[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"leadSponsorName\":\"Poznan University of Medical Sciences\",\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:":538},{"pageToken":4,"total":5,"offset":6,"count":7,"results":8},null,36,0,25,[9,42,65,86,105,123,145,161,176,195,215,232,248,264,286,314,335,354,374,405,439,466,485,501,520],{"id":10,"slug":11,"hasResults":12,"nctId":13,"briefTitle":14,"officialTitle":15,"acronym":4,"eligibilityCriteria":16,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":20,"targetDuration":4,"studyType":23,"phases":24,"briefSummary":26,"conditions":27,"keywords":4,"overallStatus":29,"whyStopped":4,"lastUpdateSubmitDate":30,"lastUpdatePostDateStruct":31,"startDateStruct":34,"completionDateStruct":36,"leadSponsor":38,"locationsCount":41},"100644943","acb-and-ipack-blocks-with-intravenous-dexamethasone-and-perineural-dexmedetomidine-in-total-knee-arthroplasty-100644943",false,"NCT07677215","ACB and iPACK Blocks With Intravenous Dexamethasone and Perineural Dexmedetomidine in Total Knee Arthroplasty","Comparison of the Efficacy and Safety of Three Adjuvant Strategies for ACB and iPACK Blocks in Patients Undergoing Elective Total Knee Arthroplasty: A Prospective, Randomized Clinical Trial","Inclusion Criteria:\n\n* Age between 60 and 100 years\n* Scheduled for elective primary unilateral total knee arthroplasty\n* American Society of Anesthesiologists (ASA) physical status I-III\n* Ability to understand study procedures and provide written informed consent\n* Eligibility for spinal anesthesia and ultrasound-guided regional anesthesia according to institutional standards\n\nExclusion Criteria:\n\n* Known allergy or hypersensitivity to ropivacaine, dexamethasone, dexmedetomidine, or any study-related medication\n* Contraindications to spinal anesthesia or peripheral nerve blocks\n* Coagulation disorders or anticoagulant therapy preventing safe regional anesthesia\n* Infection at the planned puncture site or systemic infection\n* Severe neurological disorders affecting lower limb sensory or motor function\n* Severe hepatic, renal, or uncontrolled cardiovascular disease\n* Clinically significant bradycardia or advanced atrioventricular conduction abnormalities\n* Chronic opioid use for more than 3 months before surgery\n* Uncontrolled diabetes mellitus or contraindications to dexamethasone administration\n* Inability or refusal to provide written informed consent","ALL","60 Years","100 Years",{"count":21,"type":22},120,"ESTIMATED","INTERVENTIONAL",[25],"NA","This prospective randomized controlled trial aims to compare the analgesic efficacy and safety of three adjuvant strategies for ultrasound-guided Adductor Canal Block (ACB) and iPACK block in patients undergoing elective total knee arthroplasty under spinal anesthesia. All participants will receive standardized spinal anesthesia with 0.5% ropivacaine combined with ACB and iPACK blocks using 0.2% ropivacaine. Patients will be randomized into one of three groups: standard ACB + iPACK without adjuvants, ACB + iPACK with intravenous dexamethasone 8 mg, or ACB + iPACK with intravenous dexamethasone 8 mg combined with perineural dexmedetomidine added to both regional blocks.\n\nThe primary outcome will be total postoperative opioid consumption during the first 48 hours after surgery expressed as intravenous morphine equivalents. Secondary outcomes will include pain intensity at rest and during movement, duration of analgesia, time to first rescue analgesia, quadriceps muscle strength, early mobilization, adverse events, inflammatory markers, and length of hospital stay.",[28],"Knee Osteoarthritis","NOT_YET_RECRUITING","2026-06-29",{"date":32,"type":33},"2026-06-30","ACTUAL",{"date":35,"type":22},"2026-07-01",{"date":37,"type":22},"2027-10-01",{"name":39,"class":40},"Poznan University of Medical Sciences","OTHER",2,{"id":43,"slug":44,"hasResults":12,"nctId":45,"briefTitle":46,"officialTitle":47,"acronym":4,"eligibilityCriteria":48,"healthyVolunteers":12,"sex":17,"minAge":49,"maxAge":19,"enrollmentInfo":50,"targetDuration":4,"studyType":23,"phases":52,"briefSummary":53,"conditions":54,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":30,"lastUpdatePostDateStruct":58,"startDateStruct":59,"completionDateStruct":61,"leadSponsor":63,"locationsCount":64},"100639836","intravenous-dexamethasone-0-vs-4-vs-8-mg-as-an-adjunct-to-peng-block-for-postoperative-analgesia-in-total-hip-arthroplasty-a-randomized-double-blind-trial-100639836","NCT07581470","Intravenous Dexamethasone (0 vs 4 vs 8 mg) as an Adjunct to PENG Block for Postoperative Analgesia in Total Hip Arthroplasty: A Randomized Double-Blind Trial","A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial Evaluating Intravenous Dexamethasone (0 vs 4 vs 8 mg) as an Adjunct to PENG Block for Postoperative Analgesia in Total Hip Arthroplasty","Inclusion Criteria:\n\n* Age ≥ 18 years\n* Scheduled for elective total hip arthroplasty (THA)\n* Planned use of regional anesthesia including PENG block\n* American Society of Anesthesiologists (ASA) physical status I-III\n* Ability to understand the study procedures and provide written informed consent\n* Ability to assess pain using the Numeric Rating Scale (NRS)\n\nExclusion Criteria:\n\n* Known hypersensitivity to dexamethasone or any component of the study medication\n* Chronic corticosteroid therapy or use of systemic steroids within 14 days prior to surgery\n* Active systemic infection or sepsis\n* Significant immunosuppression (e.g., chemotherapy, biological therapy)\n* Pregnancy or breastfeeding\n* Severe cognitive impairment or inability to reliably assess pain\n* Uncontrolled diabetes mellitus (e.g., HbA1c \\> 8.5% or baseline blood glucose \\> 200 mg\u002FdL)","18 Years",{"count":51,"type":22},198,[25],"his study will test whether giving dexamethasone through a vein can improve pain control after total hip replacement surgery. Dexamethasone is commonly used to reduce nausea and may also help with pain, but it is not clear which dose works best. Patients will be randomly assigned to receive either no dexamethasone, 4 mg, or 8 mg, in addition to standard anesthesia and a nerve block (PENG block). The main goal is to see how long patients go without needing additional pain medication after surgery. The study will also look at pain levels, use of opioid painkillers, nausea and vomiting, blood sugar levels, and possible side effects.",[55,56],"Osteoarthritis, Hip","Hip Osteoarthritis","RECRUITING",{"date":35,"type":33},{"date":60,"type":33},"2026-05-08",{"date":62,"type":22},"2027-07-31",{"name":39,"class":40},1,{"id":66,"slug":67,"hasResults":12,"nctId":68,"briefTitle":69,"officialTitle":70,"acronym":4,"eligibilityCriteria":71,"healthyVolunteers":12,"sex":17,"minAge":72,"maxAge":49,"enrollmentInfo":73,"targetDuration":4,"studyType":23,"phases":75,"briefSummary":76,"conditions":77,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":30,"lastUpdatePostDateStruct":80,"startDateStruct":81,"completionDateStruct":83,"leadSponsor":85,"locationsCount":64},"100639340","tranexamic-acid-in-pediatric-idiopathic-scoliosis-surgery-100639340","NCT07581457","Tranexamic Acid in Pediatric Idiopathic Scoliosis Surgery","Efficacy and Safety of Two Intravenous Tranexamic Acid Regimens Versus Placebo in Pediatric Idiopathic Scoliosis Surgery: A Randomized Double-Blind Trial","Inclusion Criteria:\n\n* Age 10 to 18 years\n* Diagnosis of idiopathic scoliosis requiring surgical correction (posterior spinal fusion)\n* American Society of Anesthesiologists (ASA) physical status I-II\n* Written informed consent from parents or legal guardians and assent from the child\n\nExclusion Criteria:\n\n* Congenital or acquired coagulopathy\n* History of thromboembolic disease\n* History of seizures or epilepsy\n* Known hypersensitivity to tranexamic acid\n* Renal insufficiency (estimated glomerular filtration rate \\\u003C 60 mL\u002Fmin\u002F1.73 m²)\n* Cardiac arrhythmias or cardiovascular disease requiring antiplatelet or anticoagulant therapy","10 Years",{"count":74,"type":22},90,[25],"This study will evaluate whether tranexamic acid (TXA), a medication used to reduce bleeding, is effective and safe in children undergoing surgery for idiopathic scoliosis. Significant blood loss is common during this type of surgery and often requires blood transfusions.\n\nParticipants will be randomly assigned to one of three groups: (1) TXA given as an intravenous bolus followed by continuous infusion, (2) TXA given as two intravenous bolus doses, or (3) placebo (saline). Neither the patients nor the medical team will know which treatment is given.\n\nThe main goal is to compare how much blood is lost during and after surgery and whether TXA reduces the need for blood transfusions. The study will also assess safety, including the risk of side effects such as seizures or blood clots.\n\nPatients will be followed for up to 30 days after surgery.",[78,79],"Scoliosis Idiopathic","Scoliosis; Adolescence",{"date":35,"type":33},{"date":82,"type":22},"2026-06-01",{"date":84,"type":22},"2027-06-30",{"name":39,"class":40},{"id":87,"slug":88,"hasResults":12,"nctId":89,"briefTitle":90,"officialTitle":91,"acronym":4,"eligibilityCriteria":92,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":94,"targetDuration":4,"studyType":23,"phases":96,"briefSummary":97,"conditions":98,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":30,"lastUpdatePostDateStruct":99,"startDateStruct":100,"completionDateStruct":102,"leadSponsor":104,"locationsCount":64},"100627497","sii-levels-following-peng-block-in-hip-arthroplasty-100627497","NCT07449403","SII Levels Following PENG Block in Hip Arthroplasty","Pericapsular Nerve Group Block Mitigates Surgical Stress and Enhances Analgesia in Total Hip Arthroplasty: A Randomized Controlled Trial","Inclusion Criteria:\n\n* Patients with ASA classification I-III\n* Aged 65-100 years\n* Who will be scheduled for hip arthroplasty under spinal anesthesia\n\nExclusion Criteria:\n\n* Patients who have a history of bleeding diathesis\n* Take anticoagulant therapy\n* History of chronic pain before surgery\n* Multiple trauma\n* patients unable to assess their pain (dementia)\n* patients operated under general anesthesia\n* patients having an infection in the region of the procedure\n* the patient who does not accept the procedure","65 Years",{"count":95,"type":22},60,[25],"This randomized controlled trial evaluates the effect of ultrasound-guided Pericapsular Nerve Group (PENG) block on the Systemic Immune-Inflammation Index (SII) in elderly patients undergoing total hip arthroplasty under spinal anesthesia. SII, calculated as platelet × neutrophil \u002F lymphocyte count, is used as a composite marker of perioperative inflammatory and immune response. The study investigates whether PENG block attenuates the systemic inflammatory reaction to surgical trauma compared to sham block.",[56],{"date":35,"type":33},{"date":101,"type":33},"2026-03-01",{"date":103,"type":22},"2026-09-30",{"name":39,"class":40},{"id":106,"slug":107,"hasResults":12,"nctId":108,"briefTitle":109,"officialTitle":110,"acronym":4,"eligibilityCriteria":111,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":112,"targetDuration":4,"studyType":23,"phases":114,"briefSummary":115,"conditions":116,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":30,"lastUpdatePostDateStruct":118,"startDateStruct":119,"completionDateStruct":120,"leadSponsor":122,"locationsCount":64},"100618151","peng-block-vs-peng-plus-periarticular-injection-vs-periarticular-injection-in-older-adults-100618151","NCT07327892","PENG Block vs PENG Plus Periarticular Injection vs Periarticular Injection in Older Adults","Comparison of Pericapsular Nerve Group (PENG) Block, PENG Block Plus Periarticular Injection, and Periarticular Injection Alone for Postoperative Pain Management in Older Adults Undergoing Hip Surgery: A Randomized Controlled Trial","Inclusion Criteria:\n\n* Age 65 years or older\n* Scheduled for elective or emergency hip surgery (e.g., hip fracture fixation or hip arthroplasty)\n* ASA physical status I-III\n* Ability to communicate pain intensity using the NRS scale\n* Written informed consent obtained from the patient or legal representative\n\nExclusion Criteria:\n\n* Patient refusal or inability to provide informed consent\n* Allergy, intolerance, or contraindication to any study medication: ropivacaine\n* Pre-existing neurological deficit or neuropathy of the affected limb\n* Coagulopathy (INR \\>1.5, platelets \\\u003C100,000\u002FµL) or current therapeutic anticoagulation that contraindicates regional anesthesia\n* Infection at or near the injection site\n* Severe hepatic or renal impairment\n* History of chronic opioid use (daily opioids \\>30 days before surgery)\n* Cognitive impairment or delirium precluding reliable pain assessment\n* BMI \\> 40 kg\u002Fm² (if you want to exclude for technical difficulty)\n* Patients receiving another regional nerve block for hip surgery\n* Pregnancy or breastfeeding\n* Participation in another interventional clinical trial within 30 days",{"count":113,"type":22},108,[25],"Pain after hip surgery is common in older adults and may limit early mobilization, increase the need for opioid medications, and contribute to complications such as delirium, nausea, or prolonged hospital stay. Effective postoperative pain management that preserves muscle strength and supports early rehabilitation is especially important in this population.\n\nSeveral analgesic strategies are currently used after hip surgery. Periarticular injection (PAI), administered by the surgeon during the procedure, is commonly used as part of standard care. The pericapsular nerve group (PENG) block is a newer ultrasound-guided regional anesthesia technique that targets the sensory nerves of the hip joint while sparing motor function. It may provide effective pain relief and facilitate early mobilization. However, it is unclear whether PENG block alone is superior to periarticular injection, and whether combining both techniques provides additional benefit.\n\nThe aim of this randomized controlled clinical study is to compare three postoperative analgesic strategies in older adults undergoing hip surgery: PENG block alone, PENG block combined with periarticular injection, and periarticular injection alone. Participants will be randomly assigned to one of three study groups.\n\nThe primary hypothesis is that regional anesthesia with a PENG block, either alone or combined with periarticular injection, will provide superior postoperative pain control compared with periarticular injection alone. A secondary hypothesis is that the combination of PENG block and periarticular injection will offer additional analgesic benefit compared with PENG block alone.\n\nOutcomes assessed in this study will include postoperative pain intensity, need for additional pain medications, time to first mobilization, and the occurrence of adverse events relevant to older adults, such as hypotension, excessive sedation, or postoperative delirium.\n\nThe results of this study may help determine the most effective and practical analgesic strategy for hip surgery in older adults and support evidence-based optimization of postoperative pain management.",[56,117],"Arthropathy of Hip",{"date":35,"type":33},{"date":60,"type":33},{"date":121,"type":22},"2027-02-28",{"name":39,"class":40},{"id":124,"slug":125,"hasResults":12,"nctId":126,"briefTitle":127,"officialTitle":128,"acronym":4,"eligibilityCriteria":129,"healthyVolunteers":12,"sex":17,"minAge":130,"maxAge":131,"enrollmentInfo":132,"targetDuration":4,"studyType":23,"phases":134,"briefSummary":135,"conditions":136,"keywords":4,"overallStatus":29,"whyStopped":4,"lastUpdateSubmitDate":138,"lastUpdatePostDateStruct":139,"startDateStruct":141,"completionDateStruct":142,"leadSponsor":144,"locationsCount":64},"100638438","sii-levels-following-peng-block-in-pediatric-hip-surgery-100638438","NCT07607535","SII Levels Following PENG Block in Pediatric Hip Surgery","Pericapsular Nerve Group Block Mitigates Surgical Stress and Enhances Analgesia in Pediatric Hip Surgery: A Randomized Controlled Trial","Inclusion Criteria:\n\n* Age 3-8 years\n* Scheduled for elective unilateral hip surgery\n* American Society of Anesthesiologists (ASA) physical status I-III\n* Written informed consent from the parent or legal guardian\n\nExclusion Criteria:\n\n* Contraindications to spinal anesthesia or PENG block\n* Infection at the planned needle insertion site\n* Coagulation disorders\n* Chronic immunosuppressive therapy or chronic steroid use\n* Active infection or inflammatory disease\n* Ongoing oncological treatment\n* Known allergy to local anesthetics or study-related medications\n* Conversion to general anesthesia\n* Refusal to participate","3 Years","8 Years",{"count":133,"type":22},100,[25],"This study is a prospective, randomized, double-blind clinical trial. Its aim is to evaluate whether adding a pericapsular nerve group (PENG) block to spinal anesthesia can reduce the inflammatory response after hip surgery in children.\n\nHip surgery in children can cause a strong stress and inflammatory reaction, which may affect pain after surgery, the need for opioid medications, and recovery.\n\nChildren aged 3 to 8 years will be randomly assigned to one of two groups: spinal anesthesia alone or spinal anesthesia combined with a PENG block. The main goal is to compare changes in the Systemic Immune-Inflammation Index (SII), a blood-based marker of inflammation, measured before surgery and 24 hours after surgery.\n\nAdditional outcomes include other inflammatory markers, postoperative pain, opioid use, time to first rescue pain medication, and side effects.",[137],"Hip Dysplasia","2026-05-20",{"date":140,"type":33},"2026-05-26",{"date":82,"type":22},{"date":143,"type":22},"2027-08-31",{"name":39,"class":40},{"id":146,"slug":147,"hasResults":12,"nctId":148,"briefTitle":149,"officialTitle":150,"acronym":4,"eligibilityCriteria":151,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":152,"targetDuration":4,"studyType":23,"phases":153,"briefSummary":154,"conditions":155,"keywords":4,"overallStatus":29,"whyStopped":4,"lastUpdateSubmitDate":138,"lastUpdatePostDateStruct":157,"startDateStruct":158,"completionDateStruct":159,"leadSponsor":160,"locationsCount":64},"100637400","lumbar-paravertebral-block-vs-erector-spinae-plane-block-in-elderly-patients-undergoing-lumbar-spine-surgery-100637400","NCT07607509","Lumbar Paravertebral Block vs Erector Spinae Plane Block in Elderly Patients Undergoing Lumbar Spine Surgery","A Prospective, Randomized Controlled Trial Comparing the Analgesic Efficacy of Lumbar Paravertebral Block and Lumbar Erector Spinae Plane Block in Elderly Patients Undergoing Lumbar Spine Surgery","Inclusion Criteria:\n\n* ge ≥65 years\n* Scheduled for elective lumbar spine surgery\n* American Society of Anesthesiologists (ASA) physical status I-III\n* Ability to assess pain using the Numeric Rating Scale (NRS)\n* Provision of written informed consent\n\nExclusion Criteria:\n\n* Refusal to participate\n* Chronic opioid therapy\n* Coagulation disorders\n* Use of anticoagulant therapy contraindicating regional anesthesia\n* Infection at the planned needle insertion site\n* Allergy to ropivacaine or other study-related medications\n* Severe hepatic failure\n* Severe renal failure\n* Cognitive impairment preventing reliable pain assessment\n* Inability to cooperate with study procedures\n* Extensive reoperation or surgery of unusually large extent that may interfere with outcome assessment\n* Contraindications to general anesthesia or regional anesthesia",{"count":21,"type":22},[25],"This prospective, randomized controlled trial aims to compare the analgesic efficacy of lumbar paravertebral block (L-PVB) and lumbar erector spinae plane block (L-ESPB) in elderly patients undergoing lumbar spine surgery. Effective postoperative pain management in this population is essential due to increased susceptibility to opioid-related adverse effects.\n\nParticipants aged 65 years and older will be randomly assigned to receive either bilateral L-PVB or bilateral L-ESPB in addition to standardized general anesthesia. The primary objective is to evaluate differences in postoperative opioid consumption within the first 48 hours after surgery. Secondary outcomes include pain intensity, intraoperative opioid use, time to mobilization, length of hospital stay, and incidence of opioid-related adverse events.",[156],"Spine Disease",{"date":140,"type":33},{"date":82,"type":22},{"date":143,"type":22},{"name":39,"class":40},{"id":162,"slug":163,"hasResults":12,"nctId":164,"briefTitle":165,"officialTitle":166,"acronym":4,"eligibilityCriteria":92,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":167,"targetDuration":4,"studyType":23,"phases":168,"briefSummary":169,"conditions":170,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":138,"lastUpdatePostDateStruct":171,"startDateStruct":173,"completionDateStruct":174,"leadSponsor":175,"locationsCount":64},"100627500","sii-levels-following-ipack-block-with-adductor-canal-block-in-knee-arthroplasty-100627500","NCT07449442","SII Levels Following iPACK Block With Adductor Canal Block in Knee Arthroplasty","iPACK Block With Adductor Canal Block Mitigates Surgical Stress and Enhances Analgesia in Total Hip Arthroplasty: A Randomized Controlled Trial",{"count":95,"type":22},[25],"This randomized controlled trial evaluates the effect of ultrasound-guided iPACK block with Adductor Canal Block (ACB) on the Systemic Immune-Inflammation Index (SII) in elderly patients undergoing total hip arthroplasty under spinal anesthesia. SII, calculated as platelet × neutrophil \u002F lymphocyte count, is used as a composite marker of perioperative inflammatory and immune response. The study investigates whether iPACK block with ACB attenuates the systemic inflammatory reaction to surgical trauma compared to sham block.",[28],{"date":172,"type":33},"2026-05-22",{"date":101,"type":33},{"date":32,"type":22},{"name":39,"class":40},{"id":177,"slug":178,"hasResults":12,"nctId":179,"briefTitle":180,"officialTitle":181,"acronym":4,"eligibilityCriteria":182,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":183,"targetDuration":4,"studyType":23,"phases":185,"briefSummary":186,"conditions":187,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":138,"lastUpdatePostDateStruct":189,"startDateStruct":190,"completionDateStruct":192,"leadSponsor":194,"locationsCount":64},"100629455","diaphragm-sparing-regional-anesthesia-techniques-for-shoulder-surgery-100629455","NCT07474896","Diaphragm-Sparing Regional Anesthesia Techniques for Shoulder Surgery","Comparison of Interscalene Brachial Plexus Block Versus the Combination of Suprascapular and Infraclavicular Brachial Plexus Block for Shoulder Surgery: A Randomized Controlled Trial With Diaphragmatic Function Assessment","Inclusion Criteria:\n\n* Age ≥ 65 years\n* Elective shoulder surgery\n* ASA I-III\n* Planned use of regional anesthesia\n* Signed written informed consent\n\nExclusion Criteria:\n\n* Allergy to local anesthetics\n* Planned continuous catheter technique\n* BMI \\>40 kg\u002Fm²\n* Coagulopathy or anticoagulation\n* Pre-existing phrenic nerve palsy\n* Neurological disorder of the operative limb\n* Pregnancy or breastfeeding\n* Participation in another clinical trial within 30 days",{"count":184,"type":22},70,[25],"This study will compare two regional anesthesia techniques for shoulder surgery and evaluate their effects on diaphragmatic function. The standard regional anesthesia technique for shoulder surgery is the interscalene brachial plexus block (ISB), which provides effective analgesia but is frequently associated with ipsilateral hemidiaphragmatic paresis due to phrenic nerve involvement.\n\nAn alternative diaphragm-sparing strategy is the combination of a suprascapular nerve block (SSNB) and an infraclavicular brachial plexus block (ICB), which may reduce the risk of diaphragmatic dysfunction while maintaining effective analgesia for shoulder surgery.\n\nAll participants will receive ultrasound-guided regional anesthesia prior to surgery and will be randomly assigned to one of two groups:\n\nGroup 1: Interscalene brachial plexus block Group 2: Suprascapular nerve block combined with infraclavicular brachial plexus block The primary aim of this study is to determine whether the diaphragm-sparing technique reduces the incidence of hemidiaphragmatic paresis while providing analgesia comparable to the standard interscalene block. Diaphragmatic movement will be assessed using ultrasound before and after block placement. Secondary outcomes include postoperative pain intensity, opioid consumption, pulmonary function parameters, and block-related complications.",[188],"Osteoarthritis Shoulder",{"date":172,"type":33},{"date":191,"type":33},"2025-12-10",{"date":193,"type":22},"2027-01-31",{"name":39,"class":40},{"id":196,"slug":197,"hasResults":12,"nctId":198,"briefTitle":199,"officialTitle":200,"acronym":4,"eligibilityCriteria":201,"healthyVolunteers":12,"sex":17,"minAge":202,"maxAge":203,"enrollmentInfo":204,"targetDuration":4,"studyType":23,"phases":206,"briefSummary":207,"conditions":208,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":138,"lastUpdatePostDateStruct":211,"startDateStruct":212,"completionDateStruct":213,"leadSponsor":214,"locationsCount":64},"100629456","perineural-vs-intravenous-dexamethasone-as-an-adjuvant-to-brachial-plexus-block-in-pediatric-hand-surgery-100629456","NCT07474909","Perineural vs Intravenous Dexamethasone as an Adjuvant to Brachial Plexus Block in Pediatric Hand Surgery","Comparison of Perineural Versus Intravenous Dexamethasone as an Adjuvant to Brachial Plexus Block in Pediatric Hand and Forearm Surgery: A Randomized Double-Blind Placebo-Controlled Trial With Neurological Safety Evaluation and Neurofilament Light Chain Biomarker Assessment","Inclusion Criteria:\n\n* Age 3 months to 16 years\n* Scheduled elective hand or forearm surgery under general anesthesia with a brachial plexus block\n* ASA physical status I-III\n* Planned use of ultrasound-guided regional anesthesia\n* Written informed consent from parent(s) or legal guardian and age-appropriate assent from the child\n\nExclusion Criteria:\n\n* Pre-existing neurological disease or peripheral neuropathy\n* Preoperative sensory deficit in the operative limb\n* Infection at or near the needle insertion site\n* Coagulopathy or therapeutic anticoagulation\n* Systemic infection or sepsis\n* Chronic steroid therapy within 30 days before surgery\n* Known allergy to ropivacaine or dexamethasone\n* Diabetes mellitus\n* BMI \\> 99th percentile for age and sex.\n* Pregnancy or breastfeeding\n* Participation in another interventional clinical trial within 30 days\n* Refusal of consent","3 Months","16 Years",{"count":205,"type":22},150,[25],"This clinical trial will evaluate the neurological safety and analgesic effectiveness of dexamethasone administered perineurally or intravenously as an adjuvant to brachial plexus block in children undergoing hand or forearm surgery. Dexamethasone is commonly used to prolong the duration of regional anesthesia, but there is limited evidence on long-term neurological safety, particularly in pediatric patients.\n\nAll participants will receive a single-shot brachial plexus block using ropivacaine under ultrasound guidance. Patients will be randomized into one of three treatment groups:\n\nperineural dexamethasone, intravenous dexamethasone, or placebo. The primary objective is to determine whether perineural dexamethasone causes any clinically significant nerve injury compared with intravenous administration or placebo. Neurological function will be assessed clinically and via serum neurofilament light chain (NfL) levels over a 12-month follow-up period.\n\nThis study may provide evidence regarding the long-term safety profile of perineural dexamethasone in children and help establish evidence-based dosing and administration guidelines.",[209,210],"Hand Injuries and Disorders","Wrist Sprain",{"date":172,"type":33},{"date":191,"type":33},{"date":193,"type":22},{"name":39,"class":40},{"id":216,"slug":217,"hasResults":12,"nctId":218,"briefTitle":219,"officialTitle":220,"acronym":4,"eligibilityCriteria":221,"healthyVolunteers":12,"sex":17,"minAge":222,"maxAge":19,"enrollmentInfo":223,"targetDuration":4,"studyType":23,"phases":225,"briefSummary":226,"conditions":227,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":138,"lastUpdatePostDateStruct":228,"startDateStruct":229,"completionDateStruct":230,"leadSponsor":231,"locationsCount":64},"100627502","peng-block-and-delirium-after-hip-arthroplasty-100627502","NCT07449468","PENG Block and Delirium After Hip Arthroplasty","Effect of Pericapsular Nerve Group (PENG) Block Added to Spinal Anesthesia on Postoperative Delirium in Older Adults Undergoing Primary Total Hip Arthroplasty: A Prospective, Randomized, Assessor-Blinded Controlled Trial","Inclusion Criteria:\n\n* Age ≥ 75 years\n* Scheduled for elective primary total hip arthroplasty\n* Planned spinal anesthesia\n* ASA physical status II-III\n* Ability to provide written informed consent\n* Ability to communicate and reliably assess pain using the Numeric Rating Scale (NRS)\n* Expected postoperative hospitalization ≥ 72 hours\n\nExclusion Criteria:\n\n* Pre-existing delirium, acute psychosis, or active major psychiatric disorder\n* Documented severe dementia or inability to provide informed consent\n* Severe hearing or visual impairment preventing reliable CAM assessment\n* Contraindications to regional anesthesia (e.g., coagulopathy according to institutional standards, infection at the injection site, allergy to local anesthetics)\n* Pre-existing neurological deficits of the operative lower limb are interfering with assessment\n* Chronic opioid use (\\>30 mg morphine milligram equivalents per day for \\>2 weeks prior to surgery)\n* Severe renal impairment (eGFR \\\u003C30 mL\u002Fmin\u002F1.73 m²)\n* Severe hepatic insufficiency\n* Participation in another interventional clinical trial within 30 days\n* Any other condition that, in the investigator's judgment, may interfere with study participation or protocol adherence","75 Years",{"count":224,"type":22},180,[25],"Postoperative delirium is a common and serious complication in older adults undergoing total hip arthroplasty, associated with prolonged hospitalization, increased morbidity, delayed rehabilitation, and long-term cognitive decline. Modifiable perioperative risk factors include uncontrolled postoperative pain, opioid consumption, impaired early mobilization, and systemic inflammatory response.\n\nThe Pericapsular Nerve Group (PENG) block is a regional anesthesia technique targeting the sensory innervation of the anterior hip capsule and may provide effective analgesia while preserving motor function. Improved pain control and opioid reduction may decrease the incidence of postoperative delirium.\n\nThis prospective, randomized, parallel-group controlled trial aims to evaluate whether the addition of ultrasound-guided PENG block to spinal anesthesia reduces the incidence of postoperative delirium within 72 hours after primary total hip arthroplasty in patients aged 65 years or older. Delirium will be assessed using the Confusion Assessment Method (CAM) by blinded outcome assessors.\n\nSecondary outcomes include postoperative opioid consumption, pain intensity (NRS), time to first rescue opioid, postoperative nausea and vomiting, time to mobilization, block-related adverse events, and perioperative inflammatory indices (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio).\n\nThe study will enroll 144 patients randomized 1:1 to spinal anesthesia alone or spinal anesthesia plus PENG block.",[56],{"date":172,"type":33},{"date":101,"type":33},{"date":84,"type":22},{"name":39,"class":40},{"id":233,"slug":234,"hasResults":12,"nctId":235,"briefTitle":236,"officialTitle":237,"acronym":4,"eligibilityCriteria":238,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":239,"targetDuration":4,"studyType":23,"phases":240,"briefSummary":241,"conditions":242,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":138,"lastUpdatePostDateStruct":243,"startDateStruct":244,"completionDateStruct":246,"leadSponsor":247,"locationsCount":64},"100618390","three-variants-of-the-peng-block-with-and-without-perineural-adjuvants-in-older-adults-100618390","NCT07330999","Three Variants of the PENG Block With and Without Perineural Adjuvants in Older Adults","Comparison of Standard PENG Block Versus PENG With Perineural Dexamethasone or Perineural Dexmedetomidine in Patients Aged 65 Years and Older Undergoing Hip Surgery: A Randomized Controlled Trial","Inclusion Criteria:\n\n* Age 65 years or older\n* Scheduled for elective or emergency hip surgery (e.g., hip fracture fixation or hip arthroplasty)\n* ASA physical status I-III\n* Planned use of a PENG block as part of perioperative analgesia\n* Ability to communicate pain intensity using the NRS scale\n* Written informed consent obtained from the patient or legal representative\n\nExclusion Criteria:\n\n* Refusal or inability to provide informed consent\n* Known allergy, intolerance, or contraindication to any of the study medications: ropivacaine, dexamethasone, dexmedetomidine\n* Pre-existing neurological deficit or neuropathy in the affected limb\n* Coagulopathy or laboratory abnormality that contraindicates regional anesthesia: INR \\>1.5, or platelet count \\\u003C100,000\u002FµL, or therapeutic anticoagulation that cannot be safely paused\n* Infection at or near the needle insertion site\n* Severe hepatic or renal impairment\n* Chronic opioid therapy (\\>30 days of daily opioids before surgery)\n* Cognitive impairment or delirium that prevents reliable pain assessment\n* BMI \\>40 kg\u002Fm² (due to potential technical difficulty and reduced accuracy of ultrasound guidance)\n* Previous regional block affecting the target area for the current surgery\n* Pregnancy or breastfeeding\n* Participation in another interventional clinical trial within 30 days",{"count":21,"type":22},[25],"This study will compare three versions of the Pericapsular Nerve Group (PENG) block in adults aged 65 years and older who are undergoing hip surgery. The PENG block is a regional anesthesia technique used to reduce pain around the hip joint and may improve early recovery after surgery.\n\nAll patients in the study will receive the PENG block using 20 mL of 0.2% ropivacaine. They will then be randomly assigned to one of three groups:\n\nGroup 1: PENG block using ropivacaine only (no additional medications). Group 2: PENG block using ropivacaine with 4 mg of dexamethasone injected near the nerves.\n\nGroup 3: PENG block using ropivacaine with 25 micrograms of dexmedetomidine injected near the nerves.\n\nDexamethasone and dexmedetomidine are medications that may increase the duration and quality of regional anesthesia. It is not known whether adding one of these medications provides longer-lasting or better pain relief compared to using ropivacaine alone.\n\nThe main purpose of this study is to determine whether the addition of dexamethasone or dexmedetomidine improves the effectiveness of the PENG block in relieving pain after hip surgery. The study will evaluate pain levels, opioid consumption, time to first rescue pain medication, need for additional analgesia, and recovery outcomes. Safety, side effects, and any block-related complications will also be monitored.\n\nThe investigators hypothesize that adding either perineural dexamethasone or dexmedetomidine will result in longer and more effective pain relief compared with the standard PENG block without an adjuvant.\n\nThis research may help identify the most effective form of the PENG block for older adults undergoing hip surgery and contribute to improved pain management, reduced opioid use, and better postoperative recovery.",[56],{"date":172,"type":33},{"date":245,"type":33},"2026-02-13",{"date":193,"type":22},{"name":39,"class":40},{"id":249,"slug":250,"hasResults":12,"nctId":251,"briefTitle":252,"officialTitle":253,"acronym":4,"eligibilityCriteria":254,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":255,"targetDuration":4,"studyType":23,"phases":256,"briefSummary":257,"conditions":258,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":138,"lastUpdatePostDateStruct":260,"startDateStruct":261,"completionDateStruct":262,"leadSponsor":263,"locationsCount":64},"100618154","peng-block-variants-with-dexamethasone-and-dexmedetomidine-in-older-adults-100618154","NCT07327931","PENG Block Variants With Dexamethasone and Dexmedetomidine in Older Adults","Comparison of Three Variants of PENG Block Using 20 mL of 0.2% Ropivacaine With Different Combinations of Dexamethasone and Perineural Dexmedetomidine in Patients Aged 65 Years and Older Undergoing Hip Surgery: A Randomized Controlled Trial.","Inclusion Criteria:\n\n* Age 65 years or older\n* Scheduled for elective or emergency hip surgery (e.g., hip fracture fixation or hip arthroplasty)\n* ASA physical status I-III\n* Ability to communicate pain intensity using the NRS scale\n* Written informed consent obtained from the patient or legal representative\n* Planned use of PENG block as part of multimodal perioperative analgesia\n\nExclusion Criteria:\n\n* Patient refusal or inability to provide informed consent\n* Allergy, intolerance, or contraindication to any study medication: ropivacaine, dexamethasone, dexmedetomidine\n* Pre-existing neurological deficit or neuropathy of the affected limb\n* Coagulopathy (INR \\>1.5, platelets \\\u003C100,000\u002FµL) or current therapeutic anticoagulation that contraindicates regional anesthesia\n* Infection at or near the injection site\n* Severe hepatic or renal impairment\n* History of chronic opioid use (daily opioids \\>30 days before surgery)\n* Cognitive impairment or delirium precluding reliable pain assessment\n* BMI \\> 40 kg\u002Fm² (if you want to exclude for technical difficulty)\n* Patients receiving another regional nerve block for hip surgery\n* Pregnancy or breastfeeding\n* Participation in another interventional clinical trial within 30 days",{"count":21,"type":22},[25],"This study will compare three different versions of the Pericapsular Nerve Group (PENG) block in adults aged 65 years and older who are undergoing surgery for hip conditions. The PENG block is a regional anesthesia technique that can reduce pain after surgery and decrease the need for strong opioid pain medications.\n\nAll patients in the study will receive the PENG block with 20 mL of 0.2% ropivacaine, but they will be divided into three groups based on the additional medications used:\n\nGroup 1: PENG block with ropivacaine plus 4 mg of dexamethasone given intravenously.\n\nGroup 2: PENG block with ropivacaine plus 25 micrograms of dexmedetomidine given near the nerves and 4 mg of dexamethasone given intravenously.\n\nGroup 3: PENG block with ropivacaine plus 25 micrograms of dexmedetomidine and 4 mg of dexamethasone given near the nerves.\n\nBoth dexmedetomidine and dexamethasone are medications that may improve the strength and duration of nerve blocks.\n\nThe main goal of this study is to determine which combination provides the best pain control after hip surgery, reduces the need for opioid medications, and improves patient comfort and recovery. We also aim to evaluate the safety and side-effects of each technique.\n\nWe hypothesize that adding both dexmedetomidine and dexamethasone near the nerves will provide the longest and most effective pain relief when compared to intravenous administration alone.\n\nThis trial may help identify the most effective PENG block formula for older adults undergoing hip surgery and could improve pain management, decrease complications related to opioids, and support faster recovery.",[56,259],"Hip Pain Chronic",{"date":172,"type":33},{"date":245,"type":33},{"date":193,"type":22},{"name":39,"class":40},{"id":265,"slug":266,"hasResults":12,"nctId":267,"briefTitle":268,"officialTitle":268,"acronym":4,"eligibilityCriteria":269,"healthyVolunteers":12,"sex":17,"minAge":72,"maxAge":49,"enrollmentInfo":270,"targetDuration":4,"studyType":23,"phases":271,"briefSummary":273,"conditions":274,"keywords":276,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":138,"lastUpdatePostDateStruct":281,"startDateStruct":282,"completionDateStruct":284,"leadSponsor":285,"locationsCount":64},"100576725","phase-4-the-effect-of-dexamethasone-administration-route-and-local-anesthetic-concentration-on-pain-inflammatory-response-and-neuromonitoring-in-children-undergoing-scoliosis-correction-100576725","NCT06789029","The Effect of Dexamethasone Administration Route and Local Anesthetic Concentration on Pain, Inflammatory Response, and Neuromonitoring in Children Undergoing Scoliosis Correction","Inclusion Criteria:\n\n* \\>10 and \\\u003C18 years old\n* scheduled for idiopathic scoliosis surgery\n\nExclusion Criteria:\n\n* included infection at the site of the regional block,\n* coagulation disorders,\n* immunodeficiency,\n* American Society of Anesthesiologists (ASA) physical status of IV or higher,\n* history of regular steroid medication.",{"count":95,"type":22},[272],"PHASE4","Scoliosis correction surgery in children is a complex procedure with significant risks, including postoperative pain, inflammatory response, and potential neurological complications. Effective pain control and minimizing inflammation are critical for faster recovery and improved patient outcomes. Dexamethasone is commonly used as an adjuvant in regional anesthesia due to its anti-inflammatory effects and ability to prolong analgesia. However, limited research exists on the optimal route of dexamethasone administration (intravenous vs. perineural) and the best local anesthetic concentration for pain management, inflammatory response, and neuromonitoring during surgery.\n\nThis study aims to compare the effects of different dexamethasone administration routes and local anesthetic concentrations on postoperative pain, inflammation (NLR, PLR), and neuromonitoring in pediatric scoliosis surgery. Results may improve regional anesthesia protocols, enhance patient safety, and offer valuable insights for clinical practice.",[275],"Scoliosis Idiopathic Adolescent",[277,278,279,280],"scoliosis","Neuromonitoring,","erector spinae plane block","dexamethasone",{"date":172,"type":33},{"date":283,"type":33},"2025-02-01",{"date":103,"type":22},{"name":39,"class":40},{"id":287,"slug":288,"hasResults":12,"nctId":289,"briefTitle":290,"officialTitle":290,"acronym":291,"eligibilityCriteria":292,"healthyVolunteers":12,"sex":293,"minAge":49,"maxAge":294,"enrollmentInfo":295,"targetDuration":4,"studyType":23,"phases":297,"briefSummary":298,"conditions":299,"keywords":302,"overallStatus":29,"whyStopped":4,"lastUpdateSubmitDate":307,"lastUpdatePostDateStruct":308,"startDateStruct":309,"completionDateStruct":311,"leadSponsor":313,"locationsCount":64},"100638445","type-2-diabetes-and-pregnancy-a-single-arm-interventional-study-100638445","NCT07602036","Type 2 Diabetes and Pregnancy a Single-arm Interventional Study","pUMPreg2","Inclusion Criteria:\n\n1. Women with diagnosed pregestational type 2 diabetes or HbA1c \\>6.5% in the 1st trimester (ADA, PTD)\n2. Age 18-45 years\n3. Gestational age of 16 weeks +0 days or less at baseline\n4. Singleton pregnancy\n5. HbA1c at baseline 5.0-10%\n6. A viable pregnancy at the recruitment\n7. Willingness to continue the treatment until delivery in the clinic\n\nExclusion Criteria:\n\n1. Other types of diabetes including T1D and Monogenic diabetes\n2. Major fetal congenital defects\n3. Severe nephropathy, psychiatric illness or other serious medical disorder that in the judgment of the investigator could affect completion of the trial\n4. Pump therapy before pregnancy","FEMALE","45 Years",{"count":296,"type":22},20,[25],"This single-arm interventional study evaluates the MiniMed 780G insulin pump and continuous glucose monitoring (CGM) system in pregnant women with type 2 diabetes enrolled at ≤ 16 weeks gestation. From recruitment to delivery, participants attend regular clinical visits for active insulin adjustments. The primary objective is to measure the percentage of time spent in the target pregnancy glucose range (63-140 mg\u002FdL). Secondary outcomes track mean glucose, HbA1c, and overall maternal and neonatal health to ensure safety and efficacy.",[300,301],"Pregnancy","Type 2 Diabetes",[303,304,305,306],"type 2 diabetes","pregnancy","insulin pump","Automated insulin delivery system","2026-05-15",{"date":172,"type":33},{"date":310,"type":22},"2026-05-01",{"date":312,"type":22},"2029-02",{"name":39,"class":40},{"id":315,"slug":316,"hasResults":12,"nctId":317,"briefTitle":318,"officialTitle":319,"acronym":320,"eligibilityCriteria":321,"healthyVolunteers":12,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":322,"targetDuration":4,"studyType":23,"phases":323,"briefSummary":324,"conditions":325,"keywords":326,"overallStatus":29,"whyStopped":4,"lastUpdateSubmitDate":328,"lastUpdatePostDateStruct":329,"startDateStruct":331,"completionDateStruct":332,"leadSponsor":334,"locationsCount":64},"100637092","comparison-of-spinal-anesthesia-with-intrathecal-morphine-versus-peng-block-with-or-without-dexamethasone-in-hip-arthroplasty-100637092","NCT07584200","Comparison of Spinal Anesthesia With Intrathecal Morphine Versus PENG Block With or Without Dexamethasone in Hip Arthroplasty","Comparison of the Efficacy and Safety of Three Regional Anesthesia Strategies in Patients Undergoing Elective Total Hip Arthroplasty: A Prospective, Randomized, Multicenter Clinical Trial","THA","Inclusion Criteria:\n\n* Adults aged 60 to 100 years\n* Scheduled for elective total hip arthroplasty\n* American Society of Anesthesiologists (ASA) physical status I-III\n* Ability to understand the study procedures and provide written informed consent\n\nExclusion Criteria:\n\n* Known allergy or hypersensitivity to ropivacaine, morphine, or dexamethasone\n* Coagulation disorders or ongoing anticoagulant therapy contraindicating spinal anesthesia or regional nerve blocks\n* Infection at the site of spinal or peripheral nerve block injection\n* Pre-existing neurological disorders affecting sensory or motor function\n* Severe hepatic or renal insufficiency\n* Chronic opioid use for more than 3 months prior to surgery\n* Refusal or inability to provide informed consent",{"count":74,"type":22},[25],"The goal of this clinical trial is to learn which of three regional anesthesia approaches provides better pain relief and safety for older adults having planned hip replacement surgery. Researchers will study people aged 60 years and older who are scheduled for elective total hip arthroplasty.\n\nThe main questions this study aims to answer are:\n\nWhich anesthesia method provides better pain control after surgery? Which method reduces the need for opioid pain medicines? Are there differences in side effects and recovery between the approaches? Participants will be randomly assigned to one of three groups. All participants will receive spinal anesthesia. One group will receive spinal anesthesia with intrathecal morphine. The other two groups will receive spinal anesthesia combined with a nerve block called the pericapsular nerve group (PENG) block, with or without the addition of dexamethasone.\n\nParticipants will have their pain levels measured at regular times during the first two days after surgery. Researchers will also record opioid use, time to first pain medication, ability to move after surgery, length of hospital stay, and any side effects such as nausea or itching. Blood tests will be used to measure markers of inflammation.\n\nThe results of this study may help doctors choose safer and more effective pain control strategies for people undergoing hip replacement surgery.",[117,56],[327],"total hip arthroplasty","2026-05-06",{"date":330,"type":33},"2026-05-13",{"date":82,"type":22},{"date":333,"type":22},"2027-05-01",{"name":39,"class":40},{"id":336,"slug":337,"hasResults":12,"nctId":338,"briefTitle":339,"officialTitle":340,"acronym":4,"eligibilityCriteria":341,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":342,"targetDuration":4,"studyType":23,"phases":343,"briefSummary":344,"conditions":345,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":328,"lastUpdatePostDateStruct":347,"startDateStruct":349,"completionDateStruct":351,"leadSponsor":353,"locationsCount":64},"100606855","phase-4-peng-vs-l-espb-with-s-espb-for-analgesia-in-total-hip-arthroplasty-100606855","NCT07180979","PENG vs L-ESPB With S-ESPB for Analgesia in Total Hip Arthroplasty","Comparison of Pericapsular Nerve Group (PENG) Block Versus Lumbar Erector Spinae Plane Block (L-ESPB) Combined With Sacral ESPB (S-ESPB) for Analgesia in Total Hip Arthroplasty (THA): A Randomized Clinical Trial","Inclusion Criteria:\n\n* Age ≥ 65 years\n* ASA physical status I-III\n* Elective unilateral THA via posterior or lateral approach\n* Informed consent provided\n\nExclusion Criteria:\n\n* Allergy to study drugs (ropivacaine, dexamethasone)\n* Chronic opioid use (\\>30 MME\u002Fday)\n* Coagulopathy or infection at the injection site\n* BMI \\> 40 kg\u002Fm²\n* Pre-existing motor weakness or neuropathy in the affected limb\n* Cognitive impairment precluding informed consent",{"count":74,"type":22},[272],"The goal of this clinical trial is to evaluate whether different types of regional anesthesia can improve pain control and functional recovery after total hip arthroplasty in adult patients undergoing elective hip replacement surgery.\n\nThe main questions it aims to answer are:\n\nDoes the PENG block reduce opioid use in the first 48 hours after surgery more effectively than the combined L-ESPB + S-ESPB technique? Which method provides better pain relief, preserves muscle strength, and supports earlier mobilization? Researchers will compare the Pericapsular Nerve Group (PENG) block with the combination of Lumbar and Sacral Erector Spinae Plane Blocks (L-ESPB + S-ESPB) to see which provides better pain control, fewer side effects, and faster recovery.\n\nParticipants will:\n\nBe randomly assigned to receive one of the two types of ultrasound-guided regional anesthesia Undergo standard hip replacement surgery under spinal anesthesia Be monitored for pain scores, opioid use, time to first walking, muscle strength, satisfaction, and side effects over the first 48 hours after surgery.",[56,346,259],"Hip Arthropathy",{"date":348,"type":33},"2026-05-07",{"date":350,"type":33},"2025-09-15",{"date":352,"type":22},"2026-11-30",{"name":39,"class":40},{"id":355,"slug":356,"hasResults":12,"nctId":357,"briefTitle":358,"officialTitle":359,"acronym":4,"eligibilityCriteria":360,"healthyVolunteers":12,"sex":17,"minAge":202,"maxAge":361,"enrollmentInfo":362,"targetDuration":4,"studyType":23,"phases":363,"briefSummary":364,"conditions":365,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":328,"lastUpdatePostDateStruct":367,"startDateStruct":369,"completionDateStruct":371,"leadSponsor":373,"locationsCount":41},"100597683","phase-4-the-effect-of-dexamethasone-administration-route-in-pediatric-brachial-plexus-block-100597683","NCT07061678","The Effect of Dexamethasone Administration Route in Pediatric Brachial Plexus Block","The Effect of Dexamethasone Administration Route in Infraclavicular Brachial Plexus Block for Pediatric Arm and\u002For Hand Surgery","Inclusion Criteria:\n\n* children scheduled for arm\u002Fwrist\u002Fhand surgery\n* body weight \\> 5kg\n\nExclusion Criteria:\n\n* infection at the site of the regional block,\n* coagulation disorders,\n* immunodeficiency,\n* American Society of Anesthesiologists (ASA) physical status of IV or higher,\n* history of regular steroid medication.","6 Years",{"count":74,"type":22},[272],"This study aims to assess the impact of the administration route of dexamethasone (intravenous vs. perineural) on postoperative pain and inflammatory response in pediatric patients undergoing hip surgery. The primary outcome is postoperative pain intensity measured using an age-appropriate scale at multiple intervals. Secondary outcomes include inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), opioid consumption, time-to-first rescue analgesia, and overall patient recovery. This randomized, double-blinded study seeks to improve pain management strategies and optimize anesthesia protocols in pediatric arm surgery.",[366],"Arm",{"date":368,"type":33},"2026-05-11",{"date":370,"type":33},"2025-10-01",{"date":372,"type":22},"2026-06-28",{"name":39,"class":40},{"id":375,"slug":376,"hasResults":12,"nctId":377,"briefTitle":378,"officialTitle":379,"acronym":380,"eligibilityCriteria":381,"healthyVolunteers":12,"sex":17,"minAge":49,"maxAge":4,"enrollmentInfo":382,"targetDuration":4,"studyType":23,"phases":384,"briefSummary":385,"conditions":386,"keywords":389,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":397,"lastUpdatePostDateStruct":398,"startDateStruct":400,"completionDateStruct":402,"leadSponsor":404,"locationsCount":64},"100632189","the-hypotension-prediction-index-versus-standard-advanced-haemodynamic-monitoring-in-patients-undergoing-major-aortic-surgery-100632189","NCT07510451","The Hypotension Prediction Index Versus Standard Advanced Haemodynamic Monitoring in Patients Undergoing Major Aortic Surgery","The Hypotension Prediction Index Software Compared With Standard Advanced Haemodynamic Monitoring in Patients Undergoing Major Aortic Surgery: A Prospective Randomized Controlled Trial","HYPE-AORTA","Inclusion Criteria:\n\n1. Age ≥ 18 years\n2. American Society of Anesthesiologists (ASA) physical status classification III or IV\n3. Scheduled for elective major abdominal aortic surgery (open or endovascular repair) with an expected surgical duration exceeding 2 hours\n4. Able to provide written informed consent\n\nExclusion Criteria:\n\n1. Emergency or urgent surgery\n2. Pregnancy or breastfeeding or positive\u002Funcertain pregnancy test\n3. Haemodynamically significant valvular heart disease:\n\n   * Severe aortic stenosis (aortic valve area \\\u003C 1.5 cm\\^2)\n   * Moderate to severe aortic regurgitation\n   * Moderate to severe mitral regurgitation\n   * Moderate to severe mitral stenosis\n4. Severe heart failure with left ventricular ejection fraction \\\u003C 35%\n5. Permanent atrial fibrillation (reduces accuracy of pulse contour analysis)\n6. Inability to provide informed consent\n7. Participation in another interventional trial that may influence haemodynamic management or study outcomes",{"count":383,"type":22},200,[25],"The standard procedure during general anesthesia is to monitor vital functions, including cardiovascular functions such as cardiac electrical activity, using continuous ECG recording, blood pressure measurement with a sphygmomanometer, heart rate measurement, and tissue oxygenation measurement with a pulse oximeter. These are non-invasive methods, which are often insufficient in the case of extensive procedures within the abdominal aorta. In such cases, the anesthesiologist additionally use direct blood pressure measurements and central venous pressure measurements. To perform these measurements, it is necessary to insert a cannula into an artery (usually the radial artery) and a catheter into the central veins (through the internal jugular or subclavian vein). Vascular cannulation is an invasive method and may be associated with complications such as vascular thrombosis, infection at the puncture site or catheter-related infections, pneumothorax, air embolism, cardiac arrhythmias, neuropathies, hematomas, and bleeding. At the same time, they allow for a more accurate assessment of cardiovascular function and the implementation of appropriate treatment, including the administration of large amounts of infusion fluids, vasoconstrictors, and cardiac support drugs.\n\nIn the current study, the investigators will additionally use a special sensor and monitor to assess the heart's performance (cardiac output) and its response to the treatment used, optimizing and supporting the circulatory system. This monitoring requires the insertion of a catheter into a central vein and artery, which is necessary during vascular surgery procedures and does not involve any additional invasive procedures. In the postoperative period, the investigators will analyze the frequency of abnormalities in laboratory tests routinely collected after surgery and the function of the central nervous system by performing simple non-invasive cognitive function tests.\n\nThe benefits of using the method of assessing the patient's response to surgery and anesthesia in presented study are related to increased safety for each patient and improved perioperative treatment for all patients undergoing surgery.",[387,388],"Elective Endovascular Abdominal Aortic Surgery With an Expected Surgical Duration Exceeding 2 Hours","Elective Open Abdominal Aortic Surgery With an Expected Surgical Duration Exceeding 2 Hours",[390,391,392,393,394,395,396],"hypotension","Hypotension Prediction Index","Acumen IQ","FloTrac","haemodynamic monitoring,","aortic abdominal surgery","major vascular surgery","2026-04-23",{"date":399,"type":33},"2026-04-28",{"date":401,"type":33},"2026-04-12",{"date":403,"type":22},"2028-06",{"name":39,"class":40},{"id":406,"slug":407,"hasResults":12,"nctId":408,"briefTitle":409,"officialTitle":410,"acronym":4,"eligibilityCriteria":411,"healthyVolunteers":12,"sex":17,"minAge":412,"maxAge":4,"enrollmentInfo":413,"targetDuration":4,"studyType":23,"phases":414,"briefSummary":415,"conditions":416,"keywords":419,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":431,"lastUpdatePostDateStruct":432,"startDateStruct":434,"completionDateStruct":436,"leadSponsor":438,"locationsCount":64},"100629755","phase-4-tdm-guided-treatment-with-ssris-in-hospitalized-adults-and-children-100629755","NCT07478796","TDM-Guided Treatment With SSRIs in Hospitalized Adults and Children","Therapeutic Drug Monitoring-Guided Treatment With Sertraline, or Escitalopram in Hospitalized Adults and Children","Inclusion Criteria:\n\n* Male or female gender.\n* Age 12 years or older.\n* Diagnosis of moderate or severe depressive episode requiring SSRI treatment (fluoxetine, escitalopram, or sertraline).\n* Written informed consent provided by patient and\u002For legal guardian.\n* Women of childbearing potential must agree to use effective contraception or sexual abstinence.\n\nExclusion Criteria:\n\n* Pregnancy, breastfeeding, or planning pregnancy.\n* Diagnosis of other mental disorders (schizophrenia, bipolar disorder, intellectual disability).\n* Decompensated severe somatic disorders (e.g., endocrine disorders, asthma exacerbation, hepatic\u002Frenal failure).\n* Treatment with fluoxetine, sertraline, or escitalopram at an adequate dose for at least 4 weeks for the current episode (unless washout of 5x half-life is observed).\n* Use of medications with high risk of CYP enzyme interactions.","12 Years",{"count":224,"type":22},[272],"Depression in childhood and adolescence is a serious and increasing public-health problem associated with profound short- and long-term consequences, including impaired social and educational functioning, increased risk of somatic illness and substance use, and elevated mortality from suicide. Up to half of depressive disorders beginning in youth persist into adulthood, and the COVID-19 pandemic, with its attendant social isolation, has further increased the incidence of clinically significant depressive illness in children and young adults. Despite the high burden of disease, pharmacotherapeutic guidance for pediatric depression remains limited. Selective serotonin reuptake inhibitors (SSRIs) are first-line agents, yet dosing recommendations for youth do not adequately account for major sources of variability such as developmental pharmacokinetics, body size, age, comorbid diagnoses, and pharmacogenetic differences. Fluoxetine is commonly recommended in pediatric populations largely for historical reasons, while newer SSRIs such as escitalopram and sertraline are increasingly prescribed off-label without robust comparative evidence. This randomized clinical trial evaluates therapeutic drug monitoring (TDM)-guided treatment with fluoxetine, sertraline, or escitalopram in children and adults diagnosed with Major Depressive Disorder. TDM procedures will be implemented across all randomized arms to capture drug exposure and enable dose adjustments according to predefined safety and efficacy criteria. Treatments will be initiated at the lower end of recommended pediatric doses and titrated if prespecified clinical nonresponse or tolerability thresholds are met, allowing evaluation of dose-response dynamics while prioritizing patient safety. The study combines prospective, randomized comparative effectiveness methodology with intensive pharmacokinetic\u002Fpharmacodynamic (PK\u002FPD) assessment. Repeated plasma concentration measurements will be collected at multiple timepoints to characterize within- and between-patient PK variability for each SSRI. Standardized clinical instruments will be used longitudinally to assess depressive symptom severity, response and remission rates, time to onset of therapeutic effect, adverse events (including early activation and worsening of suicidal ideation), treatment adherence, and functional outcomes (academic performance, social functioning, and quality of life). Pharmacogenetic testing will be performed to evaluate the contribution of genetic variants (including but not limited to CYP enzymes, serotonin transporter and MAO-A related polymorphisms) to PK parameters and clinical response. Integrated population PK and PK\u002FPD modeling will (1) quantify concentration-effect and concentration-adverse-effect relationships over time, (2) identify demographic, clinical and genetic moderators of exposure and response, (3) evaluate nonlinearity in PK (e.g., dose-dependent absorption or clearance patterns), and (4) derive evidence-based therapeutic concentration ranges and individualized dosing algorithms for pediatric practice. Secondary objectives include head-to-head comparison of efficacy, tolerability, time to response, and persistence on treatment between the three SSRIs, as well as exploratory analyses of diagnostic subtypes and comorbidities that may influence outcomes. By filling critical gaps in controlled PK\u002FPD data for the most commonly prescribed SSRIs in youth, this trial aims to move beyond meta-analytic inference toward actionable, individualized dosing recommendations. The expected outcomes are earlier identification of atypical pharmacokinetics, safer and more effective dose optimization, reduced adverse events and early discontinuation, shortened time to symptomatic improvement, and ultimately improved functional recovery and quality of life for children and young adults with depression. The study's translational PK\u002FPD outputs will inform clinical TDM protocols, pediatric dosing guidelines, and future precision-medicine strategies in adolescent psychopharmacology.",[417,418],"Depression - Major Depressive Disorder","Depressive Episodes",[420,421,422,423,424,425,426,427,428,429,430],"Therapeutic Drug Monitoring (TDM)","SSRI","Pharmacokinetics","Pharmacodynamics","Personalized Medicine","Pediatrics","Adolescents","Fluoxetine","Escitalopram","Sertraline","Biomarkers","2026-03-15",{"date":433,"type":33},"2026-03-18",{"date":435,"type":33},"2025-04-03",{"date":437,"type":22},"2027-11-30",{"name":39,"class":40},{"id":440,"slug":441,"hasResults":12,"nctId":442,"briefTitle":443,"officialTitle":444,"acronym":445,"eligibilityCriteria":446,"healthyVolunteers":12,"sex":17,"minAge":49,"maxAge":447,"enrollmentInfo":448,"targetDuration":4,"studyType":23,"phases":449,"briefSummary":450,"conditions":451,"keywords":453,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":459,"lastUpdatePostDateStruct":460,"startDateStruct":462,"completionDateStruct":464,"leadSponsor":465,"locationsCount":64},"100628124","will-the-use-of-respiratory-quotient-rq-improve-treatment-outcomes-for-intensive-care-unit-icu-patients-100628124","NCT07457554","Will the Use of Respiratory Quotient ''RQ'' Improve Treatment Outcomes for Intensive Care Unit (ICU) Patients?","Will the Use of Respiratory Quotient \"RQ\" to Optimize Nutrition Therapy With Indirect Calorimetry Improve Treatment Outcomes for Intensive Care Unit (ICU) Patients?","RQCal","Inclusion Criteria:\n\n* patient treated in the ICU\n* mechanically ventilated\n* covered by universal health insurance\n\nExclusion Criteria:\n\n* ECMO therapy\n* mechanical ventilation with an oxygen concentration in the breathing mixture FiO2 \\> 60%\n* breathing independently without the aid of a ventilator\n* critically ill patients who are not expected to survive the next 48 hours\n* pregnant women","85 Years",{"count":383,"type":22},[25],"Introduction and assumptions of the research project:\n\nPatients treated in intensive care units (ICUs) require comprehensive treatment. Nutrition is an important and integral part of this therapy. Both insufficient and excessive calorie intake are associated with poorer prognosis and increased mortality in ICU patients. Furthermore, the caloric requirements of patients in life-threatening conditions in the ICU are characterized by periods of hypo- and hypermetabolism, which, if nutrition is not optimized, expose patients to overfeeding or underfeeding. Therefore, monitoring resting energy expenditure (REE) using indirect calorimetry has become the \"gold standard\" in the ICU. Previous methods based on mathematical formulas for calculating REE were characterized by insufficient correlation with actual demand. Indirect calorimetry uses measured exhaled carbon dioxide and the concentration of oxygen administered. Then, taking into account patient-dependent parameters such as gender, height, and weight, it indirectly calculates energy expenditure, which corresponds to caloric demand. By dividing the volume of CO2 released by the volume of O2 absorbed, investigators can obtain the respiratory quotient (RQ). This quotient is related to the type of diet and is, for example, 0.7 for fats, 0.8 for proteins, and 1.0 for carbohydrates. Its value also changes with nutritional status. High values may suggest an excessive energy supply (relative to demand), while low values may indicate a calorie deficit. Some authors suggest that the RQ ratio could potentially be used to further optimize nutritional status. Currently, however, due to insufficient research, it is mainly used in clinical practice to assess the accuracy of recording and monitoring calorimetry. This study, is trying to assess the usefulness of RQ for optimizing nutrition in patients treated in the ICU.\n\nMethodology:\n\nStudy group:\n\nThis will be a randomized study with a study group and a control group in patients treated in the ICU. All patients participating in the study are patients who, at the time of qualification, are mechanically ventilated and treated in the ICU. These will be patients of both sexes, aged 18-85 years. The control group will be fed under the supervision of indirect calorimetry and REE, in accordance with current ICU nutrition guidelines. In the study group, nutritional preparations will be additionally systematized and selected for each patient depending on their RQ value, and caloric requirements will be controlled by indirect calorimetry and REE, as in the control group. Regular assessments of albumin, total protein, total cholesterol, LDL, HDL, iron, glycemia, Na+, K+, and triglycerides will be conducted, collected along with the routine test package. In addition, typical endpoints for patients treated in the ICU will be assessed, such as length of stay in the ICU, length of mechanical ventilation, number of days without a ventilator, 28-day survival, and survival to hospital discharge.\n\nExpected duration of the study: October 2024 to October 2026 (2 years) Conditions for inclusion in the study: patients \\> 18 years of age, treated in the ICU, mechanically ventilated, covered by universal health insurance Conditions for exclusion from the study: ECMO therapy, the need for mechanical ventilation with an oxygen concentration in the breathing mixture FiO2 \\> 60%, patients breathing independently without the aid of a ventilator, critically ill patients who are not expected to survive the next 48 hours, pregnant women, patients \\\u003C 18 years of age or \\> 85 years of age\n\nReasons for discontinuing the study:\n\n1. if, during the course of the study, there are clear indications that one of the groups will experience or worsen final outcomes such as mortality, 28-day mortality, length of stay in the ICU - which would suggest a clear advantage of one of the chosen strategies, along with an increase in the number of patients included in the study, a regular analysis of the current effects of both strategies will be conducted,\n2. the patient develops hypersensitivity\u002Fintolerance to nutritional preparations, with no possibility of switching to another preparation used in the study,\n\nExpected results and their planned subsequent use:\n\nPatients from the control group, should achieve faster stabilization of nutritional parameters and fewer episodes of underfeeding and overfeeding. This should translate into improved endpoints such as mortality, length of stay in the ICU, and shorter mechanical ventilation time. In addition, the systematization and algorithms for the use of nutritional products developed during the study can be further used in department of the study and other departments around the world.",[452],"Nutritional Therapy in an ICU",[454,455,456,457,458],"intensive care unit","ICU","respiratory quotient","RQ","indirect calorimetry","2026-03-03",{"date":461,"type":33},"2026-03-09",{"date":463,"type":33},"2024-10-01",{"date":352,"type":22},{"name":39,"class":40},{"id":467,"slug":468,"hasResults":12,"nctId":469,"briefTitle":470,"officialTitle":471,"acronym":4,"eligibilityCriteria":472,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":473,"targetDuration":4,"studyType":23,"phases":475,"briefSummary":476,"conditions":477,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":478,"lastUpdatePostDateStruct":479,"startDateStruct":481,"completionDateStruct":483,"leadSponsor":484,"locationsCount":64},"100618111","peng-block-with-dexmedetomidine-in-older-adults-100618111","NCT07327372","PENG Block With Dexmedetomidine in Older Adults","Effect of Perineural Dexmedetomidine as an Adjuvant to Pericapsular Nerve Group Block in Older Adults: A Randomized Controlled Trial","Inclusion Criteria:\n\n* Age 65 years or older\n* Scheduled for elective or emergency hip surgery (e.g., hip fracture fixation or hip arthroplasty)\n* ASA physical status I-III\n* Ability to communicate pain intensity using the NRS scale\n* Written informed consent obtained from the patient or legal representative\n* Planned use of PENG block as part of multimodal perioperative analgesia\n\nExclusion Criteria:\n\n* Patient refusal or inability to provide informed consent\n* Allergy, intolerance, or contraindication to any study medication: ropivacaine, dexmedetomidine\n* Pre-existing neurological deficit or neuropathy of the affected limb\n* Coagulopathy (INR \\>1.5, platelets \\\u003C100,000\u002FµL) or current therapeutic anticoagulation that contraindicates regional anesthesia\n* Infection at or near the injection site\n* Severe hepatic or renal impairment\n* History of chronic opioid use (daily opioids \\>30 days before surgery)\n* Cognitive impairment or delirium precluding reliable pain assessment\n* BMI \\> 40 kg\u002Fm² (if you want to exclude for technical difficulty)\n* Patients receiving another regional nerve block for hip surgery\n* Pregnancy or breastfeeding\n* Participation in another interventional clinical trial within 30 days",{"count":474,"type":22},30,[25],"Pain after hip surgery is a common problem in older adults and may delay early mobilization, increase the need for opioid pain medications, and contribute to complications such as delirium, nausea, or prolonged hospital stay. Regional anesthesia techniques are increasingly used to improve pain control while reducing the use of systemic opioids.\n\nThe pericapsular nerve group (PENG) block is a modern ultrasound-guided regional anesthesia technique designed to provide effective pain relief after hip surgery while preserving muscle strength. It allows patients to begin mobilization earlier and may reduce the risk of postoperative complications, which is particularly important in older adults.\n\nRopivacaine is a commonly used local anesthetic for nerve blocks. Dexmedetomidine is a medication that, when added in small doses to local anesthetics, may prolong pain relief and improve the quality of nerve blocks without significantly increasing side effects. However, the benefits and safety of adding dexmedetomidine to the PENG block in older adults have not been sufficiently studied.\n\nThe aim of this randomized controlled clinical study is to compare the effectiveness and safety of two PENG block techniques in older adults undergoing hip surgery. Participants will be randomly assigned to one of two groups. One group will receive a PENG block with 20 mL of 0.2% ropivacaine. The second group will receive a PENG block with 20 mL of 0.2% ropivacaine combined with 25 micrograms of dexmedetomidine.\n\nThe study hypothesis is that the addition of dexmedetomidine to ropivacaine in the PENG block will provide longer-lasting and more effective postoperative pain relief compared with ropivacaine alone, without increasing adverse effects. Outcomes assessed in the study will include postoperative pain intensity, need for additional pain medications, time to first mobilization, and the occurrence of side effects such as low blood pressure, slow heart rate, excessive sedation, or delirium.\n\nThe results of this study may help optimize regional anesthesia techniques for hip surgery in older adults and contribute to safer, more effective postoperative pain management strategies.",[56,117],"2026-03-02",{"date":480,"type":33},"2026-03-04",{"date":482,"type":33},"2026-02-06",{"date":121,"type":22},{"name":39,"class":40},{"id":486,"slug":487,"hasResults":12,"nctId":488,"briefTitle":489,"officialTitle":490,"acronym":4,"eligibilityCriteria":491,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":492,"targetDuration":4,"studyType":23,"phases":494,"briefSummary":495,"conditions":496,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":478,"lastUpdatePostDateStruct":497,"startDateStruct":498,"completionDateStruct":499,"leadSponsor":500,"locationsCount":64},"100615159","peng-block-vs-suprainguinal-ficb-vs-lumbar-espb-for-analgesia-after-hip-surgery-100615159","NCT07288983","PENG Block vs Suprainguinal FICB vs Lumbar ESPB for Analgesia After Hip Surgery","A Randomized, Double-Blinded, Controlled Trial Comparing the Analgesic Efficacy and Motor-Sparing Properties of the Pericapsular Nerve Group (PENG) Block, Suprainguinal Fascia Iliaca Compartment Block (S-FICB), and Lumbar Erector Spinae Plane Block (L-ESPB) in Patients Undergoing Hip Arthroplasty","Inclusion Criteria:\n\n* Adults aged 65 years or older scheduled to undergo elective hip arthroplasty under spinal anesthesia.\n* Ability to provide written informed consent.\n* Ability to understand and reliably use numerical pain assessment tools (NRS 0-10).\n* ASA physical status II-III.\n* Expected postoperative hospitalization of at least 48 hours to ensure complete data collection.\n\nExclusion Criteria:\n\n* Inability to provide informed consent due to cognitive impairment, language barrier, or severe hearing\u002Fspeech limitations.\n* Coagulopathy or therapeutic anticoagulation not meeting safety criteria for regional anesthesia.\n* Local infection at the planned block site.\n* Allergy, hypersensitivity, or contraindication to ropivacaine, local anesthetics, or study medications.\n* Pre-existing lower-limb neurological deficits (motor or sensory) affecting outcome assessments.\n* Severe spinal deformity or anatomical limitations preventing safe performance of regional blocks.\n* Chronic opioid use (defined as \\>30 mg oral morphine equivalents daily for more than 2 weeks).\n* Severe renal failure (eGFR \\\u003C30 mL\u002Fmin\u002F1.73m²) or severe hepatic impairment.\n* Uncontrolled diabetes mellitus (fasting glucose \\>300 mg\u002FdL or HbA1c \\>10%).\n* History of local anesthetic systemic toxicity (LAST).\n* Participation in another interventional clinical trial within the past 30 days.\n* Any condition deemed by investigators to interfere with protocol adherence, safety monitoring, or outcome reliability.",{"count":493,"type":22},93,[25],"This randomized, double-blinded, controlled clinical trial compares three motor-sparing regional anesthesia techniques used for postoperative analgesia in patients undergoing hip arthroplasty: the Pericapsular Nerve Group (PENG) block, the suprainguinal Fascia Iliaca Compartment Block (S-FICB), and the Lumbar Erector Spinae Plane Block (L-ESPB). Although all three techniques are widely used in modern hip surgery, their relative analgesic efficacy, opioid-sparing potential, and impact on early functional recovery have not been directly compared in a single study.\n\nThe primary objective is to determine which block provides the most effective postoperative analgesia while preserving motor function and facilitating early mobilization. Secondary objectives include comparisons of opioid consumption, pain scores at rest and during movement, time to first rescue analgesia, block-related adverse events, quadriceps strength, incidence of postoperative nausea and vomiting, and early functional outcomes.\n\nThis study aims to identify the optimal motor-sparing regional anesthesia strategy for older adults undergoing hip arthroplasty.",[56],{"date":480,"type":33},{"date":482,"type":33},{"date":193,"type":22},{"name":39,"class":40},{"id":502,"slug":503,"hasResults":12,"nctId":504,"briefTitle":505,"officialTitle":506,"acronym":4,"eligibilityCriteria":507,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":508,"targetDuration":4,"studyType":23,"phases":510,"briefSummary":511,"conditions":512,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":513,"lastUpdatePostDateStruct":514,"startDateStruct":516,"completionDateStruct":518,"leadSponsor":519,"locationsCount":64},"100622667","dexamethasone-vs-dexmedetomidine-for-ipack--acb-in-tka-100622667","NCT07386600","Dexamethasone vs Dexmedetomidine for iPACK + ACB in TKA","Perineural Dexamethasone Versus Perineural Dexmedetomidine as Adjuvants to Ropivacaine in iPACK and Adductor Canal Blocks for Total Knee Arthroplasty: A Randomized, Double-Blind, Controlled Trial","Inclusion Criteria:\n\n* Age ≥ 65 years\n* Scheduled for primary unilateral total knee arthroplasty under standardized anesthetic protocol\n* ASA physical status II-III (or I-III, zależnie jak planujesz)\n* Ability to understand the study procedures and provide written informed consent\n\nExclusion Criteria:\n\n* Contraindications to peripheral nerve blocks (infection at injection site, coagulopathy, patient refusal)\n* Known allergy or hypersensitivity to amide local anesthetics, dexamethasone or dexmedetomidine\n* Chronic opioid therapy or opioid use \\> 30 mg oral morphine equivalents per day in the last 3 months\n* Severe hepatic or renal impairment\n* Significant cognitive impairment, inability to cooperate with pain assessment\n* Participation in another interventional trial affecting pain or analgesic consumption",{"count":509,"type":22},96,[25],"This randomized, double-blind, controlled trial is designed to compare the analgesic efficacy and safety of perineural dexamethasone versus perineural dexmedetomidine as adjuvants to ropivacaine for ultrasound-guided interspace between the popliteal artery and the capsule of the posterior knee (iPACK) and adductor canal blocks in patients undergoing primary unilateral total knee arthroplasty (TKA). Elderly participants scheduled for elective TKA will be randomized into three parallel groups: ropivacaine alone (control), ropivacaine combined with perineural dexamethasone, or ropivacaine combined with perineural dexmedetomidine.\n\nThe primary objective is to determine whether the addition of either adjuvant reduces postoperative opioid consumption compared with ropivacaine alone and to assess potential differences in analgesic efficacy between the two adjuvants. Secondary outcomes include pain intensity at rest and during mobilization, time to first rescue analgesia, quality of early functional recovery, and the incidence of adverse events, including postoperative nausea and vomiting, motor impairment, and hemodynamic instability.",[28],"2026-01-29",{"date":515,"type":33},"2026-02-04",{"date":517,"type":33},"2026-01-01",{"date":193,"type":22},{"name":39,"class":40},{"id":521,"slug":522,"hasResults":12,"nctId":523,"briefTitle":524,"officialTitle":525,"acronym":4,"eligibilityCriteria":526,"healthyVolunteers":12,"sex":17,"minAge":93,"maxAge":19,"enrollmentInfo":527,"targetDuration":4,"studyType":23,"phases":529,"briefSummary":530,"conditions":531,"keywords":4,"overallStatus":57,"whyStopped":4,"lastUpdateSubmitDate":513,"lastUpdatePostDateStruct":532,"startDateStruct":534,"completionDateStruct":536,"leadSponsor":537,"locationsCount":64},"100615158","acb-with-s-espb-versus-acb-with-ipack-for-knee-arthroplasty-100615158","NCT07288970","ACB With S-ESPB Versus ACB With iPACK for Knee Arthroplasty","Comparison of Adductor Canal Block Combined With Sacral Erector Spinae Plane Block Versus Adductor Canal Block Combined With iPACK Block in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Tria","Inclusion Criteria:\n\n* Age 65 years or older\n* Scheduled for elective unilateral total knee arthroplasty under spinal or general anesthesia\n* ASA physical status I-III\n* Planned use of regional anesthesia with an adductor canal block as part of multimodal analgesia\n* Ability to communicate pain intensity using the NRS scale\n* Written informed consent obtained from the patient\n\nExclusion Criteria:\n\n* Refusal or inability to provide informed consent\n* Allergy, intolerance, or contraindication to local anesthetics (ropivacaine)\n* Pre-existing significant neurological deficit or neuropathy in the operative limb\n* Coagulopathy or anticoagulation that contraindicates peripheral nerve blocks (e.g., INR \\>1.5, platelets \\\u003C100,000\u002FµL, or therapeutic anticoagulation that cannot be safely paused)\n* Infection at or near the planned needle insertion sites\n* Severe hepatic or renal impairment\n* Chronic opioid therapy (\\>30 days of daily opioid use before surgery)\n* Cognitive impairment or delirium preventing reliable pain assessment BMI \\> 40 kg\u002Fm² (optional - if chcesz ograniczyć ze względu na trudność USG)\n* Previous knee arthroplasty on the same side or revision TKA (jeśli chcesz tylko primary TKA)\n* Pregnancy or breastfeeding\n* Participation in another interventional clinical trial within 30 days",{"count":528,"type":22},80,[25],"This study will compare two regional anesthesia strategies for pain management after total knee arthroplasty in adults. Both strategies use an adductor canal block (ACB) to provide analgesia while preserving quadriceps muscle strength. The ACB is then combined with either a sacral erector spinae plane block (S-ESPB) or an iPACK (infiltration between the popliteal artery and the posterior capsule of the knee) block to improve posterior knee analgesia.\n\nAll patients will receive an ultrasound-guided adductor canal block with 20 mL of 0.2% ropivacaine. They will then be randomly assigned to one of two groups:\n\nGroup 1: ACB combined with a sacral erector spinae plane block (S-ESPB) using 20 mL of 0.2% ropivacaine.\n\nGroup 2: ACB combined with an iPACK block using 20 mL of 0.2% ropivacaine. Both techniques aim to provide effective postoperative analgesia while minimizing motor blockade and allowing for early mobilization. It is not known whether combining ACB with S-ESPB or with iPACK provides superior pain control, reduces opioid requirements, or results in better functional recovery after total knee arthroplasty.\n\nThe main purpose of this study is to compare the time to first rescue analgesia and overall postoperative pain control between the two regional anesthesia strategies. The study will also evaluate opioid consumption, motor function, functional mobility, side effects, and block-related complications.\n\nWe hypothesize that both combinations will provide effective analgesia, but their impact on pain intensity, duration of analgesia, and functional recovery may differ.",[28],{"date":533,"type":33},"2026-02-02",{"date":535,"type":33},"2025-12-25",{"date":193,"type":22},{"name":39,"class":40},""]