Clinical Research Directory

The Effect of Preoperative Oral Care Procedures on Postoperative Thirst Discomfort

Aim: To determine the effect of an oral care procedure using cold distilled water, initiated in the preoperative period, on the level of discomfort associated with thirst in patients undergoing lung resection. Methods: This randomized controlled study was conducted between December 12, 2024, and December 24, 2025 with the participation of a sample of 78 patients who undergoing lung surgery in the Thoracic Surgery Department of a University hospital. Patients who received oral care using cold distilled water at four-hour intervals starting from the time of hospital admission were included in the experimental group.

Effect of Teach-Back-Based Discharge Education in Lower Extremity Surgery Patients

This study aims to determine the effect of discharge education based on the Teach-Back method on patients' learning needs and readiness for hospital discharge following lower extremity surgery. Lower extremity surgeries are associated with pain, limited mobility, and decreased self-care ability, which may negatively affect recovery and quality of life. Effective discharge education is therefore essential to support postoperative recovery and continuity of care. This randomized controlled experimental study will be conducted with patients undergoing lower extremity surgery in an orthopedic clinic. Participants will be randomly assigned to an intervention group receiving Teach-Back-based discharge education and a control group receiving routine discharge education. Data will be collected at three time points (before the intervention, at discharge, and 15 days after discharge) using standardized instruments, including the Readiness for Hospital Discharge Scale-Short Form and the Patient Learning Needs Scale. The findings of this study are expected to contribute to improving discharge education practices, enhancing patient readiness for discharge, and reducing postoperative complications and unmet educational needs.

Effect of Probiotic Nasal Irrigation on the Postoperative Care of Chronic Rhinosinusitis

Chronic rhinosinusitis is a common chronic disease in otolaryngology, with a prevalence of approximately 20% in Taiwan. Patients often experience symptoms such as nasal congestion, runny nose, postnasal drip, and olfactory abnormalities, significantly impacting their quality of life. When drug treatment is ineffective, patients may require functional endoscopic sinus surgery to improve symptoms. However, proper postoperative care is often a crucial factor in the success of the surgery. Nasal irrigation is widely used to treat nasal and sinus diseases, with saline solution being the most commonly used irrigation fluid. However, recent studies have indicated that the nasal microbiome may be related to the inflammatory response in chronic rhinosinusitis; therefore, the application of probiotics as nasal irrigation additives has gradually attracted attention. Some studies suggest that certain probiotics may have the potential to regulate local immune responses and reduce inflammation. This study employs a prospective, randomized comparative study design. This study aims to enroll 120 patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis. One month post-surgery, patients will be randomly assigned to two groups: Group 1 (saline nasal irrigation group): Nasal irrigation with 240 mL of warm saline solution twice daily for eight weeks, supplemented with 3 g of maltodextrin as a placebo. Group 2 (probiotic nasal irrigation group): Nasal irrigation with 240 mL of warm saline solution containing 3 g of probiotic heat-killed probiotic LDL557 twice daily for eight weeks (concentration 10\^8 cfu/mL). The heat-killed probiotic LDL557 (Lactobacillus delbrueckii subsp. lactis LDL557) used in this study is a lactic acid bacteria strain screened from corn and developed by Taiwan Synbio Tech Co., Ltd. Two groups of subjects underwent questionnaire assessments, nasal endoscopy, olfactory testing, nasal function testing, nasal bacterial culture, and measurement of inflammatory markers of nasal irrigation fluid before and after nasal irrigation. This study aims to further evaluate the potential clinical benefits of probiotic nasal irrigation in the postoperative care of chronic rhinosinusitis, serving as a reference for future postoperative care models for chronic rhinosinusitis.

Timing of Complications in the First 24 Hours After Admission to a Postoperative

The optimal duration and intensity of intensive care monitoring after surgery is largely determined by clinical experience rather than by objective, time-based evidence. This prospective observational cohort study aims to determine how frequently clinically significant complications occur in adult patients admitted to a postoperative intensive care unit (ICU), and - more specifically - when they occur during the first 24 hours after ICU admission. Patients will be followed under standard clinical care, with no additional intervention. The time of ICU admission is defined as hour 0. Complications are recorded with their exact time of first onset, and cumulative incidence is calculated for the predefined windows 0-2, 2-6, 6-8, 8-12 and 12-24 hours. The study will assess whether complications cluster in the early postoperative period (first 6-8 hours) and what proportion of the total 24-hour complication burden this early window represents. A separate analysis will determine how often patients who remain complication-free during the first 6 hours subsequently develop a new, clinically significant complication. The findings are intended to inform evidence-based decisions about the required duration of close postoperative ICU monitoring

Early Mobilization and No Urinary Catheter After Cesarean for Improved Post Operative Recovery: A Randomized Trial

ERAS (Enhanced Recovery After Surgery) is a set of steps used around surgery to help patients recover faster and better. ERAS guidelines have been adopted in several surgical fields, and evidence-based recommendations have recently been developed for cesarean delivery as well. These guidelines address multiple parts of post-operative care, including prevention of nausea and vomiting, pain control, thromboprophylaxis, early mobilization, urinary catheter use, and discharge counseling. Early mobilization is a key element of ERAS, but there is currently limited high-quality evidence about its specific benefits after cesarean delivery. In theory, mobilizing earlier may reduce thromboembolic events, shorten hospitalization, and speed up return of bowel function. Another important ERAS component is avoiding routine urinary catheter use. Evidence suggests that a no-catheter policy can shorten the time to first mobilization, first eating, and first bowel movement, and can reduce overall hospital stay compared with routine catheter use around cesarean delivery. In a randomized controlled trial of 300 women assigned to immediate versus delayed (12-hour) catheter removal after cesarean delivery, immediate removal reduced bacteriuria and urinary symptoms (dysuria, frequency, urgency), and also shortened time to first mobilization and length of stay. A systematic review also found that inserting a catheter before cesarean delivery increases the risk of urinary tract infection without improving surgical ease. A 2014 Cochrane review concluded that routine catheter use increases time to first urination, increases discomfort, delays mobilization, and prolongs hospital stay. The aim of the present study is to compare early mobilization combined with no urinary catheter in women undergoing planned cesarean delivery versus standard perioperative care, to improve recovery after surgery.

Postoperative Pacing for Cardiac Efficiency

The goal of this study is to determine whether temporarily increasing a child's heart rate after heart surgery can improve blood flow and oxygen supply to the body's tissues. The study will compare temporary atrial pacing at 10 and 20 beats per minute above the child's natural heart rate with the child's natural heart rate without pacing. Participants will be randomly assigned to one of two schedules for these pacing approaches. Each pacing approach has previously been used as part of routine care after heart surgery. The study will test whether temporarily increasing the heart rate improves blood flow and oxygen supply during the first 10 hours after surgery.

Prevalence of Post Anesthesia Care Unit Complications and Associated Factors

The post-anesthesia care unit (PACU) is a crucial component of the surgical process, providing patients with vital support and monitoring as they recover from anesthesia. Despite advancements in perioperative anesthesia, PACU complications are still common. PACU organization and setup in low-income country like Ethiopia is poor. Previous research's done in some neighbor African countries presumed to have comparable to sociodemographic and economical profile shows varied degree of incidence and prevalence of PACU complication and associated factors. The main objective of this study is to determine the prevalence of PACU complications and its associated factors. An institutional based prospective cohort study will be conducted in the PACUs of the three selected tertiary care hospitals in Ethiopia from Februery 15, 2025 to June 30, 2025. These data will be compared with those obtained in a tertiary hospital in Spain.

Turkish APA5 Validity Reliability

The aim of this research is to contribute to the nursing and medical literature by examining the validity and reliability of the English-language "APA 5 (Acute Pain Assessment Tool)" in Turkish.

Portal and Splenic Venous Pulsatility in Postoperative Critically Ill Patients

Venous congestion is common in critically ill postoperative patients and may be associated with adverse outcomes. Doppler ultrasound assessment of venous flow patterns, including portal venous pulsatility, is increasingly used to evaluate systemic venous congestion. This prospective observational study aims to determine the correlation between portal venous pulsatility and splenic venous pulsatility measured by Doppler ultrasound in adult patients admitted to a postoperative intensive care unit. The study will evaluate whether splenic venous pulsatility may provide additional information for the assessment of venous congestion. Ultrasound examinations will be performed in addition to standard clinical care, without any therapeutic intervention or modification of patient management.

Trans-Auricular Stimulation for Postoperative Inflammation in Spine Surgery

This study is a randomized controlled trial that will evaluate the effect of non-invasive auricular vagal nerve stimulation on inflammatory markers, glycemic control, postoperative pain, and inflammation-related clinical outcomes after long-segment spinal fusion surgeries when compared to current accepted management.

Multisensory and Cognitive Interventions in the ICU: Effects on Health and Recovery

The goal of this clinical trial is to examine the effects of sensory and cognitive stimulation on physiological, psychological, and functional recovery in adult patients after cardiac surgery who are treated in the intensive care unit (ICU). The main questions it aims to answer are: * Does sensory and/or cognitive stimulation reduce anxiety and improve hemodynamic stability in ICU patients? * Does it enhance physical function and independence during early rehabilitation in the ICU? Researchers will compare four groups: 1. Standard care (control), 2. Cognitive stimulation, 3. Auditory stimulation (music), 4. Multisensory stimulation (touch + smell) to assess which intervention is most effective in improving recovery parameters. Participants will: * Be randomly assigned to one of four groups during early mobilization in the ICU * Receive a 30-minute intervention session depending on group assignment * Be evaluated for heart rate, blood pressure, oxygen saturation, anxiety (VAS), physical function (PFIT, FIM), and satisfaction before and after the session

Early Mobilization and Prolonged ICU Stay in Postoperative Patients

This prospective observational cohort study aims to evaluate early mobilization in adult postoperative patients admitted to the intensive care unit (ICU) and to investigate its association with short-term clinical outcomes. Early meaningful mobilization is defined as achieving at least sitting at the edge of the bed (mobilization level ≥4) within the first 24 hours after ICU admission. Patients will be classified according to whether early meaningful mobilization is achieved. The primary objective is to evaluate the association between early meaningful mobilization and prolonged ICU stay. Secondary outcomes include mechanical ventilation requirement and duration, hospital length of stay, need for reintubation, development of delirium, complications occurring during mobilization, and ICU mortality.

Machine Learning for Predicting Spinal Anesthesia Duration

Spinal anesthesia provides significant advantages over general anesthesia in knee arthroplasty, including reduced blood loss, faster recovery, and fewer complications. However, predicting its duration is critical for patient safety and effective postoperative management. This study evaluates the usability of machine learning (ML) algorithms to predict the termination time of spinal anesthesia and the patient's readiness for mobilization. Using demographic, surgical, and anesthetic variables, ML models were trained to estimate anesthesia duration. Accurate predictions may improve intraoperative planning, optimize postoperative care, and enhance patient outcomes. Integrating ML-based predictive systems into anesthesia practice can contribute to safer, more efficient, and personalized perioperative management.

The Perioperative Pathway for Older Adults

More than 1.5 million people undergo surgery in Sweden each year, and over 770,000 of them are aged 65 years or older. Older adults often have more complex health needs and may require additional support throughout the surgical care process. Surgical care can be divided into three phases: before, during, and after surgery. Before surgery, older adults may need to improve their health status and prepare for the procedure. Many also feel worried about the surgery and recovery. It is important that patients understand the information they receive and are involved in decisions about their care. However, some older adults find it difficult to understand health information or to ask questions, which can make participation in care more challenging. Recovery after surgery means returning to the same level of function as before surgery, or adjusting to a new level if needed. For older adults, recovery can take longer and often continues after leaving the hospital. Support during this period is important for a safe and successful recovery. The POP project aims to improve the care and support provided to older adults undergoing surgery. The project focuses on identifying gaps and differences in current care and improving support throughout the entire surgical pathway, regardless of the type of surgery. There is currently limited knowledge about how older adults in Sweden experience the surgical care process. By increasing this understanding, the project aims to support improvements in care and outcomes for older adults.

Effectiveness of Telephonic and Digital Postoperative Follow-up Communication Strategies on Patient Compliance, Clinical Recovery, and Quality of Life After Dental Extraction

Effectiveness of Telephonic and Digital Postoperative Follow-up Communication Strategies on Patient Compliance, Clinical Recovery, and Oral Health-related Quality of Life Following Dental Extraction (CONNECT Study - CONtinuous post-operative NETwork Communication to Enhance Compliance after Tooth Extraction) Tooth extraction is one of the most commonly performed dental procedures. Although most patients recover uneventfully, complications such as pain, swelling, bleeding, infection, and dry socket may occur if postoperative instructions are not followed correctly. Dentists routinely provide verbal and written instructions after tooth extraction; however, patients may forget or misunderstand these instructions once they leave the clinic, resulting in reduced compliance and delayed recovery. Previous research conducted at our institution demonstrated that postoperative telephone follow-up improved patient compliance with post-extraction instructions compared with routine verbal and written instructions alone. Building on these findings, the present study aims to evaluate whether different methods of postoperative communication-including telephone calls, digital messaging, and a combination of both-can further improve patient compliance and clinical recovery following dental extraction. Participants undergoing routine dental extraction will receive the standard postoperative verbal and written instructions provided by the Department of Oral and Maxillofacial Surgery. Depending on the assigned study group, participants may also receive structured telephone follow-up, digital communication via a secure messaging platform, or both during the early postoperative period. The information provided through these communication methods will reinforce the same postoperative instructions routinely given in the clinic and will not alter the clinical treatment received. Participants will be followed for one week after the extraction. Information will be collected regarding their adherence to postoperative instructions, pain levels, occurrence of complications such as dry socket, and oral health-related quality of life using validated questionnaires. These assessments will help determine whether additional postoperative communication improves patient recovery and overall treatment outcomes. The study involves minimal risk because the communication methods are intended only to reinforce standard postoperative care and provide patients with an opportunity to clarify any concerns they may have during recovery. Participation in the study is entirely voluntary, and patients may withdraw at any time without affecting the quality of their dental treatment. The findings of this study are expected to provide evidence on the most effective postoperative communication strategy following dental extraction. This may help improve patient education, enhance compliance with postoperative instructions, reduce preventable complications, and support the integration of digital communication technologies into routine dental practice.

Benzydamine Hydrochloride and Post-operative Sore Throat

Postoperative sore throat (POST) after laryngeal mask airway (LMA) insertion is prevalent and unappealing. A significant cause of POST is mechanical injury to the airway mucosa during airway instrumentation, leading to mucosal injury and inflammation. The Difflam Forte Anti-Inflammatory Throat Spray (Difflam) contains benzydamine hydrochloride, a non-steroidal anti-inflammatory agent with topical analgesic properties. This study will randomize 106 women undergoing gynaecological surgery under general anaesthesia with LMA use at KK Women's and Children's Hospital (KKH) in 1:1 allocation ratio of study (Difflam spray) and control (usual practice; no intervention) groups. Demographic and intraoperative airway data collection will be conducted in perioperative period. Those allocated to study group will receive Difflam spray when awake in the post-anaesthesia care unit (PACU). The primary aim to determine if patients undergoing general anaesthesia with LMA use with the Difflam spray in PACU will have a lower incidence of POST in the immediate and 4 hours postoperative recovery period, as compared with those in the control group. Other outcome measures include the severity of pain of sore throat as measured by the visual analog scale, and incidence of side effects associated with the Difflam spray. This proposal will determine whether the use of Difflam spray is suitable to be implemented in local clinical setting and improve perioperative care.

Effect of Postoperative Holistic Nursing Care on Children's Satisfaction and Nursing Image Perception

This randomized controlled study aims to evaluate the effect of holistic nursing care applied during the postoperative period on children's satisfaction with care and their perception of nursing image. The study will be conducted in the Pediatric Surgery Clinic of Antalya Training and Research Hospital with children aged 8 to 11 years who undergo surgical procedures. Participants will be randomly assigned to either an intervention group or a control group. All children will receive routine postoperative nursing care. In addition to routine care, children in the intervention group will participate in a mandala coloring activity accompanied by music. This supportive activity is designed to help children relax, express their feelings, and improve their hospital experience. Data will be collected using standardized questionnaires that measure children's satisfaction with nursing care and their perception of nurses. The study aims to determine whether holistic nursing practices can improve children's satisfaction and positively influence how they perceive the nursing profession.

Sedation With Dexmedetomidine-esketamine Combination and Delirium in ICU Patients

Patients in the intensive care unit (ICU) often develop anxiety and agitation, sleep disturbances, and delirium. Delirium occurrence is associated with worse early and long-term outcomes. Dexmedetomidine and ketamine are recommended for sedation and analgesia in postoperative ICU patients, but each may induce side effects. The sedative effects of dexmedetomidine can help mitigate the neuropsychiatric side effects of esketamine. Recent studies showed that dexmedetomidine-esketamine combination improved analgesia and sleep quality without increasing side effects. This trial is designed to test the hypothesis that dexmedetomidine-esketamine combination for sedation and analgesia in postoperative ICU patients may reduce delirium.

Risk Factors of Atrial Fibrillation After Cardiac Surgery

Supraventricular arrhythmias complicate more than 40% of cardiac surgeries and are associated with an increased risk of bleeding, stroke, heart failure, and death. Preventing the occurrence of these arrhythmias is a major challenge. This study aims to investigate risk factors and protective factors regarding atrial fibrillation and other iatrogenic cardiac arrhythmias after cardiac surgery, particularly innovative anesthetic strategies such as stellar ganglion blockade which have been recently implemented in our center.

Evaluation of ChatGPT-5 and Anesthesiologist Predictions of Postoperative Intensive Care Unit Admission Using Preoperative Clinical Data

Accurate prediction of postoperative intensive care unit (ICU) requirement is essential for patient safety and efficient use of limited ICU resources. In routine clinical practice, decisions regarding postoperative ICU admission are primarily based on anesthesiologists' preoperative clinical judgment, which may vary among clinicians. This prospective, observational study aims to evaluate the agreement between predictions made by ChatGPT-5(Chat Generative Pre-trained Transformer) and anesthesiologists regarding postoperative ICU requirement using routinely collected preoperative patient data, and to compare these predictions with actual postoperative ICU admission outcomes. The study does not involve any intervention, treatment modification, or additional procedures beyond standard clinical care. All patient data are anonymized, and clinical management is not influenced by the model's predictions

Optimized Novel Wireless Assessment of Respiratory and Circulatory Dirstress - Alarm Validation

The ONWARD study evaluates user experiences from continuous vital sign monitoring alarms sent to the clinical staff in case of deviating vital signs at the general hospital ward. User experiences are evaluated though a 5-point likert questionnaire.

Neurocognitive Loading Following Anterior Shoulder Stabilization: A Randomized Controlled Trial

The goal of this randomized controlled clinical trial is to learn if adding neurocognitive loading to standard shoulder rehabilitation improves physical and psychological recovery in adults who have undergone arthroscopic anterior shoulder stabilization surgery (such as Bankart repair, Latarjet, or remplissage procedures). The main questions it aims to answer are: Does adding neurocognitive loading exercises improve shoulder proprioception, muscle strength, and functional performance compared to standard therapy alone? Does this integrated training approach reduce the kinesiophobia? Does it lead to better overall clinical outcomes and improve psychological readiness to return to sports? Researchers will compare a group receiving standard shoulder exercises combined with dual-task neurocognitive loading (using light-based reaction systems and cognitive tasks) to a control group receiving standard shoulder rehabilitation alone. Participants will:Undergo supervised physical therapy sessions starting 10 days after surgery up to the 16th postoperative week (twice a week for the first 12 weeks, and once a week for weeks 13-16) alongside an assigned home exercise program. Complete neurocognitive loading tasks (if assigned to the intervention group) that challenge attention, quick decision-making, and visual reactions while executing physical movements. Attend detailed clinical evaluation sessions lasting about 60 minutes before the treatment starts, and at 6, 12, and 24 weeks after surgery. These assessments include neurocognitive, functional and clinical tests, and questionnaires.

Postoperative Vaginal Compression After Prolapse Surgery - an RCT

The goal of this clinical trial is to learn if omitting postoperative vaginal compression (packing) can facilitate a more efficient recovery after elective surgery for uterovaginal prolapse. The main questions it aims to answer are: Will the omission of vaginal compression result in a non-inferior (unchanged) rate of prolapse recurrence within the first three months after surgery? Does the omission of vaginal compression lead to a shorter hospital stay and a faster return of normal bladder function? Researchers will compare a group that receives no postoperative vaginal compression to a control group that receives standard vaginal gauze packing for two hours to see if skipping the packing leads to shorter hospital stays and faster bladder emptying without increasing the risk of the prolapse returning.

Multimodal AI-Guided Recovery Management After Lung Cancer Surgery

This study is a multicenter, prospective, randomized controlled trial designed to evaluate the effectiveness and safety of a multimodal artificial intelligence (AI)-guided postoperative recovery management system in patients after lung cancer surgery. Eligible patients will be enrolled after surgery when their clinical condition is stable and will be randomly assigned to either an AI-guided recovery management group or a usual postoperative care group. Patients in the AI-guided group will receive usual postoperative care plus a multimodal AI-based recovery management system. The system will collect patient-reported symptoms, vital signs, physical activity, respiratory rehabilitation information, recovery-related data, and, when needed, wound or chest-related images or short videos. Based on these data, the system will provide recovery feedback, general nursing advice, respiratory rehabilitation reminders, activity guidance, and risk stratification alerts. For red-flag symptoms or high-risk conditions, the system will advise patients to contact the clinical team or seek medical care. Patients in the usual-care group will receive standard postoperative management after lung cancer surgery and will complete symptom assessments at the same prespecified time points, but they will not receive AI-generated individualized recovery feedback or AI-generated risk alerts. The primary outcome is the number of MDASI-LC-derived target symptom threshold events within 30 days after surgery. Target symptoms include pain, fatigue, disturbed sleep, shortness of breath, and cough. Secondary outcomes include overall target symptom burden, quality of recovery, time to recovery to a mild-symptom state, functional interference, respiratory rehabilitation adherence, physical activity adherence, unplanned healthcare utilization, pulmonary complications, and unplanned readmission.