Sahiwal

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.

Researchers are comparing the effects of dexmedetomidine and dexamethasone when added to 0.5% ropivacaine for ultrasound-guided supraclavicular brachial plexus block in patients having upper limb surgeries. This study focuses on improving anesthesia onset and postoperative pain relief for surgeries below the mid-humerus level. The trial is a randomized, double-blind study conducted during phases 2 and 3 to assess these two drug combinations. Participants will be randomly assigned to one of two groups one group receives 28 ml of 0.5% ropivacaine combined with 1 mcgkg dexmedetomidine diluted in 2 ml normal saline, while the other group receives 28 ml of 0.5% ropivacaine plus 8 mg dexamethasone. The supraclavicular brachial plexus block is performed under ultrasound guidance with the patient lying supine and the head turned 30 degrees away. The drugs are injected carefully around the brachial plexus to ensure effective anesthesia. During the study, patients will be monitored with standard equipment like pulse oximetry, ECG, and blood pressure measurements. Sensory and motor block onset will be checked every 5 minutes up to 30 minutes using standardized scales. Side effects and any complications will be tracked and treated as needed. The primary outcome is the time to onset of sensory and motor block within 5 minutes after block performance. The study is expected to end by March 2026, with participants aged 18 to 70 years included.

The trial investigates the effectiveness of two types of nerve blocks, ultrasound-guided Supra-inguinal Fascia Iliaca Block S-FICB and Pericapsular Nerve Group PENG Block, in patients with femur fractures. The goal is to compare their immediate and postoperative pain relief during positioning for spinal anesthesia, duration of analgesia, opioid-sparing effects, and associated complications. This is a phase 2 and 3 study that addresses the lack of local data comparing these blocks under ultrasound guidance for improving spinal anesthesia positioning. Participants will be randomly assigned to receive either the S-FICB or PENG block, both performed using 20 mL of 0.5% bupivacaine administered under ultrasound guidance by experienced anesthesiologists. The blocks are done in a sterile environment with detailed ultrasound techniques to guide needle placement and drug delivery. After the nerve block, patients will sit for spinal anesthesia when pain is reduced. Post-surgery, patients will be monitored for pain and given rescue analgesia as needed. Throughout the study, pain levels will be assessed before, during, and after the block using a numeric pain rating scale. Vital signs and safety parameters will be monitored continuously. The primary outcome is the ease of positioning for spinal anesthesia within 20 minutes of block performance. Secondary outcomes include duration of postoperative pain relief and opioid use over 24 hours. The study lasts for the surgery and 24-hour postoperative period, with ongoing pain assessments and rescue medication tracking.

The trial investigates severe pain management during thigh and knee surgeries, focusing on comparing two regional anesthesia techniques called supra-inguinal fascia iliaca block S-FIB and infra-inguinal fascia iliaca block I-FIB. These blocks aim to ease spinal positioning and provide postoperative pain relief. The study is a randomized controlled trial involving 60 patients aged 30 to 60 undergoing such surgeries, assessing pain control and patient satisfaction. Participants will be randomly assigned to one of two groups Group A receives the supra-inguinal fascia iliaca block with 30 ml of 0.125% bupivacaine, and Group B receives the infra-inguinal fascia iliaca block with the same dosage. Both blocks are performed under ultrasound guidance before surgery by experienced anesthesiologists. The blocks are administered using a sterile technique with specific ultrasound probe positioning to guide needle placement for precise drug delivery. During the study, patients pain levels are recorded at rest and on movement before and after the block using a numeric rating scale. Researchers will measure how easily patients can be positioned for spinal anesthesia, the duration of postoperative pain relief, and patient satisfaction using standardized scales. Monitoring includes heart rate, oxygen levels, and blood pressure during and after surgery. Follow-up pain assessments occur every 2 hours for 12 hours post-surgery, with rescue pain medication provided if needed.

Researchers are investigating the effects of dexmedetomidine and lignocaine infusions on patients undergoing laparoscopic cholecystectomy, focusing on perioperative hemodynamics, postoperative pain, and gastrointestinal recovery. This randomized controlled trial compares these two drugs to find evidence regarding their impact on reducing opioid-related side effects and managing pain and hemodynamic responses during and after surgery. The study is conducted at Sahiwal Teaching Hospital over 12 months with 140 patients divided into two groups. Participants will be randomly assigned to receive either dexmedetomidine infusion at 0.2-0.4 gkgh or lignocaine infusion at 1-2 mgkgh during surgery. All patients undergo standardized anesthesia induction and maintenance, including pre-oxygenation, propofol, nalbuphine, succinylcholine, isoflurane, nitrous oxide, oxygen, and atracurium. Intraoperative monitoring includes heart rate, blood pressure, oxygen saturation, end-tidal CO2, and temperature. Rescue treatments for hypotension and bradycardia are provided as needed. Postoperative care includes pain assessment, opioid use tracking, nausea and vomiting monitoring, and evaluation of gastrointestinal function using the I-FEED scale over 24 hours. Participants will be assessed before surgery, during anesthesia, and for 24 hours postoperatively in the intensive care unit. Heart rate and mean arterial pressure are monitored at several time points during surgery. Postoperative pain is measured with a visual analogue scale, and rescue analgesia is given when pain reaches a specific level. Researchers will record total opioid consumption and recovery of gastrointestinal function at 6, 12, and 24 hours after surgery. All data, including demographics and operative details, are collected systematically to evaluate the effects of the two infusions.