Clinical Research Directory

Blast-related Regional Anaesthesia and Peripheral nerVe Injury Evaluation

This randomized study will examine whether ultrasound-guided regional anaesthesia (a nerve block) contributes to new or worsening peripheral nerve problems after blast-related limb trauma. Blast injuries themselves can damage nerves, making it difficult to determine whether later numbness, weakness, or neuropathic pain is caused by the injury, surgery, or the nerve block. Adults with blast-related upper- or lower-limb trauma who need pain treatment will be randomly assigned to one of two standard pain-management strategies: regional anaesthesia plus multimodal analgesia, or multimodal systemic analgesia without a planned nerve block. All participants will receive appropriate rescue pain treatment if needed. Neurological function will be documented before treatment and reassessed during hospital care and follow-up. The main outcome is a new or worsened peripheral nerve deficit 30 days after treatment. The study will also assess pain relief, opioid use, function, neuropathic pain, and safety events up to 6 months.

Nerve Blocks or Combat Trauma: What Drives Peripheral Nerve Injury?

This study will examine nerve problems after combat-related injuries to the arms or legs. Some patients receive a peripheral nerve block, an injection of local anaesthetic near a nerve, to help control pain. However, combat injuries themselves can damage nerves through blast effects, fractures, blood vessel injury, bleeding, infection, surgery, or use of a tourniquet. The study will follow adults with combat-related limb injuries who receive routine care at a specialised trauma centre. Treatment will not be assigned by the study. Researchers will record details of the injury, pain treatment, nerve block use, and nerve function over time. The main goal is to determine how often patients have new or worsened numbness, weakness, or nerve pain after injury, and whether these problems are more closely related to the injury itself, the nerve block, or several factors together. The findings may help clinicians provide safer pain treatment and recognise nerve problems earlier.

Preoperative Maxillary Nerve Block and Remifentanil Use in Septorhinoplasty

Septorhinoplasty is generally a prolonged surgical procedure that frequently involves osteotomy, which may lead to increased intraoperative remifentanil requirements. Moreover, it is often associated with significant bleeding due to the dense capillary network of the nasal region, making the maintenance of low-to-normal blood pressure preferable during surgery. Consequently, achieving stable hemodynamics and providing sufficient analgesia throughout the procedure is essential. This study aims to evaluate the effects of bilateral maxillary nerve block on intraoperative remifentanil consumption and postoperative analgesic efficacy in patients undergoing Septorhinoplasty. A total of 90 patients will be included in the study. Forty-five patients (Group M) will undergo Septorhinoplasty under general anesthesia combined with bilateral maxillary nerve block, while the remaining 45 patients (Group N) will receive general anesthesia alone. In the preoperative phase, a bilateral maxillary nerve block will be performed under ultrasound guidance via the pterygopalatine fossa. During the intraoperative period, total remifentanil consumption will be recorded, alongside assessments of hemodynamic stability, sevoflurane consumption, extubation time, intraoperative bleeding volume, and the satisfaction levels of both the anesthesiologist and the surgeon. In the postoperative period, patient satisfaction, pain scores at 0, 1, 2, 4, 6, 12, 18, and 24 hours as well as at 1 month (measured using the Visual Analog Scale - VAS), additional analgesic requirements, and Quality of Recovery-15 (QoR-15) scores (assessed on preoperative day 1, postoperative day 1, and at 1 month) will be evaluated.