Bact Alert and Vitek2c systems to isolate bacteria and assess their antibiotic biogram. Two or more sets of aerobic and anaerobic blood cultures are taken from different sites to confirm bacteremia. The study also includes biochemical tests such as CRP and Procalcitonin to support infection diagnosis. Calibration and interpretation follow established laboratory standards. Participants provide medical history and undergo clinical examinations along with lab tests including serum electrolytes, liver and kidney function, and procalcitonin levels. Data on antibiotic use and response are recorded. Researchers measure outcomes like microbiological diagnosis results and antibiotic sensitivity over six months. Statistical analysis is performed to evaluate data, and patient confidentiality is maintained. Participants are informed of results and receive appropriate treatment, with the option to withdraw at any time without affecting their care.

This research aims to evaluate whether combining transcutaneous electrical nerve stimulation (TENS) with isometric exercise (IE) can improve blood pressure control in men and women aged 50 to 60 years who have resistant hypertension. Resistant hypertension is a form of high blood pressure that remains above target levels despite the use of three or more different types of blood pressure medications at their highest tolerated doses. The study focuses on how these combined non-drug treatments affect peripheral hemodynamic measures such as systolic and diastolic blood pressure, mean arterial pressure, pulse pressure, and heart rate variability. Participants will be randomly assigned to one of two groups. The experimental group will receive their usual medication plus an 8-week program of TENS and IE. TENS will be applied to the upper thoracic spine area three times a week for 30 minutes at a low frequency, while IE involves handgrip exercises at 30% of maximum contraction for about 14 minutes per session, also three times weekly. The control group will receive medication plus a conventional physical therapy program including aerobic brisk walking, dynamic resistance weight training, stretching, and slow breathing exercises, all performed three times per week over 8 weeks. Both groups receive lifestyle advice on diet, sleep, stress reduction, and activity tracking. During the 8-week intervention, participants will be monitored with regular assessments including blood pressure and heart rate measurements. Researchers will track changes in pulse pressure, mean arterial pressure, systolic and diastolic blood pressure, and heart rate. Safety and adherence will be observed throughout the treatment period. This study involves a total of 50 patients, equally divided between men and women, with ongoing evaluations to understand the effects of these combined therapies on blood pressure control in resistant hypertension.

Researchers are evaluating opioid-free anesthesia (OFA) compared to opioid-based anesthesia in adolescents aged 8 to 18 years undergoing surgical correction for idiopathic scoliosis. This phase 4 prospective randomized controlled trial focuses on the use of dexmedetomidine, a non-opioid drug with pain-relieving and calming effects, to reduce opioid exposure during surgery and improve recovery outcomes. The study addresses a gap in clinical evidence regarding dexmedetomidine's analgesic impact in spinal surgery under general anesthesia. Participants will be randomly assigned to one of two groups: one receiving dexmedetomidine with a loading dose of 1 mcg/kg followed by a continuous infusion of 0.5 mcg/kg/h, and the other receiving fentanyl with the same dosing schedule. Both groups will also receive standard anesthesia care, including propofol, atracurium, magnesium sulfate, and tranexamic acid. The study includes intraoperative monitoring, a wake-up test during surgery for neurological assessment, and postoperative pain management with intravenous paracetamol. Throughout the surgery, heart rate and blood pressure will be continuously monitored to assess intraoperative analgesic effectiveness, the primary outcome measured over two hours. Secondary outcomes include the need for additional fentanyl, perioperative complications, surgeon satisfaction, and the quality of the surgical field. Postoperative pain will be assessed at multiple time points using a numerical rating scale, and rescue analgesia will be provided if needed. Patients will be observed in specialized care units after surgery, with recovery scores and adverse events closely tracked to ensure safety and evaluate treatment effects.