Clinical Research Directory

THE EFFECT OF REIKI ON BREASTFEEDING, PAIN AND COMFORT AFTER CESAREAN SECTION

EFFECT OF REİKİ APPLİED DURİNG THE POSTPARTUM PERİOD ON BREASTFEEDİNG, PAİN, AND COMFORT IN WOMEN WHO DELİVERED BY CESAREAN SECTİON The aim of this randomized controlled trial is to determine the effect of Reiki applied to volunteer women after cesarean section on breastfeeding, pain, and comfort in the postpartum period. The main questions it aims to answer are: Is there a difference in postpartum breastfeeding, pain, and comfort between the group receiving Reiki and the group receiving standard care? Is there a difference in postpartum breastfeeding, pain, and comfort between the group receiving Reiki and the group receiving Sham Reiki? Participants will receive Reiki six times postpartum: three times one-on-one during their hospital stay, and remotely in the second, third, and fourth weeks. The control group will receive standard care. The Sham Reiki group will receive Reiki points applied by a person without Reiki knowledge.

Intrathecal Versus Epidural Morphine for Post-Cesarean Analgesia

Cesarean section is one of the most commonly performed surgical procedures worldwide, making effective management of acute postoperative pain a key issue in obstetric anesthesiology. Post-cesarean analgesia should promote rapid maternal recovery, support newborn care, and consider the pharmacological implications for breastfeeding. According to recent PROSPECT® guidelines from ESRA, neuraxial opioids play a central role in post-cesarean analgesia and are at least as effective as other techniques, such as continuous local anesthetic infusion. However, the optimal route of opioid administration remains unclear. While earlier studies favored epidural morphine, more recent evidence suggests that intrathecal morphine may provide superior analgesia. Due to limited and conflicting data, no definitive conclusion can be drawn. Given that epidural morphine remains standard practice at Hospital Central do Funchal, a randomized clinical trial is proposed to compare the analgesic efficacy of intrathecal versus epidural morphine after elective cesarean section.

Melatonin on Post Operative Pain After CS

The goal of this clinical trial is to learn if melatonin will decrease pain after C.S. The main questions it aims to answer are: Does melatonin lower the number of times participants need to use a rescue analgesia? What medical problems do participants have when taking melatonin? Researchers will compare different doses of melatonin to see the ideal dose to decrease pain after C.S. Participants will: Take melatonin 30 min before C.S and will be observed for 24 hours for pain and consumption of other analgesia

Enhanced Recovery After Emergency Cesarean Section: A Comparative Study Assessing Postoperative Recovery and Outcomes

Cesarean section (CS) remains one of the most common major surgical procedures worldwide, with emergency CS accounting for approximately 30% of cases. Emergency CS presents unique challenges including increased maternal stress, higher complication rates, and prolonged recovery compared to elective procedures . Enhanced Recovery After Surgery (ERAS) protocols offer a promising approach to optimize outcomes in this population. Originally developed for colorectal surgery, ERAS principles have been successfully adapted to obstetric practice over the past decade. These evidence-based protocols emphasize multimodal interventions including preoperative counseling, optimized analgesia, early mobilization, and timely nutrition. In obstetrics, ERAS implementation has demonstrated reduced length of stay, decreased opioid use, and improved patient satisfaction for elective CS . Application of ERAS to emergency CS requires special considerations due to the urgent nature of the procedure. Modified protocols focus on rapid preoperative assessment, regional anesthesia with intrathecal opioids, and immediate postoperative care initiation . Emerging evidence suggests these adaptations maintain benefits while accommodating time constraints . Key outcomes include reduced postoperative pain, earlier return of bowel function, and improved breastfeeding rates . Current research demonstrates ERAS protocols can be safely implemented in emergency CS with proper staff training and institutional support . Ongoing studies continue to refine optimal practices, particularly regarding fluid management and thromboprophylaxis . As evidence accumulates, standardized guidelines for emergency CS ERAS pathways are expected to emerge .

Insufficient Regional Anesthesia and Conversion to General Anesthesia for Cesarean Section A Qualitative Multicenter Study

Background In Denmark, approximately 20% of all children are born via cesarean section (C-section), making it the most common surgical procedure (also internationally). The recommended anesthesia for cesarean sections is regional anesthesia (spinal or epidural, "spinal anesthesia"), as it has several advantages: the woman is awake and experiences the delivery of her child, she maintains spontaneous breathing (the risk of difficult airway management is significantly higher in pregnant women), and the risk of aspiration of stomach contents into the lungs (which is clearly increased in pregnant women) is reduced. Furthermore, regional anesthesia can contribute to early postoperative pain management to some extent. With spinal anesthesia, most women feel pressure and touch but no pain during the cesarean section. However, some women do experience pain during the procedure, necessitating a change in the plan. If inadequate anesthesia is detected before the surgery begins, one may choose (depending on, for example, the urgency of the cesarean) to administer renewed regional anesthesia (typically an epidural). However, if the woman first experiences pain after the surgery has commenced, it is necessary to place her under general anesthesia for the remainder of the procedure. Experience shows that this process can be challenging, and there are frequent examples in clinical practice of inappropriate courses of action, where women have experienced unacceptable pain during their cesarean sections without being placed under general anesthesia. It is difficult to obtain an exact figure on how many women experience inadequate anesthesia during cesarean sections under regional anesthesia, as not all cases are recognized or followed up on. Studies indicate that up to 12% experience pain during a cesarean section. The consequences of inadequate anesthesia for cesarean sections can be quite significant for women, including impaired bonding with the child, poorer establishment of breastfeeding, increased risk of postpartum reactions and post-traumatic stress, as well as (anecdotally) the risk of women opting out of future pregnancies, as they may be reluctant to subject themselves to a similar situation again. Aim The aim of this study is to investigate how women experience insufficient regional anesthesia during cesarean sections that require conversion to general anesthesia. The focus is on exploring the factors that contribute positively and negatively to the woman's experience in this situation. Method Qualitative study in six Danish hospitals. Inclusion criteria: * Women undergoing elective or emergency cesarean section, aged over 17 years * Regional (spinal or epidural or combined epidural-spinal) anesthesia converted to general anesthesia intraoperatively (i.e., after surgery has commenced) due to insufficient regional anesthesia (i.e., not for obstetric indications, such as in cases of difficult fetal extraction) Exclusion criteria: * Does not speak Danish or English * Does not wish to participate The woman will be contacted for the first time on day 1 or 2 after the cesarean section (before she is discharged from the hospital). She will be informed about the project and invited to participate. As a potential project participant, she is entitled to a 24-hour consideration period, and if desired, a new contact will be arranged for the following day. If she wishes to participate, she will be contacted again after 3 months. At this time, she will receive a call to schedule a follow-up telephone interview within a few days. This will take place as a semi-structured interview, initiated with open questions and concluded with a few more specific questions. At the end of the interview, a screening for post-traumatic stress will be conducted using the PTSD-8 tool. Follow-up interviews will be recorded digitally and transcribed verbatim. Sample Size The project encompasses all women at the participating centers who experience insufficient regional anesthesia during a cesarean section and conversion to general anesthesia during 1 year.

Comparison of Dexmedetomidine + Ketamine for Postoperative Pain in C-Section

This study aims to compare three different doses of dexmedetomidine, when combined with a fixed dose of ketamine, for pain control in women undergoing cesarean section. The goal is to find the most effective combination with the fewest side effects.

Postoperative in Cesarean Section, the Women Suffering from Pain Due to Wound "incisional Pain", High Level Laser One of Most Effective Methods That Promoting Healing and Decrease Pain so It Will Effective If Use in Decreasing Pain of Cesarian Section

High power laser is safe and effective methods, it's uses increasing one day after day in decreasing pain and promoting healing so its use in postoperative cesarian section will help mothers to overcome pain and return to ADLs faster