Clinical Research Directory

Tourniquet Pain Prevention During Distal Upper Limb Surgery

Post-tourniquet pain remains a common problem. It disturbs the quality of anesthesia during brachial plexus block for distal upper-limb surgery. Current evidence shows that adding an intercostobrachial nerve block using the landmark-based technique can improve analgesia for medial upper-arm procedures.

Pericapsular Nerve Group Block Versus Intrathecal Morphine for Pain After Hip Surgery

Pain after hip replacement surgery is often severe and is commonly treated with opioids, which may cause nausea, vomiting, sedation, difficulty passing urine and slow breathing. This study will compare two ways of controlling pain in adults having hip surgery under spinal anesthesia. One group will receive morphine added to the spinal injection. The other group will receive an ultrasound-guided pericapsular nerve group (PENG) block, in which local anesthetic is injected near the nerves that carry pain signals from the hip joint. Participants will be assigned to one of the two groups by chance. Sixty-four adults aged 18 to 65 years will take part, with 32 in each group. Pain scores at rest and during movement, the total amount of morphine used through a patient-controlled pump, the time until the first request for extra pain medicine, the amount of additional paracetamol used, side effects such as nausea and vomiting, and complications related to the block will be compared between the groups during the first 48 hours after surgery.

SPSIP Block for Pain Control After Breast Reduction Surgery

The goal of this clinical trial is to learn whether an ultrasound-guided serratus posterior superior intercostal plane block (SPSIP block) can lower the need for opioid pain medicine after breast reduction surgery. The main question it aims to answer is: Does adding an SPSIP block to standard anesthesia and pain treatment lower opioid use during the first 24 hours after surgery? Researchers will compare participants who receive standard anesthesia and pain treatment with participants who receive standard anesthesia and pain treatment plus an SPSIP block. Participants will: * Have planned bilateral breast reduction surgery under general anesthesia * Be randomly assigned to the SPSIP block group or the control group * Receive standard local anesthetic infiltration during surgery and standard pain treatment after surgery * Have their pain score and pain medicine use recorded during the first 24 hours after surgery * Be followed for safety and complications for 30 days after surgery

Regional Block for Post-mastectomy Analgesia

A large number of patients undergoing major surgical procedures for the management of breast cancer complain of acute and chronic postoperative pain. Morphine administration for acute pain after mastectomy surgery has many side effects. Regional block techniques, such as paravertebral block and thoracic epidural anaesthesia, have possible complications and technical difficulties. So, we will discuss adding dexmedetomidine as an adjuvant to bupivacaine for serratus-intercostal versus erector-spinae plane block to relieve post-mastectomy pain.

Analgesia for Perineal Surgeries in High-risk Pediatric Patients

Perioperative pain management in pediatric patients, especially for anorectal and penile surgeries, presents significant challenges for anesthetists. Complications associated with systemic analgesia, such as respiratory issues, cardiovascular problems, and neurological effects, can be avoided by using regional anesthesia. This study aims to evaluate the effectiveness of Ultrasound-Guided Sacral Multifidus Plane Block as a method for perioperative analgesia in high-risk pediatric patients undergoing anorectal and penile surgeries, to reduce the risks associated with systemic analgesia.

Transversus Abdominis Plane Block Compared to Local Anesthetic Wound Infiltration in Gynecologic Oncology Surgery

This study is being done to see if preoperative transversus abdominis plane (TAP) analgesia will provide similar postoperative pain control, hospital length of stay, and postoperative outcomes compared to surgeon-initiated wound infiltration with local anesthetic in participants undergoing laparotomy for gynecologic indications.

Ultrasound-Guided Bilateral Transversalis Fascia Plane Block With vs Without Dexamethasone for Cesarean Delivery

Cesarean delivery is one of the most frequently performed surgical procedures worldwide, and effective postoperative pain management is essential to facilitate early mobilization, maternal-infant bonding, breastfeeding, and overall recovery. Ultrasound-guided transversalis fascia plane block (TFPB) has become an increasingly utilized component of multimodal analgesia following cesarean delivery because it provides effective somatic analgesia of the lower anterior abdominal wall. Adjuvants such as dexamethasone are frequently added to local anesthetics with the aim of prolonging block duration and improving postoperative analgesia; however, evidence regarding the clinical benefits of dexamethasone as an adjunct in TFPB remains limited. At our institution, bilateral ultrasound-guided TFPB is routinely performed for postoperative analgesia in patients undergoing cesarean delivery under spinal anesthesia, provided there is no contraindication and informed consent has been obtained. According to the treating anesthesiologist's routine clinical preference, dexamethasone may be added to the local anesthetic solution in some patients, whereas others receive local anesthetic alone. This retrospective cohort study will review the medical records and postoperative follow-up forms of patients who underwent cesarean delivery between November 1, 2025, and June 30, 2026. Postoperative analgesic outcomes, including opioid consumption, pain scores, time to first analgesic request, postoperative nausea and vomiting, recovery quality, and block-related adverse events, will be compared between patients receiving bilateral TFPB with dexamethasone and those receiving bilateral TFPB without dexamethasone. The findings are expected to provide real-world evidence regarding the potential contribution of dexamethasone to the analgesic efficacy of bilateral TFPB following cesarean delivery.

Evaluation of the Effects of Ketorolac Dose on Duration of Analgesia in Emergency Department (ED) Renal Colic Patients

This is a prospective interventional study examining the effect of ketorolac at doses of 15mg versus 30 mg for duration of analgesia in emergency department patients with suspected renal colic.

Ultrasound-Guided Recto-Intercostal Fascial Plane Block in Laparoscopic Cholecystectomy

The aim of the study is to reduce postoperative pain by performing rectointercostal block in L/S cholecystectomy surgeries. Main goal is to provide well managed post-operative analgesia.

Safety and Efficacy of Esketamine - Dexmedetomidine Combination Versus Dexmedetomidine Monotherapy for Hyperactive Delirium in ICU Patients on Non-Invasive Respiratory Support (ESSENTIAL Trial): Study Protocol of a Randomized Controlled Trial

This investigator-initiated, randomized, controlled, single-blind, superiority trial aims to assess the efficacy and safety of esketamine combined with dexmedetomidine for the management of agitation or delirium in intensive care unit (ICU) patients receiving non-invasive respiratory support. The primary endpoint is a clinically prioritized hierarchical composite endpoint within 28 days, including intubation or tracheostomy, delirium duration, and agitation duration.

Understanding the Effects of Transcutaneous Auricular Neurostimulation for Treatment of Chronic Pain

The purpose of the study is to find out how a stimulation device worn on the ear works. This device is thought to stimulate nerves in the area around the ear to change the signals in the brain. The device has been shown to reduce pain and to reduce the symptoms of withdrawal. The investigator will also investigate changes in the way each participant perceive sensations of pressure and heat. The participant will be asked to reduce the amount of pain medication that they take. Then, the participant will spend several days and nights in the Clinical Research Center at UTMB (University of Texas Medical Branch) in Galveston. During that time, the participant will be monitored for withdrawal symptoms and will receive either active (e.g., "real") brain stimulation or sham (e.g., "fake") brain stimulation for two days (four hours each day). At two times over the course of the study (before and after ear stimulation treatment), the participant will complete questionnaires about their pain score and how they are feeling, sensory testing, and will undergo magnetic resonance imaging (MRI) of their brain. The investigator will collect the following information from the participant's medical record: age, gender, medication history, medical diagnoses, recent vital signs, past doctor visits or hospital stays, and results of urine drug tests. Participation in this study will last approximately four days, and the participant will stay in the Clinical Research Center.

Perioperative Music Listening on Anxiety, Analgesia Use and Patient Satisfaction

The capacity of music to relieve pain has been used in many forms of medicines and has been proven to reduce anxiety, pain and need for analgesia in perioperative setting. However, music listening as an inexpensive and duplicable method has not been studied in the local context. The investigators hereby propose a prospective study to recruit women who undergo surgery to evaluate the effectiveness of music in pain relief and post-operative recovery in KKH; as well as the possibility of implementing music listening in perioperative setting. The patients will be offered to listen to one out of several pre-determined lists of music of different genres before, and after surgery. Data including pain score, Hospital Anxiety and Depression Scale (HADS) score, EuroQol-Five Dimensions questionnaire-using Three Levels (EQ-5D-3L), vital signs, analgesia usage and patient satisfaction will be collected in the perioperative period. The collected data shall also be assessed if they are affected by the presence of music, duration of music listening, and the genre chosen by the patients. The investigators believe that this study could help determine the clinical relevance of music for pain relief in local setting, which potentially could reduce patient pain and anxiety caused by surgery. This in turn could allow music listening to be adopted as a non-invasive pain relief intervention in local healthcare settings and further improve patient outcome with lower cost and greater convenience as well as safety.

Perioperative Music Listening on Anxiety, Pain, Analgesia Use and Patient Satisfaction

The use of music to relieve pain has been studied in many forms of medicines and has been proven to reduce anxiety, pain and analgesic use in the perioperative setting. However, music listening as an inexpensive and duplicable method has not been investigated and implemented in the local context. The investigators hereby propose a prospective study to recruit patients undergoing surgery to evaluate the effectiveness of music in pain relief and post-operative recovery; as well as the implementation and operational readiness of music listening.

Evaluation of Postoperative Pain Control in Ear Surgery

Middle ear surgery is the most popular procedure in ear, nose and throat surgery. Increased sympathetic stimulation after surgery can activate the sympathetic system, causing hypertension and increased heart rate. As a result of these clinical conditions, hemorrhage can occur, which can impair the quality of the surgical field, which is undesirable in middle ear surgery.Clinical studies should be conducted with auricularis magnus nerve block applied in the perioperative period in middle ear surgery and postoperative pain scores.

Postoperative Analgesic Effects of Subcostal Transversus Abdominis Plane Block Versus External Oblique Intercostal Block on Patients Undergoing Gastrectomy

Open Gastrectomy surgery is a big surgery with upper umbilical median incision where the postoperative pain is occur frequently. pain managements of this surgery with intravenous opioid analgesics are currently standard approach. but its side effects as sedation, decreased bowel movement and respiratory depression are limiting its use. so local anesthesia done with regional block methods provides good analgesia after surgery that decrease use of opioid analgesics. in this study we intend to compare subcostal TAP block with external oblique intercostal block

Optimal Bupivacaine Dose for Initiation of Labor Epidural Techniques

To estimate the dose of bupivacaine required to achieve initial effective comfort in 90% of patients (ED90) via the epidural (DPE or EPL) technique in women undergoing labor.

Offset Mechanisms in Evaluation of Lumbar Medial Branch Blocks

This study examines the relationship between central nervous system (CNS) mechanisms of pain inhibition and the pain relief that occurs following a lumbar medial branch block (MBB).

TaVNS for Capsaicin-Induced Pain

Effective pain management remains a major clinical challenge. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising, non-invasive neuromodulation technique due to its safety, ease of administration, and cost-effectiveness. Preliminary evidence suggests that taVNS exerts analgesic effects by activating afferent vagal fibers, which integrate signals in key central nodes such as the nucleus tractus solitarius (NTS). This process subsequently modulates pain-processing networks, neurotransmitter balance, inflammatory responses, and autonomic function. Despite its potential, the precise central neural mechanisms underlying taVNS-induced analgesia remain unclear, limiting the optimization of stimulation parameters (e.g., intensity, frequency, and target specificity) and the enhancement of long-term therapeutic outcomes. Previous studies have highlighted the role of taVNS in activating descending pain inhibitory pathways and modulating the limbic system, yet a comprehensive understanding of the causal neurophysiological dynamics is still lacking. This study aims to investigate the analgesic efficacy of taVNS using a capsaicin-induced pain model. Furthermore, by employing Transcranial Magnetic Stimulation combined with Electroencephalography (TMS-EEG), we seek to elucidate the central neural mechanisms of taVNS. By integrating causal intervention with high-temporal resolution brain activity recording, this research will provide scientific insights into the modulation of pain-related pathways-such as descending inhibitory and cognitive-affective networks-ultimately facilitating the development of standardized, individualized, and precise clinical interventions for pain management.

Mid-transverse Process to Pleura Block in Pediatric Thoracotomy

The aim of this study is to assess the effectiveness of analgesia of US guided MTP block in pediatrics undergoing thoracotomy.

HTX-011 for Post-bunionectomy Analgesia

A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Two-Part Evaluation of the Efficacy and Safety of Locally Administered HTX-011 for Postoperative Analgesia Following Bunionectomy

Assessment of PENG Block Analgesia Versus Intra-articular Infiltration in Hip Prosthesis Surgery

After hip arthroplasty, pain intensity is maximum within the first 6 hours and is then estimated to last between 36 and 72 hours. Pain management (analgesia) after hip prosthetic surgery remains a challenge. A bad analgesic treatment can result in delay in mobilization/ambulation and thus increase duration of patient's stay which can have a significant economic impact. The different recognized analgesia techniques (intra-articular infiltration and peripheral nerve blocks) are effective but have shown certain limits. A new peripheral nerve block, the PENG block has shown very encouraging results on postoperative analgesia quality. In this context, this research is based on the hypothesis that ultrasound-guided PENG block could provide more effective analgesia than intra-articular infiltration during mini-invasive anterior hip prosthesis surgery.

Liposomal Bupivacaine Versus Ropivacaine for Preperitoneal Infiltration Analgesia in Upper Abdominal Laparotomy

Upper abdominal open surgery is associated with significant trauma, and postoperative pain management poses considerable challenges. The inflammatory response triggered by peritoneal incision and the transmission of visceral pain via the vagus nerve are key components of "surgical stress" and pain. A potential intervention strategy involves the local administration of anesthetic agents to suppress peritoneal overreaction and block the cascade of pro-inflammatory cytokines in related nerves. Liposomal bupivacaine, as a long-acting local anesthetic, may provide more prolonged postoperative analgesia compared to ropivacaine. Therefore, this trial aims to prospectively compare the analgesic efficacy and anti-inflammatory effects of the two drugs when administered as pre-closure preperitoneal infiltration. Secondary endpoints include opioid consumption, complication rates, and postoperative recovery indicators, to comprehensively evaluate their clinical value.

Ultrasound-Guided Parasternal/Rectus Sheath Block vs Erector Spinae Plane Block for Pain Control in Cardiac Surgery

The researchers are working to improve recovery after heart surgery by reducing reliance on opioids. Newer regional anesthesia techniques can provide strong pain relief with fewer risks, but the choice of method depends on each patient's condition, medications, and surgical plan

HONEY for the Treatment of POst-Tonsillectomy Pain

Double-blind, randomised, placebo controlled, single-site trial in adults to compare the effect of Manuka honey with standard of care compared to placebo with standard of care on post-tonsillectomy pain and postoperative outcomes. Main aim is to investigate a potential improvement in post-tonsillectomy pain control, with a low cost and freely available alternative to conventional analgesics. Recent systematic review and multidisciplinary consensus suggest a potential role for the inclusion of honey for this purpose. Clinical efficacy over placebo remains to be conclusively demonstrated in robust clinical trials.