Clinical Research Directory

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."

Effect of ASMR and White Noise on Sleep Quality in Patients Undergoing Elective Lower Extremity Surgery

This randomized controlled trial aims to evaluate the effects of Autonomous Sensory Meridian Response (ASMR) and white noise on postoperative sleep quality in patients undergoing elective lower extremity surgery. Postoperative sleep disturbances are common after orthopedic surgery and may negatively affect pain perception, recovery, and overall patient outcomes. Participants will be randomly assigned to one of three groups: ASMR intervention, white noise intervention, or control group. Patients in the intervention groups will listen to standardized 30-minute audio recordings before sleep during the postoperative period, while the control group will receive routine care with headphones only. Sleep quality will be assessed using the Richards-Campbell Sleep Questionnaire (RCSQ). The study aims to determine which non-pharmacological intervention is more effective in improving postoperative sleep quality.

Effect of Lateral Decubitus Position After Spinal Anesthesia on Hemodynamic Stability in High-Risk Geriatric Patients

Spinal anesthesia is a common and preferred anesthetic technique for lower extremity orthopedic surgery in elderly patients. However, it can cause a significant drop in blood pressure (hypotension), especially in high-risk older patients with multiple medical conditions. This complication can lead to serious consequences such as heart attack, stroke, or death in vulnerable patients. This study investigates whether keeping patients in a lateral (side-lying) position for 15 minutes after spinal anesthesia - instead of immediately turning them onto their back (supine position) - can reduce the risk of hypotension. When a patient lies on their side after receiving spinal anesthesia with a heavy (hyperbaric) local anesthetic, the medication tends to stay concentrated on the lower (operative) side, resulting in a more limited nerve block. This may help preserve blood pressure stability. We will enroll 70 patients aged 65 years or older with high anesthetic risk (ASA physical status III or IV) scheduled for unilateral lower extremity orthopedic surgery under spinal anesthesia. Patients will be randomly assigned to two groups: one group will be kept in the lateral decubitus position (operative side down) for 15 minutes before being turned supine, and the other group will be turned supine immediately after spinal anesthesia. Blood pressure, heart rate, and oxygen saturation will be monitored continuously. The primary outcome is the incidence of hypotension during the first 15 minutes after spinal anesthesia.

Effect of Lavender Aromatherapy on Preoperative Anxiety, Stress, and Depression in Orthopedic Surgery Patients

This study evaluates whether inhalation aromatherapy with lavender essential oil can reduce anxiety, stress, and depression in adult patients before orthopedic surgery in Jordan. Orthopedic procedures are often associated with high levels of psychological distress, which may worsen pain, delay recovery, and prolong hospital stay. Aromatherapy is a simple, non-drug intervention that may help patients feel calmer and better prepared for surgery. The study was conducted in two large public hospitals, Al-Bashir Hospital in Amman and Al Hussein Al-Salt New Hospital in Al-Salt. Adult patients (18 years or older) scheduled for major orthopedic operations who could read and write Arabic and agreed to participate were invited to join the study. Patients with respiratory problems, an allergy to lavender oil, pregnancy, or severe non-orthopedic pain were excluded. Participants were assigned to one of two groups. In the intervention group, patients inhaled 100% lavender essential oil for 20 minutes from a cotton pad placed about 5 cm from the nose before surgery. In the control group, patients inhaled room air only and received routine preoperative nursing care. All participants completed a short questionnaire, the 21-item Depression Anxiety Stress Scale-21 (DASS-21), before and after the intervention to measure their levels of anxiety, stress, and depression. A total of 128 patients took part, with 64 in the lavender group and 64 in the control group. The results showed that patients who received lavender aromatherapy had lower anxiety, stress, and depression scores before surgery compared with those who did not receive aromatherapy. These findings suggest that lavender inhalation aromatherapy may be a safe, low-cost, and easy-to-use option to improve psychological well-being for orthopedic surgery patients in the preoperative period.