Clinical Research Directory

Feasibility of a Standardized Fascial Plane Block Protocol for Breast Cancer Surgery

The goal of this observational study is to evaluate the feasibility of a standardized locoregional anesthesia protocol for patients undergoing breast cancer surgery under procedural sedation or adjunctive hypnosis. The main questions it aims to answer are: * Can breast cancer surgery be successfully completed using this standardized anesthetic protocol without conversion to general anesthesia? * Is this standardized protocol feasible to implement in routine clinical practice, based on patient acceptance, protocol adherence, anesthesia induction time, patient and surgeon satisfaction, perioperative complications, and reasons for conversion to general anesthesia? Participants will: * receive the standardized locoregional anesthesia protocol, combined with either procedural sedation or adjunctive hypnosis, as part of their routine clinical care; * allow the research team to collect information from their medical records regarding the anesthesia and surgical procedure; * complete a short satisfaction questionnaire before hospital discharge

Continuous Interscalene Blocks and Rebound Pain

The primary objectives of this present study are to examine whether a continuous interscalene block of a total duration of 48 hours reduces the incidence of rebound pain comparatively to single-shot interscalene block, through the evaluation of the NRS scores at rest and on movement in the postoperative period at 24, 48, 72 and 96 hours as well as the total opioid consumption in the same timeframe for patients undergoing total shoulder arthroplasty. Rebound pain has been defined in some studies as the "the transition from well-controlled pain (numerical rating scale \[NRS\] ≤3) while the block is working to severe pain (NRS ≥7) within 24 h of block performance."

Optimal Postoperative Chest Tube and Pain Management in Patients Surgically Treated for Primary Spontaneous Pneumothorax (Pneumotrial)

Guidelines lack high quality evidence on optimal postoperative chest tube and pain management after surgery for primary spontaneous pneumothorax (PSP). This results in great variability in postoperative care and length of hospital stay (LOS). Chest tube and pain management are prominent factors regarding enhanced recovery after thoracic surgery, and in standardised care they are crucial to improve quality of recovery and decrease LOS. Historically, postoperative chest tubes are left in place for at least a fixed number of 3-5 days, irrespective of absence of air leakage. This period was deemed necessary for adequate pleurodesis and prevention of recurrence. However, it is suggested that removal on the same day of surgery is safe and associated with a reduced LOS. Regarding postoperative pain management, thoracic epidural analgesia (TEA) is the gold standard for postoperative pain management following video-assisted thoracic surgery (VATS). Although the analgesic effect of TEA is clear, it is associated with hypotension and urinary retention. Therefore, unilateral regional techniques, such as paravertebral blockade (PVB), are developed. The investigators hypothesize that early chest tube removal accompanied by a single-shot paravertebral blockade (PVB) for analgesia is safe regarding pneumothorax recurrence and non-inferior regarding pain, but superior regarding LOS when compared to standard conservative treatment.