Behaviors and Mental Disorders

All Conditions

Neoplasms

Skin and Connective Tissue Diseases

Symptoms and General Pathology

Depression

Depressive Disorder

Depressive Disorder, Major

Depressive Disorder, Treatment-Resistant

Ganglion Cysts

Synovial Cyst

Cysts

Behavioral Symptoms

Mood Disorders

Mental Disorders

Psychotic Disorders

Mucinoses

Connective Tissue Diseases

Central Nervous System Depressants

All Drugs and Chemicals

Pharmaceutical Solutions

Bupivacaine

Anesthetics

Anesthetics, Local

Injection of Bupivacaine Hydrochloride 0.5% near the stellate ganglion.

Injection of Normal Saline near the stellate ganglion

Injection of Bupivacaine near the stellate ganglion

Bupivacaine Hydrochloride

Normal Saline

Karim Ladha, MD

This is a feasibility study, to investigate a new treatment option for major depressive disorders by performing a Stellate Ganglion Block (SGB). A SGB is an injection of local anesthetic into the sympathetic nervous system (peripheral nervous system) located in the lower part of the neck, to relieve pain in the head, neck, upper arm, and upper chest.

Stellate Ganglion Block for Major Depressive Disorder.

Stellate Ganglion Block for Major Depressive Disorder: A Randomized Controlled Pilot Trial

No individual participant data has been planned to be shared with other researchers at this point since this is a feasibility study with only 10 participants.

Recruitment rate, withdrawal rate, adherence rate, frequency of adverse events

≥ 50% reduction in the Montgomery-Åsberg Depression Rating Scale (MADRS) score. The MADRS score range from 0 to 6 = no depression; from 7 to 19 = mild depression, 20 to 34 = moderate depression, 35 and greater = severe depression, and a total score of 60 or greater = very severe depression

Unity Health Toronto

Soft Tissue Neoplasms

Exparel mixed with bupivacaine to be infiltrated in the subcutaneous region of the wound instead of plain bupivacaine

Liposomal bupivacaine

plain bupivacaine subcutaneous injection as standard of care control

Jared Sanderford, DO

Nicolas Tedesco, DO

Liposomal bupivacaine (Exparel) has been used as an adjunct to pain management in the perioperative setting. However, the efficacy of the drug has not bewen studied in patients with benign soft tissue tumor resections. The goal of the study is to see if Exparel controls pain and improves functional outcomes for patients after these procedures compared to the current standard Bupivacaine HCL.

Liposomal bupivacaine (Exparel) has been used as an adjunct to pain management in the perioperative setting. However, the efficacy of the drug has not bewen studied in patients with benign soft tissue tumor resections. The goal of the study is to see if Exparel controls pain and improves functional outcomes for patients after these procedures compared to the current standard Bupivacaine HCL.

Patients will be randomly assigned Exparel or Bupivacaine HCL intraoperatively during the tumor resection. The amount administered is based on the size of wound after tumor resection. The patients are then provided a pain diary in which they record the amount of pain medications taken, VAS pain scores, and musculoskeletal and tumor society score (MSTS) for the first week postoperatively.

The study will end once 140 patients have been enrolled. Data will be analyzed comparing morphine equivalents, pain scores, and functional scores between the groups.

Liposomal Bupivacaine in Benign Soft Tissue Tumor Resection

Efficacy of Liposomal Bupivacaine in Benign Soft Tissue Tumor Resection: A Randomized Controlled Trial

Amount of morphine equivalents used for postoperative pain control

Samaritan Health Services

Breast Neoplasms

Analgesics

Dexmedetomidine

Ketamine

Anesthetics, Dissociative

Anesthetics, Intravenous

Anesthetics, General

Excitatory Amino Acid Antagonists

Neurotransmitter Agents

Will receive ultrasound guided ESPB with 0,25% Bupivacaine .

Will receive ultrasound guided ESPB with 0,25% Bupivacaine + Dexmedetomidine.

will receive ultrasound guided ESPB with 0,25% Bupivacaine + Ketamine.

injection of Bupivacaine 0.25% and dexmedetomedine in ESPB

Bupivacaine Hydrochloride and dexmedetomedine

injection of Bupivacaine 0.25% and ketamine in ESPB

Bupivacaine Hydrochloride and ketamine

Ehab H Shaker, MD

Persistent pain after breast cancer surgery is frequently observed in more than 60% of patients.The suboptimal management of perioperative pain can lead to the occurrence of persistent breast cancer pain syndrome and phantom breast pain. Dexmedetomidine, a novel α2-agonist with an eight-fold affinity for α2-adrenergic receptors (sedate and analgesic effects) as clonidine, while exerts much less α1-effects., has been found to significantly increase the duration of peripheral nerve blocks, with minimal systemic side effects.

Ketamine is a non-competitive antagonist of the N-methyl-D-aspartate (NMDA) receptors. It is used for sedation, premedication, induction, and maintenance of general anesthesia. Central, regional, and local anesthetic and analgesic properties have been reported for ketamine. Both can be used through Erector spinae plane block for postoperative pain control.

Persistent pain after breast cancer surgery is frequently observed in more than 60% of patients.The suboptimal management of perioperative pain can lead to the occurrence of persistent breast cancer pain syndrome and phantom breast pain.

A systematic review and meta-analysis of experimental studies showed that the provision of effective analgesia reduces both the number and incidence of metastases in experimental cancer models . Pain may influence body homeostasis and cancer progression by pain-related immune suppression.

General anesthesia is the conventional, most frequently used anesthetic technique in breast cancer surgical interventions. Various regional anesthetic techniques have also been used; these include local wound infiltration, thoracic epidural anesthesia, paravertebral block (PVB), thoracic spinal anesthesia, and more recently, ultrasound-guided interfacial plane blocks such as pectoral nerve (PECS) blocks type 1 and 2 and the serratus plane block (SPB). Recently introduced erector spinae plane block (ESPB) requires less technical expertise (easy), and may be a safe alternative to PVB. ESP block is described for treating thoracic neuropathic pain with encouraging results. ESP is a potential space deep to erector spinae muscle (ES), where the injected local anaesthetic (LA) spreads cranio-caudally up to several levels as the ES fascia extends from nuchal fascia cranially to the sacrum caudally (C7-T2 cranially and L2-L3 caudally), The block covers somatic and visceral pain during breast surgery blocks by blocking ventral rami, dorsal rami of spinal nerves, and rami communicans that transmit sympathetic fibers.

There is another potentially beneficial effects of regional anaesthesia and analgesia on perioperative outcomes, these include decreased opioids consumption , lower rate of post-operative pulmonary complications, decreased post-operative nausea vomiting (PONV) and decreased duration of post-anaesthesia care unit stay. Regional anaesthesia has long-term oncological outcomes as it is considered protective for cancer recurrence by its indirect and direct antiproliferative effects.

Over recent years, the addition of multiple types of additives to local anesthetics has been reported to improve analgesic effect of peripheral nerve block and regional blocks Dexmedetomidine, a novel α2-agonist with an eight-fold affinity for α2-adrenergic receptors (sedate and analgesic effects) as clonidine, while exerts much less α1-effects., has been found to significantly increase the duration of peripheral nerve blocks, with minimal systemic side effects.

Ketamine is a non-competitive antagonist of the N-methyl-D-aspartate (NMDA) receptors. It is used for sedation, premedication, induction, and maintenance of general anesthesia. Central, regional, and local anesthetic and analgesic properties have been reported for ketamine.

Dexmedetomedine and Ketamine in Erector Spinae Block for Postoperative Analgesia Following Mastectomy.

Comparative Study Between Dexmedetomedine and Ketamine in Erector Spinae Plane Block for Postoperative Analgesia Following Modified Radical Mastectomy. A Prospective Randomized Controlled Study.

Calculation of Visual analogue scale at rest and mouvement. It is 10 points scale from 0 to 10 where 0 represents no pain while 10 represents maximum pain

National Cancer Institute, Egypt

Associate Professor of Anesthesia, ICU and Pain management

Respiratory Tract (Lung and Bronchial) Diseases

Pain, Postoperative

Lung Neoplasms

Pain

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

Bupivacaine Hydrochloride in perioperative intercostal blockades

Liposomal bupivacaine in perioperative intercostal blockades

Jannie Bisgaard, MD, PhD

Phillip Sperling, BSc

To investigate the effect of liposomal bupivacaine compared with bupivacaine hydrochloride for intercostal blockades for patients undergoing Video-assisted thoracoscopic surgery.

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive routine procedure. It's less invasive than thoracotomy but postoperative pain is still a problem.

At Aalborg University Hospital, intercostal blockades with bupivacaine is used as standard pain treatment for patients undergoing VATS. Adding adjuvants to the blockades may prolong the effect.

The aim of this study is to examine if intercostal nerve blockades with liposomal bupivacaine improves postoperative pain management compared to intercostal nerve blockades with bupivacaine hydrochloride.

Pain After Lung Cancer Surgery - Comparing Traditional Versus Prolonged Release Nerve Blockades

Pain After Thoracoscopic Lung Surgery - the Effect of Intercostal Nerve Blockades With Standard Bupivacaine and Liposomal Bupivacaine - a Randomised Controlled Feasibility Trial

Time in hours to first postoperative administration of Pro Re Nata (PRN) opioids

Total equipotent opioid dose in milligrams during the first 48 hours after surgery.

Pain intensity on a Numerical Rating Scale ranging from 0 indicating no pain to 10 indicating worst pain imaginable during the first two postoperative days.

Time in hours to full mobilisation defined as walking with or without aids.

Need for opioids at discharge (yes or no and equipotent dosage)

Patients are asked to fill out a questionnaire rating their general satisfaction with pain management and sufficiency of pain treatment on a scale from 0 to 10. The questionnaire also assess whether the patients had any perceived side effects and how uncomfortable they were on a scale from 0 to 10.

Jannie Bisgaard Stæhr

Principal Investigator

Analgesics, Opioid

Tramadol

Narcotics

patient will be placed in a sitting position under complete aseptic condition and a cover sheath will be used for the ultrasound probe with an appropriate amount of lubricating gel applied on the probe, a high-frequency linear ultrasound transducer will be placed in a longitudinal orientation 3 cm lateral to the L3 spinous process. This should reveal three muscles superficial to the hyperechoic transverse process shadow as follows: trapezius, rhomboid major, and erector spinae.

Patient in group T will intravenously administrate dose of 1 mg/kg/8hr tramal ( opioid) to be increased upon patient needs up to 2mg/kg/6hr as rescue analgesic.

The patient will be placed in a sitting position under complete aseptic condition and a cover sheath will be used for the ultrasound probe with an appropriate amount of lubricating gel applied on the probe, a high-frequency linear ultrasound transducer will be placed in a longitudinal orientation 3 cm lateral to the L3 spinous process. This should reveal three muscles superficial to the hyperechoic transverse process shadow as follows: trapezius, rhomboid major, and erector spinae. then injecte bupivacaine hydrochloride

Patients in group Tramadol will intravenously administrate dose of 1 mg/kg/8hr tramal to be increased upon patient needs up to 2mg/kg/6hr as rescue analgesic

Tramadol hydrochloride

fatma el sherif, MD

The aim of this study is to evaluate the analgesic efficacy of erector spinae plane block in pediatric cancer patients undergoing open nephrectomy

* Sixty patients will be included in this prospective randomized study. The patients will be allocated into two groups: the ESPB group (group E, n = 30) and the tramal group (group T, n =30).
* All patients will receive standard general anesthesia. Ultrasound-guided ESPB will be performed to group erector spinae plane block

Continuous Erector Spinae Block for Post Analgesia in Pediatric Patients

Continuous Erector Spinae Plane Local Anesthetic Infusion for Postoperative Analgesia in Pediatric Patients Undergoing Nephrectomy: Randomized Controlled Study

total amount of opioid consumption in the frist 48hours postoperative

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Stellate Ganglion Block for Major Depressive Disorder.	NCT04727229	Treatment Resis... Major Depressiv...	Bupivacaine Hyd... Normal Saline	18 Years - 65 Years	Unity Health Toronto
Stellate Ganglion Block for Major Depressive Disorder.	NCT04727229	Treatment Resis... Major Depressiv...	Bupivacaine Hyd... Normal Saline	18 Years - 65 Years	Unity Health Toronto
Liposomal Bupivacaine in Benign Soft Tissue Tumor Resection	NCT05082441	Benign Neoplasm	Liposomal bupiv... Bupivacaine Hyd...	18 Years -	Samaritan Health Services
Dexmedetomedine and Ketamine in Erector Spinae Block for Postoperative Analgesia Following Mastectomy.	NCT05727098	Breast Cancer	Bupivacaine Hyd... Bupivacaine Hyd... Bupivacaine Hyd...	18 Years - 65 Years	National Cancer Institute, Egypt
Pain After Lung Cancer Surgery - Comparing Traditional Versus Prolonged Release Nerve Blockades	NCT05038007	Postoperative P... Lung Cancer Video Assisted ... Blockades Neuro... Anesthesia, Loc...	Liposomal bupiv... Bupivacaine Hyd...	18 Years -	Aalborg University Hospital
Liposomal Bupivacaine in Benign Soft Tissue Tumor Resection	NCT05082441	Benign Neoplasm	Liposomal bupiv... Bupivacaine Hyd...	18 Years -	Samaritan Health Services
Continuous Erector Spinae Block for Post Analgesia in Pediatric Patients	NCT04613830	Pediatric Cance...	Bupivacaine Hyd... Tramadol hydroc...	2 Years - 7 Years	Assiut University

Spots Global Cancer Trial Database for bupivacaine hydrochloride