Clinical Research Directory

Effects of Different Bispectral Index Target Depths on Early Postoperative Recovery Quality in Elderly Patients Undergoing Total Knee Arthroplasty

This is a prospective, single-center, randomized, double-blind controlled trial. The purpose of this study is to determine whether depth-controlled anesthesia with ciprofol guided by Bispectral Index (BIS) can improve early postoperative recovery quality in elderly patients undergoing knee replacement surgery. A total of 130 eligible participants aged 60 years or older will be enrolled. Participants will be randomly assigned to two groups using block randomization based on the Charlson Comorbidity Index (CCI): Deep-anesthesia group: general anesthesia maintained with ciprofol targeting a BIS value of 35-50. Light-anesthesia group: general anesthesia maintained with ciprofol targeting a BIS value of 50-65. Intraoperative BIS values will be continuously monitored, and ciprofol infusion rates will be adjusted to keep BIS within the target range in each group. Standardized pain management including peripheral nerve blocks and postoperative ultrasound-guided continuous femoral nerve block will be provided for all participants. Blood pressure will be managed following the same protocol in both groups. The primary outcome is postoperative recovery quality assessed by the Quality of Recovery-15 (QOR-15) questionnaire on the first day after surgery. Investigators will also collect QOR-15 scores on postoperative day 2 and day 3, and record other clinical outcomes including intraoperative hemodynamic events, postoperative delirium, nausea and vomiting, pain level, sleep quality and hospital length of stay. This study aims to compare postoperative recovery between two different BIS-targeted anesthesia depths for older adults receiving joint-replacement surgery.

Nutrition and Swelling

This study is looking at whether taking a nutritional supplement before and after knee replacement surgery affects normal recovery. The supplement is Xcelerated Recovery (XR), an over-the-counter supplement made with essential amino acids (EAAs), which are building blocks of protein that the body cannot make on its own. Participants aged 65 and older with planned knee replacement surgery, and signs of nutritional risk or reduced muscle strength on short screening questionnaires, will be invited to join. Participants are assigned by chance to one of two groups. One group receives usual care plus the XR supplement, taken twice a day starting 7 days before surgery and continuing for 14 days after surgery. The other group receives usual care without the supplement. Everyone in the study wears a small temporary skin sensor (similar to a temporary tattoo) on the knee and uses a smartphone app to take scans that measure knee size. Participants also have in-person visits before surgery and 2 weeks and 1 month after surgery. The main goal is to measure how knee and leg size (circumference) changes after surgery in each group. Researchers will also look at muscle strength, knee movement, walking and mobility tests, and reported pain. This study is not testing the supplement as a treatment for any disease or medical condition. The results may help researchers better understand how nutrition relates to normal recovery after knee replacement surgery.

Quality ImprOvement stUdy ouTpatient Surgery rapID movE

This quality improvement study aims to evaluate whether the implementation of the Rapid Recovery pathway improved the efficiency of patient flow and evaluating protocol adherence.

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.

Preoperative Muscle Stiffness, Functional Reserve, and Postoperative Quality of Recovery in Lower Extremity Arthroplasty

In elderly patients undergoing arthroplasty surgery, postoperative recovery quality is closely related to preoperative physical reserve. Sarcopenia and reduced muscle quality can increase postoperative complications. This prospective observational study aims to investigate whether preoperative Handgrip Strength (HGS) and muscle stiffness measured by Shear Wave Elastography (SWE) can predict the quality of recovery at postoperative 24 hours (assessed via the Quality of Recovery-15 \[QoR-15T\] score) in patients aged 60 and older undergoing elective total knee or hip arthroplasty.

Total Intravenous Versus Inhalational Anesthesia in Patients Undergoing Hip Fracture Surgery

This prospective observational study aims to compare total intravenous anesthesia (TIVA) with sevoflurane-based inhalational anesthesia in patients aged 65 years and older undergoing hip fracture surgery under general anesthesia. The study will evaluate postoperative quality of recovery using the Quality of Recovery-40 (QoR-40) questionnaire and cognitive outcomes, including postoperative delirium and cognitive status. Pain scores, opioid consumption, recovery room stay, postoperative complications, and patient satisfaction will also be recorded. The anesthesia technique will be determined by the attending anesthesiologist as part of routine clinical practice, and the researchers will not interfere with the choice of anesthesia.

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.

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.

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.

Menthol Chewing Gum After Laparoscopic Colorectal Surgery

This randomized controlled trial was conducted to evaluate the effect of menthol chewing gum on postoperative nausea and vomiting, bowel function, and recovery in patients undergoing laparoscopic colorectal surgery. A total of 50 patients were randomly assigned to an intervention group (n=25) or a control group (n=25). Participants in the intervention group received menthol chewing gum in addition to standard postoperative care, while participants in the control group received standard postoperative care only. Nausea, bowel function, and postoperative recovery were assessed during the first three postoperative days.

Enhanced Recovery Protocol Compliance and Quality of Recovery After Cesarean Delivery

This prospective observational study will evaluate whether adherence to enhanced recovery after cesarean delivery protocols is associated with postoperative recovery quality in women undergoing elective cesarean delivery under spinal anesthesia. A total of 150 participants will be enrolled. Recovery quality will be assessed using the Turkish version of the Obstetric Quality of Recovery-10 questionnaire at 24 hours after surgery. Pain, opioid use, nausea, mobilization, oral intake, breastfeeding, and patient satisfaction will also be evaluated.

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.

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.

VIRTUAL REALITY TRAINING AFTER THORACIC SURGERY

This study aims to investigate the effects of virtual reality-based exercise training after thoracic surgery. Participants undergoing lung resection surgery will be assigned to either a virtual reality exercise training group or a control group receiving standard care. Physical function, pulmonary function, exercise capacity, dyspnea, anxiety, depression, and quality of life will be evaluated before and after the intervention. The findings may help determine whether virtual reality-assisted exercise training improves postoperative recovery in patients undergoing thoracic surgery.

Recovery With Virtual Reality for Stress and Pain

This randomized controlled trial will evaluate whether a brief preoperative virtual reality intervention reduces anxiety and improves early recovery in adults undergoing elective gynecological surgery. Approximately 140 participants will be randomly assigned in a 1:1 ratio to either virtual reality in addition to usual care or usual care alone. The virtual reality intervention will consist of approximately 10-20 minutes of an immersive relaxation experience before surgery. The primary outcome is the change in preoperative anxiety measured before and after the intervention. Secondary outcomes include postoperative quality of recovery, pain, opioid consumption, postoperative nausea and vomiting, and early recovery-related healthcare outcomes.

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.

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.

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.

Pre-emptive Local Anesthesia and Emergence Behavior After Pediatric Dental General Anesthesia

This study will evaluate whether pre-emptive local anesthesia improves early recovery after ambulatory pediatric dental general anesthesia. Children aged 7-12 years scheduled for dental treatment under general anesthesia will be randomly assigned to receive either pre-emptive local anesthesia or no local anesthesia. Emergence delirium, pain, sedation level, and recovery quality will be assessed during the early postoperative period. The primary outcome will be the longitudinal Pediatric Anesthesia Emergence Delirium Scale score during the first 30 minutes in the post-anesthesia care unit.