Clinical Research Directory

Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Postoperative Recovery Quality in Patients Undergoing Anterior Cruciate Ligament Reconstruction

Background: Arthroscopic anterior cruciate ligament reconstruction (ACLR) is a common orthopedic surgery. Postoperative pain, inflammatory response and opioid-related adverse events impair early recovery quality. Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neuromodulation technique with potential analgesic and anti-inflammatory effects. Participants: A total of 144 eligible participants undergoing ACLR under spinal anesthesia combined with an adductor canal block will be enrolled. Methods: This prospective, randomized, double-blind, sham-controlled trial will evaluate the effects of perioperative taVNS on early postoperative recovery. Participants will be randomly assigned in a 1:1 ratio to receive active taVNS or sham stimulation. Each participant will receive three 30-minute stimulation sessions, scheduled 30-45 minutes before surgery, 6 ± 1 hours after surgery, and 18 ± 1 hours after surgery. All participants will receive standardized multimodal postoperative analgesia. The primary outcome will be the score on the 15-item Quality of Recovery (QoR-15) questionnaire at 24 hours after surgery. Secondary outcomes will include rescue opioid consumption expressed as oral morphine equivalents, pain scores measured using the Numeric Rating Scale (NRS), functional recovery, and adverse events. Conclusion: The investigators hypothesize that perioperative taVNS will improve early postoperative recovery quality after ACLR.

Effect of Opioid-free Anesthesia on Sleep Quality, Cognitive Function and Recovery Quality After General Anesthesia in Elderly Patients

Postoperative cognitive dysfunction (POCD)is a common well disorder of the central nervous system after surgery, mainly manifested by impaired memory, spirit, language ability or other aspects of brain function. POCD, which often occurs in elderly patients over 65 years, The recent phase is recommended to be changed to perioperative neurocognitive impairment ( PND), The PND is used to describe the cognitive function changes that occur before and within 1 year after surgery, Based on the time of disease onset, It can be divided into neurocognitive impairment existing before surgery, postoperative delusion (POD) occurring hours to days after surgery, neurocognitive recovery delay (DNR) within 30 days after surgery, and postoperative neurocognitive impairment occurring weeks to months after surgery (POND). With the acceleration of the aging process of Chinese social population, the frequency of surgical treatment for elderly inpatients has also increased, and the elderly patients have postoperative sleep disorders, and POCD is relatively common. Surgical patients after surgical trauma, the body inflammation, sympathetic excitation and endocrine disorders, make postoperative sleep structure or pattern change, often lead to postoperative sleep disorders (PSD) , the main performance for patients with postoperative complaint difficult to enter and maintain sleep, frequent nightmares, total sleep quantity and quality reduction, etc. PSD is not only the most common manifestation of postoperative brain dysfunction, but also an important risk factor for inducing postoperative fatigue, postoperative hyperalgesia, metabolic dysfunction, and cardiovascular and cerebrovascular diseases. Moreover, it is considered to promote the development of postoperative delusion. At present, the common mode of general anesthesia is still mainly opioids, and opioids are an important part of general anesthesia and perioperative analgesia. Perioperative use of opioids is not only associated with adverse effects such as postoperative nausea and vomiting, excessive sedation, and ileus, but also leads to the occurrence of postoperative hypoxemia, hyperalgesia and postoperative chronic pain, and cognitive impairment. Therefore, the Association of Accelerated Rehabilitation Surgery indicates that the use of a multimodal analgesic regimen during the perioperative period reduces pain and reduces opioid-related adverse effects, and that opioid-free anesthesia ( OFA) is used in clinical work. At present, most clinical studies of OFA focus on adults aged 18-65 or 18 years old, and few studies focus OFA solely on the elderly population to observe its application effect. Therefore, it is necessary to conduct clinical studies to observe postoperative recovery in elderly patients with different types of anesthetics, investigate the incidence and severity of POCD, and determine the efficacy and safety of each anesthetic agent.

The Effects of Regional Anaesthesia Techniques on Hemidiaphragm Paralysis, Postoperative Recovery Quality, Opioid Consumption, and Pain Scores

This study aims to evaluate the effects of ultrasound-guided interscalene, erector spinae plane, costoclavicular, and supraclavicular blocks on hemidiaphragmatic paralysis, postoperative recovery quality, opioid consumption, and pain scores.

Effect of Virtual Reality Application Applied to Patients With Total Knee Replacement at Different Times

The aim of this study was to examine the effect of virtual reality application on anxiety and quality of recovery at different times (preoperatively and intraoperatively) in patients undergoing total knee replacement.