Clinical Research Directory

Quality of Recovery-15 After Opioid-free Versus Opioid-based General Anesthesia in Major Urological Surgery

This randomized controlled trial evaluates postoperative quality of recovery assessed with the Quality of Recovery-15 questionnaire in adult patients undergoing elective major urological surgery under opioid-free versus opioid-based general anesthesia. Opioid-free anesthesia is a multimodal anesthetic technique that avoids intraoperative opioids by combining non-opioid analgesic and sympatholytic agents such as dexmedetomidine, ketamine, lidocaine, non-steroidal anti-inflammatory drugs, and regional analgesia. Opioid-based general anesthesia in this trial includes intraoperative remifentanil infusion. Participants will undergo elective urological surgery, including laparoscopic nephrectomy, robotic nephrectomy, laparoscopic prostatectomy, robotic prostatectomy, laparoscopic cystectomy, or robotic cystectomy. The primary objective is to compare patient-reported quality of recovery between the opioid-free anesthesia group and the remifentanil-based anesthesia group using the Quality of Recovery-15 questionnaire. QoR-15 will be assessed before surgery and on postoperative day 7. Secondary objectives include total postoperative oxycodone dose administered via patient-controlled analgesia during the first 24 hours after surgery, postoperative pain intensity measured using the Numeric Rating Scale at 1, 2, 6, 12, and 24 hours after surgery, incidence of postoperative nausea and vomiting, change in serum creatinine from baseline to postoperative day 1, change in white blood cell count from baseline to postoperative day 1, and the ratio of demanded to delivered PCA boluses. Pre-specified subgroup analyses will compare outcomes according to surgical procedure type: laparoscopic nephrectomy, robotic nephrectomy, laparoscopic prostatectomy, robotic prostatectomy, laparoscopic cystectomy, and robotic cystectomy. Subgroup-by-treatment interaction tests will be performed. Planned enrollment is approximately 600 patients, with 300 patients per treatment arm. The primary patient-reported recovery endpoint will be assessed on postoperative day 7, while analgesic, pain, and early postoperative safety outcomes will be assessed during the first 24 hours after surgery.

V-NOTES Versus Laparoscopy for Sterilization and Sexual Function

The goal of this randomized clinical trial is to compare two minimally invasive surgical approaches, transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) and conventional laparoscopy, in women undergoing bilateral tubal ligation or bilateral salpingectomy for sterilization. The main questions it aims to answer are: * Does V-NOTES have a different effect on postoperative sexual function compared with conventional laparoscopy? * Does V-NOTES improve postoperative recovery, including pain, discharge time, and return to normal activity? * What surgical or medical problems occur with each surgical approach? * Researchers will compare V-NOTES with conventional laparoscopy to see whether one approach provides better postoperative sexual function and recovery outcomes after sterilization surgery. Participants will: * Undergo bilateral tubal ligation or bilateral salpingectomy using either V-NOTES or conventional laparoscopy. * Complete sexual function questionnaires before surgery, at 6 weeks after surgery, and at 6 months after surgery. * Be evaluated for postoperative pain, discharge time, return to normal activity, need for additional pain medication, complications, and perioperative laboratory changes. * Attend scheduled postoperative follow-up visits at 6 weeks and 6 months after surgery.

Remimazolam Versus Propofol for Early Recovery After Cytoreductive Surgery

The REPAIR Trial is a single-center, prospective, randomized, parallel-group superiority trial enrolling 320 adults scheduled for elective cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC). Participants will be assigned 1:1 to bispectral index-guided remimazolam- or propofol-based general anesthesia under standardized perioperative care. The primary objective is to determine whether remimazolam improves patient-reported recovery 48 ± 4 hours after surgery, measured by the Chinese 15-item Quality of Recovery score (QoR-15; range, 0 to 150; higher scores indicate better recovery). The investigators hypothesize that remimazolam will produce a higher 48-hour QoR-15 score than propofol. Secondary outcomes will characterize recovery at 24 and 72 hours, intraoperative hypotension burden and vasopressor use, acute kidney injury, infection, delirium, respiratory complications, other safety events, and 30-day mortality.

Artificial Intelligence-Supported Individualized Discharge Education After Coronary Artery Bypass Grafting

This randomized controlled trial aims to evaluate the effect of artificial intelligence-supported individualized discharge education on postoperative recovery in patients undergoing coronary artery bypass grafting. A total of 80 patients will be randomly assigned to an intervention group or a control group. Both groups will receive standard discharge education, while the intervention group will additionally receive individualized discharge education generated with artificial intelligence based on patients' sociodemographic and clinical characteristics, health literacy level, and learning needs. The intervention will be structured according to Gagné's instructional events and will include the teach-back method to assess understanding. Outcomes will include readiness for hospital discharge, postoperative recovery, satisfaction with discharge education, self-care adherence, complications, and unplanned health care use. Assessments will be conducted before discharge, on the day of discharge, and during follow-up after discharge.

Hope Theory-Based Nursing Intervention After Hip Fracture Surgery

This is a randomized controlled trial to evaluate the effectiveness of a Snyder Hope Theory-based nursing intervention on elderly patients following hip fracture surgery. The study aims to improve the patient's psychological well-being, reduce pain, and enhance their functional recovery. Participants will be randomly assigned to either the intervention group or the control group. The intervention involves individualized counseling, goal setting, and rehabilitation training based on the Snyder Hope Theory. The trial will assess changes in hope levels, anxiety, pain, hip joint function, and quality of life before and after the intervention.

Lower Back Muscle Size and Recovery After Lumbar Disc Herniation Surgery

Recovery after surgery for a herniated disc in the lower back differs from person to person. The size of the muscles around the lower spine may be related to recovery, but this relationship is not well understood. The purpose of this observational study is to determine whether the size of two lower-back muscles, the psoas and multifidus muscles, measured on magnetic resonance imaging (MRI) scans obtained before surgery is related to recovery after surgery. The study will include 100 adults aged 18 to 75 years who are scheduled for elective surgery for lumbar disc herniation. Participants will receive their usual anesthesia, surgery, and postoperative care. The study will not require any additional imaging, blood tests, medicines, or procedures. Researchers will use each participant's existing preoperative lumbar MRI scan to measure the psoas and multifidus muscles. Participants will complete the 15-item Quality of Recovery questionnaire (QoR-15) before surgery and again 24 hours, 48 hours, and 7 days after surgery. Researchers will also collect information routinely recorded during care, including pain scores, pain medicine use, nausea and vomiting, time spent in the recovery unit, time to first walking, and length of hospital stay. The primary objective is to determine whether preoperative psoas muscle index and multifidus muscle cross-sectional area are independently associated with postoperative Quality of Recovery-15 (QoR-15) scores 24 hours after lumbar disc herniation surgery.

Effect of AI-Personalized Virtual Reality on Postoperative Recovery After Major Abdominal Surgery

Major abdominal surgery is frequently associated with postoperative pain, anxiety, delayed recovery, and prolonged hospitalization. This study aims to evaluate the effectiveness of an AI-personalized virtual reality (VR) intervention as an adjunct to routine postoperative care in improving recovery outcomes among patients undergoing major abdominal surgery. Participants assigned to the intervention group receive immersive VR sessions delivered through a smartphone-based head-mounted display integrated with an AI-assisted personalization system. The system combines patient-reported pain and anxiety levels, postoperative recovery status, emotional state estimates obtained through facial emotion recognition technology, and previous session feedback to personalize VR content and enhance patient engagement. VR sessions are initiated on the first postoperative day and administered twice daily until hospital discharge. The primary outcome is postoperative quality of recovery measured using the Quality of Recovery-15 (QoR-15) questionnaire. Secondary outcomes include pain intensity, anxiety, recovery milestones, opioid requirements, simulator sickness, and length of hospital stay. The study compares AI-personalized VR plus routine postoperative care with routine postoperative care alone. Findings from this trial will help determine whether AI-enhanced VR is a feasible, safe, and effective strategy for improving postoperative recovery and reducing hospital stay following major abdominal surgery.

Effect of Combined Intravenous-Inhalational Anesthesia (CIVIA) on Postoperative Recovery Patterns.

This study was planned as a single-center, prospective, randomized trial. Adult patients undergoing elective spinal surgery lasting longer than three hours, performed in a neurosurgery operating room, will be evaluated. Patients managed with three different anesthesia methods currently used will be examined for recovery patterns: 1. Total intravenous anesthesia (TIVA), 2. TIVA Combined anesthesia with sevoflurane and intravenous agents (sevoflurane-CIVIA), 3. TIVA Combined anesthesia with desflurane and intravenous agents (desflurane-CIVIA). Recovery patterns include; extubation time, eye opening time, emergence agitation, postoperative nausia and vomiting and postoperative recovery unit discharge time.

Target-Controlled Infusion (TCI) vs Inhalational Anesthesia in Video-Assisted Thoracoscopic Surgery (VATS)

This study is designed as a prospective observational cohort to evaluate recovery after video-assisted thoracoscopic surgery (VATS). In our clinic, anesthesia for VATS is commonly provided either with target-controlled infusion (TCI) or with inhalational agents, depending on the routine practice of the anesthesiologist. No randomization or additional intervention will be performed. During the study period, patients who receive either method as part of standard care will be followed, and perioperative and postoperative data will be recorded. Awakening time, extubation time, Aldrete score progression, pain levels, and early postoperative complications will be compared between the two groups. The aim is to better understand how these widely used anesthesia techniques may influence recovery in VATS patients and to support future clinical decision-making.

The Effect of the Web-Based Gamified Application on Functional Results and Recovery Conditions

The aim of this clinical trial is to determine the effect of a mobile-compatible web-based gamified application (Game-App-KNEE) developed for post-operative care of total knee replacement (TKA) surgery on functional outcomes and recovery status. Based on this, the hypotheses of our project are; In the intervention group where the mobile-compatible web-based gamified application to be developed for the home care of individuals undergoing TKA due to osteoarthritis is applied, compared to the control group; Hypothesis 1 (H1): After the application of Game-App-KNEE, the functional levels of individuals in the intervention group are higher than the control group. Hypothesis 2 (H1): After the application of Game-App-KNEE, the post-operative recovery levels of individuals in the intervention group are higher than the control group. Participants: Receive the game module application (intervention group) or only the educational booklet (control group) every day for 3 months after discharge Visit the clinic every 1st and 3rd month for check-ups and tests.

Processed EEG Monitoring During Controlled Hypotension in Patients Undergoing Rhinoplasty

This prospective observational study evaluates intraoperative processed electroencephalography parameters in adult patients undergoing elective rhinoplasty under total intravenous anesthesia with controlled hypotension. The study focuses on qCON and qNOX values during anesthesia, their relationship with early postoperative recovery, and their association with intraoperative surgical bleeding and surgical field quality.

Enhanced Recovery Versus Standard Care After Emergency Abdominal Surgery in Patients Requiring Emergency Laparotomy

This study aims to compare an Enhanced Recovery After Surgery (ERAS) protocol with conventional postoperative care in adults undergoing emergency laparotomy for intestinal obstruction or intestinal perforation. The main question this study aims to answer is: • Does the ERAS protocol reduce surgical site infections compared with conventional care after emergency laparotomy? Researchers will also compare other recovery outcomes between the two groups, including length of hospital stay, occurrence of paralytic ileus (temporary loss of bowel function), time to first bowel movement, and time to start taking fluids by mouth after surgery. A total of 102 participants will be enrolled and randomly assigned to one of two groups. One group will receive postoperative care according to the ERAS protocol, while the other group will receive conventional postoperative care. All participants will undergo emergency laparotomy using standard surgical and anesthetic techniques. Participants will: * Undergo emergency laparotomy for intestinal obstruction or intestinal perforation. * Receive either ERAS-based postoperative care or conventional postoperative care. * Be monitored during their hospital stay for recovery and postoperative complications. * Be assessed for bowel function recovery, ability to tolerate oral fluids, and length of hospital stay. * Be followed for 30 days after surgery to determine whether a surgical site infection develops. The researchers hypothesize that patients managed with the ERAS protocol will have a lower frequency of surgical site infections and improved postoperative recovery compared with those receiving conventional care.

Timing of Aminophylline and Recovery in Pediatric Ambulatory Surgery

Beyond its established use as a bronchodilator and therapy for apnea of prematurity, aminophylline has demonstrated utility in reversing the effects of anesthetics, enhancing recovery by accelerating respiratory and cognitive functions. Variations in dosage (1-6 mg/kg) have been explored, but questions persist regarding optimal timing and dosing for pediatric surgical populations to achieve maximal efficacy with minimal adverse effects. This randomized controlled study aims to evaluate the effect of early versus late aminophylline administration on recovery profiles in pediatric patients undergoing ambulatory surgery under sevoflurane anesthesia. Sixty children aged 4-12 years will be randomly allocated into three groups: Group (E) will receive aminophylline early intraoperatively, Group (L) will receive aminophylline late intraoperatively, and Group (C) will receive normal saline post-anesthetic discontinuation.

QoR-15T in Cardiac Surgery

The objective of this prospective observational cohort study is to evaluate the validity, reliability, and responsiveness of the Turkish version of the Quality of Recovery-15 (QoR-15T) scale in adult patients undergoing elective cardiac surgery. While the QoR-15T has been validated for general surgery in Turkey, its performance remains to be established in high-risk cardiac surgery populations involving cardiopulmonary bypass and intensive care stays.Approximately 150 patients at Kocaeli City Hospital will be enrolled. The study will compare the patients' QoR-15T scores-recorded preoperatively and on the 7th postoperative day-with the Global Recovery Visual Analog Scale (VAS) to determine construct validity.

Interscalene Brachial Plexus Block and Early Wound-Related Symptoms After Open Rotator Cuff Repair

This exploratory randomized controlled trial evaluated the association of interscalene brachial plexus block (ISB) with early postoperative wound-related symptom scores and perioperative biomarker responses in patients undergoing open rotator cuff repair. Participants were randomly allocated to receive either ultrasound-guided interscalene brachial plexus block or standardized general anaesthesia. The primary outcome was postoperative wound-related assessment using the Toronto Symptom Assessment System for Wounds (TSAS-W) on postoperative days 5 and 14. TSAS-W was used as an exploratory patient-reported wound symptom assessment tool. Secondary outcomes included perioperative serum cytokine and growth-factor concentrations (IL-1β, IL-2, TNF-α, EGF, PDGF, and TGF-β), platelet counts, postoperative pain scores, tramadol consumption within 48 hours, time to mobilisation, and postoperative nausea and vomiting. This study aimed to investigate whether interscalene brachial plexus block was associated with differences in perioperative biological responses and postoperative wound-related symptom scores compared with general anaesthesia.

Impact of Topical Aromatherapy on Postoperative Quality of Recovery After Lung Resection

The key to early surgery recovery lies in optimal and immediate control of postoperative pain. Despite standard pain management protocols, lung resection is often associated with acute, neuropathic, or chronic pain, compounded by the side effects of morphine-based treatments. In this context, aromatherapy can provide complementary support, both to alleviate pain and to improve the quality of recovery after surgery.

ERAS Protocols in Breast Conserving Surgery

Enhanced Recovery After Surgery (ERAS) protocols have been of increasing interest in the surgical community for decades. The emphasis has been development of protocols to maximize pain control post-operatively without the use of opioids. While this approach has been studied extensively in the oncology surgery literature, little data exists on the utility of ERAS protocols in the setting of breast conserving surgery (BCS), which is a type of surgery to remove breast cancer while saving as much of the breast as possible. The purpose of this study is to determine the utility of implementing ERAS protocols in breast cancer patients undergoing breast conserving surgery. Study participants will be randomized to either ERAS protocol or standard peri-operative care without ERAS. The study will assess the how many opioid prescriptions are given in the first week after surgery and how much pain participants report right after surgery. Investigators will also look at how long participants stay in the recovery room and if medicine for nausea is needed.

The Effect of Oral Gan Shuangbi During the Perinatal Period on the Recovery of Intestinal Function After Cesarean Section in Pregnant Women- A Multicenter, Double-blind, Randomized Controlled Clinical Trial

This study aims to evaluate the effect of probiotics 7 days before cesarean section (CS) on postoperative recovery and the change of gut microbiota in pregnant women. Samples were obtained from a total of 202 pregnant individuals, divided into control group and probiotics group. Anal exhaust time and first defecating time were set as the primary outcome of recovery of CS.

Intercultural Adaptation and Validation of the Ukrainian Quality of Recovery-15 Questionnaire

The Quality of Recovery 15-questionnaire (QoR-15) is used to assess postoperative quality of recovery after surgery and anesthesia from the patient's perspective. It evaluates five dimensions including pain, physical comfort, physical independence, psychological support, and emotional state. The aim of this study is to validate a Ukrainian version of the QoR-15 scale (QoR-15Ukr) to measure postoperative recovery in Ukrainian-speaking patients.

Impact of Combined Intravenous-Inhalational vs Inhalational Anesthesia on QoR-15 Recovery Scores in Gynecologic Surgery

This study aims to compare the effects of combined intravenous-inhalational anesthesia versus inhalational anesthesia alone on postoperative recovery in patients undergoing elective gynecologic surgery. A total of 100 patients, aged 18-65 years and classified as ASA I-III, scheduled for elective gynecologic procedures at Sakarya University Faculty of Medicine Training and Research Hospital, will be included. The sample size was calculated based on the primary outcome, the Quality of Recovery-15 (QoR-15) score. Patients will complete the QoR-15 questionnaire preoperatively, before knowing which anesthesia method will be applied. Postoperative QoR-15 scores will be collected on postoperative days 1 and 2, and intraoperative data will be obtained from anesthesia records. The study evaluates postoperative recovery using QoR-15 scores, covering physical comfort, emotional state, psychological support, pain, and ability to perform daily activities. Higher scores indicate better recovery, whereas lower scores indicate impaired postoperative recovery.

Comparison of the Effects of Moderate- and High-Dose Glucocorticoids on Postoperative Recovery

Laparoscopic cholecystectomy is a commonly performed minimally invasive surgical procedure; however, postoperative pain, nausea, and delayed recovery remain clinically relevant problems. Glucocorticoids such as dexamethasone are widely used in perioperative care for the prevention of postoperative nausea and vomiting and as part of multimodal analgesia strategies. This prospective randomized controlled trial aims to compare the effects of moderate- and high-dose intravenous dexamethasone administered intraoperatively on postoperative recovery in patients undergoing elective laparoscopic cholecystectomy. The primary outcomes include postoperative nausea and vomiting, inflammatory markers (CRP and WBC), and Quality of Recovery-15 (QoR-15) scores. Secondary outcomes include postoperative pain scores, intraoperative remifentanil consumption, postoperative opioid consumption, and adverse events.

Early Postoperative Intervention in Gastric Cancer Patients

This study was conducted by Qilu Hospital and five other renowned medical centers, aiming to evaluate the impact of early structured postoperative intervention on quality of life and prognosis in patients with gastric cancer after neoadjuvant therapy.

Effects of a Recovery-Promoting Program in Patients Undergoing CABG Surgery

Patients undergoing coronary artery bypass graft (CABG) surgery often experience physical limitations, psychological stress, and challenges during recovery after hospital discharge. Inadequate preparation and limited follow-up support may affect patients' confidence in self-care and overall recovery. The purpose of this study is to evaluate the effects of a recovery-promoting program on self-efficacy, quality of recovery, and clinical outcomes in patients undergoing CABG surgery. Participants will receive standard postoperative care. In addition, participants in the intervention group will receive a recovery-promoting program provided by nurses, which includes structured education, guidance on postoperative activity and symptom management, and follow-up support after discharge. The study will assess changes in self-efficacy, quality of recovery, and selected clinical outcomes to compare recovery between participants who receive the recovery-promoting program and those who receive standard care.

Nurse-Led Early Mobilization After Colorectal Surgery

This study was designed to evaluate the effectiveness of a nurse-led early mobilization protocol on postoperative recovery outcomes in patients undergoing elective colorectal surgery. The outcomes assessed include walking distance, mobility levels, gastrointestinal function (time to first flatus and first defecation), nausea, vomiting, comfort, fatigue, time to initiation of oral intake, patient satisfaction, incidence of postoperative complications, and length of hospital stay. Research Question: In patients undergoing colorectal surgery (P), does a nurse-led early mobilization protocol (I), compared with standard mobilization practices (C), improve postoperative recovery outcomes (O), including walking distance, mobility levels, gastrointestinal function (time to first flatus and first defecation), nausea, vomiting, comfort, fatigue, time to initiation of oral intake, patient satisfaction, postoperative complication rates, and length of hospital stay?