Al Arab

Researchers are evaluating the effects of adding dexmedetomidine or fentanyl to heavy bupivacaine spinal anesthesia in patients undergoing elective lower limb orthopedic surgeries. This study aims to compare the hemodynamic stability, onset, and duration of motor block with these adjuvants, addressing the current limitation of short action duration of local anesthetics. Both drugs are studied for their potential to enhance analgesia while monitoring possible side effects. Participants are randomly assigned to receive either 4 g dexmedetomidine or 25 g fentanyl added to 3 mL of 0.5% hyperbaric bupivacaine via intrathecal injection. The anesthesia is administered after standard preloading and under strict aseptic technique, with continuous monitoring of vital signs including blood pressure and heart rate during surgery. The study includes detailed assessments of motor block onset and duration using the Modified Bromage scale, with treatment adjustments for any complications such as hypotension or bradycardia. During the study, participants undergo baseline clinical evaluation and continuous intraoperative monitoring of vital signs every 15 to 30 minutes over approximately 90 minutes. Researchers document the time to full motor block and its resolution, as well as any intraoperative complications like nausea, vomiting, or respiratory depression. The primary outcomes focus on motor block duration and onset, along with heart rate and blood pressure stability, all assessed within specific time frames. The total participation period aligns with the surgery and immediate recovery phase, emphasizing safety and efficacy monitoring.

Researchers are evaluating whether combining transcutaneous electrical nerve stimulation TENS with isometric exercise IE can improve blood pressure in adults aged 50 to 60 who have resistant hypertension. This condition involves blood pressure that remains high despite taking three or more different blood pressure medications at maximum doses. The study aims to understand the effect of this combined approach on various blood pressure and heart function measures compared to conventional physical therapy. Participants will be randomly assigned to one of two groups. The experimental group will receive TENS applied to the upper thoracic spine three times a week for 30 minutes per session, alongside isometric handgrip exercises performed with a dynamometer at 30% of maximum effort, repeated four times per session, also three times weekly, for eight weeks. The control group will follow a conventional physical therapy program including aerobic brisk walking, dynamic resistance weight training, stretching, breathing exercises, and lifestyle advice, also three times per week for eight weeks. Throughout the study, participants will be monitored with heart rate and blood pressure measurements before sessions to ensure safety. Researchers will assess blood pressure parameters including systolic, diastolic, mean arterial pressure, pulse pressure, and heart rate variability over the eight-week period. Secondary measures will include oxygen saturation, quality of life, and functional capacity. The study lasts eight weeks, with treatments and assessments conducted regularly to evaluate the effects of the interventions on resistant hypertension.

This research aims to evaluate opioid-free anesthesia OFA compared to opioid-based anesthesia in adolescents with idiopathic scoliosis undergoing spinal surgery. OFA uses a combination of non-opioid medications to reduce opioid exposure during surgery, potentially improving recovery and minimizing harm. The study specifically investigates the use of dexmedetomidine DEX, a non-opioid drug with pain-relieving and calming effects, which has not been previously studied for its analgesic impact in spinal surgery under general anesthesia. Participants will be randomly assigned to one of two groups the opioid-free group receiving dexmedetomidine with a loading dose of 1 gkg followed by an infusion of 0.5 gkgh, and the opioid-based group receiving fentanyl with the same dosing schedule. Both groups will receive additional anesthetic care including propofol infusion, magnesium sulfate, tranexamic acid, and other standard measures for surgical preparation and monitoring. The study includes careful intraoperative management and a wake-up test to assess neurological function during surgery. During the study, participants will be closely monitored with continuous heart rate and blood pressure measurements, surgical field bleeding assessments, and surgeon satisfaction ratings. Postoperative recovery will be evaluated using pain scales and sedation scores, with rescue analgesia available as needed. The study will also track complications such as nausea, shivering, and respiratory issues. Overall participation includes preoperative preparation, intraoperative monitoring, and postoperative care and observation, lasting throughout the surgery and immediate recovery period.