Clinical Research Directory

Artificial Intelligence vs. Automated Messaging for Continuous Regional Analgesia Follow-up

Effective postoperative analgesia is critical for patient recovery, satisfaction, and the reduction of hospital stay duration. Continuous peripheral nerve blocks (CPNB) via catheter placement represent a cornerstone in achieving these objectives. Traditionally, follow-up for these patients has relied on standardized telephone protocols conducted by trained personnel. Original previous research in 2024 demonstrated that an automated text-messaging platform was feasible and maintained high patient satisfaction, it resulted in a significantly higher rate of unscheduled patient-initiated inquiries (28.3% vs. 6.4%) compared to traditional phone calls, likely due to a lack of adaptive response capabilities. Objective: This study aims to evaluate an enhanced technological iteration of our follow-up platform. By integrating an Artificial Intelligence (AI) interface trained on specialized clinical protocols, the new system is designed to provide automated, personalized and adaptive recommendations to patients. Methods and Intervention: The study will compare the effectiveness of this AI-driven platform against the previous version of the non-adaptive automated messaging system. The primary outcome is to compare the number of patient-initiated inquiries (re-consultations). Secondary outcomes include patient satisfaction, adherence to the follow-up protocol, and response rates from postoperative days one through three. Impact: The investigators hypothesize that the integration of AI will optimize human resources and improve patient autonomy without compromising safety or satisfaction, ultimately providing a scalable model for postoperative regional analgesia monitoring.

Comparison of Caudal and Quadratus Lumborum Blocks With Pain Monitoring in Children

Study Type: Prospective, Randomized, Observational Clinical Study Primary Purpose: The primary objective of this study is to compare the analgesic efficacy of caudal block (CB) and quadratus lumborum block (QLB) in children undergoing lower abdominal surgery using objective pain monitoring methods. Key Questions Addressed: Does the quadratus lumborum block provide superior intraoperative and postoperative analgesia compared to the caudal block, as measured by the Pain Monitor (PAM) and the FLACC scale? Is the PAM monitor a reliable tool for objectively assessing nociception and pain in children who are unable to verbally express pain? Which regional anesthesia technique more effectively delays the time to first postoperative analgesic requirement and reduces total analgesic consumption? Which method is associated with higher parental satisfaction and fewer postoperative side effects, such as postoperative nausea and vomiting? Comparison Groups: Children receiving ultrasound-guided quadratus lumborum block will be compared with those receiving caudal block. Intervention Group: Bilateral quadratus lumborum block with 0.5 mL/kg of 0.25% bupivacaine. Active Comparator Group: Caudal block with 1 mL/kg of 0.125% bupivacaine. Participant Population: A total of 68 children, aged 2 months to 6 years, with ASA physical status I-II, scheduled for elective lower abdominal surgeries (e.g., inguinal hernia repair, orchiopexy, hydrocele). What Participants Will Do: Participants will receive the assigned regional block as part of standard anesthetic care. Observational data will be collected as follows: Intraoperative: Continuous nociception monitoring using the PAM device at predefined time points (during laryngeal mask airway insertion, block performance, surgical incision, 20 minutes after block performance, and extubation). Postoperative: Pain assessment using the FLACC scale at 1, 2, and 4 hours in the post-anesthesia care unit. Rescue analgesia (intravenous paracetamol) will be administered if the FLACC score is ≥4. Time to first analgesic administration and total analgesic consumption will be recorded. Additional outcomes include postoperative nausea and vomiting (PONV) scores, Steward recovery scores, and parental satisfaction scores assessed using the Pediatric Parental Satisfaction Scale (PPPS). Primary Outcome: Intraoperative PAM index scores. Secondary Outcomes: Postoperative FLACC scores, time to first analgesic requirement, total postoperative analgesic consumption, incidence and severity of PONV, Steward recovery scores, and parental satisfaction (PPPS) scores.

Perioperative Analgesic Effects of PENG Versus PENG Plus LFCN Block in Hip Surgeries

This study is designed to find the best way to control pain after hip surgery performed through a side (lateral) incision. Two different types of nerve blocks used before the operation will be compared. In one group, patients will receive a Pericapsular Nerve Group (PENG) block, which numbs the main nerves that carry pain signals from the hip joint. In the other group, patients will receive a PENG block together with a Lateral Femoral Cutaneous Nerve (LFCN) block, which adds extra pain relief for the skin and outer part of the thigh. A total of 72 patients between 18 and 80 years old will take part in this study. All operations will be done under spinal anesthesia. Pain levels will be measured several times during the first 24 hours after surgery using a simple 0-10 pain scale. Patients will receive pain medicine through a pump that allows them to press a button when they feel pain. The total amount of medicine used will be recorded. The researchers will also monitor when patients first need pain medicine, when they can start walking, how satisfied they are with pain control, and if they experience side effects such as nausea or dizziness. By comparing the two methods, the study aims to see whether adding the LFCN block to the PENG block provides better pain control, lower drug use, faster recovery, and higher patient comfort after hip surgery.