Pain After Surgery

This randomized, double-blind controlled trial will evaluate whether intraoperative injection of bupivacaine at the sling insertion site reduces postoperative pelvic and thigh pain in women undergoing TVT or TVT-O surgery for stress urinary incontinence. Women aged 18 years and older scheduled for vaginal surgery including a mid-urethral sling procedure will be randomly assigned to receive either 0.5% bupivacaine or saline injection at the surgical site at the end of the procedure. Postoperative pain will be assessed using the Numerical Rating Scale (NRS) within 24 hours after surgery, at one month, and at least six months postoperatively. The study will also evaluate opioid consumption and examine the relationship between early postoperative pain and the development of chronic postsurgical pain. The results may help determine whether local anesthetic injection during sling surgery can improve short- and long-term pain outcomes.

The goal of this clinical trial is to see if a new pain medicine called Tegileridine is at least as effective as morphine (the standard treatment) for pain relief after spinal surgery in teenagers with scoliosis. This type of study is called a "non-inferiority" trial. The study will also carefully compare the safety of both medicines. The main questions it aims to answer are: Is Tegileridine no worse than morphine at controlling pain in the first 24 hours after surgery? How do the side effects (like sleepiness or nausea) of Tegileridine compare to those of morphine? Researchers will compare two different doses of Tegileridine against morphine. Neither the participants nor the doctors assessing them will know which medicine is being given. Participants in this study will: Receive one of the three pain medicine options through a pump (called a PCA pump) that they can control themselves after surgery. Use the pump for up to 48 hours. Regularly rate their pain levels using a simple number scale. Have their health closely monitored by the study team during this time.

This is a multi-center, randomized, double-blind, double-dummy, placebo/active-controlled study. 200 subjects undergoing abdominal surgery under general anesthesia are planned to be enrolled and randomized into the HSK55718 group, morphine group, and placebo group.

The objective of this study is to evaluate the clinical impact of the NOL nociception level index monitoring on intraoperative and post operative patient outcomes and institutional metrics when used to guide intraoperative analgesia dosing in patients undergoing spine surgery under general anesthesia when compared to a case controlled retrospective cohort.

The goal of this clinical trial is to investigate the analgesic efficacy of ultrasound-guided Romboid Intercostal and Subserratus (RISS) block versus lower thoracic Erector Spinae Plane (ESP) block after laparoscopic abdominal surgery. The main questions it aims to answer are: Does ultrasound-guided Romboid Intercostal and Subserratus (RISS) block is effective as the lower thoracic Erector Spinae Plane (ESP) block for intra and postoperative analgesia after laparoscopic abdominal surgery for the first 24 hours? What complications do participants have when doing these interventions? Researchers will compare the analgesic efficacy of ultrasound-guided Romboid Intercostal and Subserratus (RISS) block with the lower thoracic Erector Spinae Plane (ESP) block after laparoscopic abdominal surgery. Participants will: Start general anesthesia and be given either block according to the randomization chart. The blood pressure and heart rate will be measured at intervals to determine if the participants need extra intraoperative analgesics. Numerical Rating Scale (NRS) will be used postoperatively to test pain severity. Rescue morphine analgesia will be measured and compared in both groups. Any complications will be reported. Patient and surgeon satisfaction will be measured.

The goal of this clinical trial is to learn whether use of a virtual reality (VR) headset showing a meditative nature video will help reduce pain and anxiety during a first trimester procedural abortion. Investigators will enroll 72 patients undergoing a first trimester procedural abortion with usual care to manage pain and anxiety compared to use of a VR headset in addition to usual care to see if use of the VR headset will decrease pain and anxiety and increase satisfaction with the procedure.

This is a multi-center, randomized, double-blind, placebo/active-controlled study. 200 subjects undergoing orthopedic surgery under general anesthesia are planned to be enrolled and randomized into the HSK55718 group, morphine group, and placebo group.

This prospective randomized study will compare the effects of Erector Spinae Plane Block (ESPB) and Serratus Anterior Plane Block combined with Pectoral Nerve Block Type II (SAPB + PECS II) on intraoperative analgesia and postoperative opioid consumption in patients undergoing breast cancer surgery. Seventy patients (ASA I-III, aged 18-75 years) will be randomized into two groups using the sealed envelope method. Ultrasound-guided blocks will be performed preoperatively by the same anesthesiologist, with Group 1 receiving ESPB and Group 2 receiving a combined SAPB + PECS II technique performed through a single skin puncture (single needle entry site) with sequential injections into the two target fascial planes. All patients will undergo surgery under general anesthesia and receive postoperative analgesia via morphine patient-controlled analgesia. Pain scores and total opioid consumption will be statistically analyzed, with p \< 0.05 considered significant.

This study teaches participants who are having colorectal surgery how to use mindfulness to feel calmer and manage pain better. Participants will be randomized (like a flip of a coin) into one of two groups: Mindfulness Intervention or Standard Treatment. Those in the Mindfulness group will have a 30-minute Zoom session before surgery to learn simple mindfulness exercises like deep breathing, using senses, and staying focused on the present. On the day after surgery, participants will watch a short video review of the mindfulness exercises. Regardless of the group assigned, participants may be asked to complete questionnaires, and some participants will be asked to complete a semi-structured interview via Zoom, about 2 weeks to 1 month after surgery. Additionally, access to the mindfulness curriculum will be provided to those not randomized to that group. Investigators will collect information such as age, surgery details, pain levels, and pain medication usage. Participants will also fill out surveys before and after surgery to assess physical and mental well-being. All personal information will be kept safe, and interviews or Zoom sessions will be deleted after notes are taken without names attached. Participants will be in this study for about 4 weeks.

This is a pilot study in which patients taking opioids chronically who are scheduled for spine surgery at least 4 weeks in advance will be randomly assigned to one of two groups: opioid tapering with education alone or opioid tapering with education plus cognitive behavioral therapy (CBT). The primary objective is to determine the proportion of each group that is successful in achieving their opioid tapering goals by the time of surgery.

Severe limb trauma often requires the use of a tourniquet to stop life-threatening bleeding. While tourniquets are essential for saving lives, prolonged interruption of blood flow may lead to tissue ischemia, nerve injury, and inflammatory responses that could contribute to the development of chronic pain. The TOURNI-PAIN Study is a prospective observational study designed to investigate whether the duration of tourniquet use during the treatment of severe limb injuries is associated with an increased risk of persistent pain after recovery. The study will enroll adult patients with major upper or lower limb trauma who required tourniquet application in the prehospital or hospital setting. Researchers will collect information about the duration and characteristics of tourniquet use, details of the injury, surgical treatment, and recovery. Participants will be followed for up to 6 months after injury to assess pain levels, possible neuropathic pain, functional recovery, and quality of life. The goal of this research is to better understand whether longer tourniquet exposure increases the risk of long-term pain. The findings may help improve trauma care practices by balancing the life-saving benefits of hemorrhage control with strategies that minimize long-term complications and improve recovery for patients with severe limb injuries.

Ethics committee approval was obtained for this study, which was planned as a prospective, randomized, controlled, single-center trial to be conducted in patients undergoing coronary artery bypass grafting (CABG) surgery between December 2025 and March 2026. Patients eligible for inclusion were randomized into two groups at a 1:1 ratio using a random number list generated via the random.org website. Randomization was performed by an independent investigator who was not involved in the study procedures. The allocation sequence was placed into sequentially numbered, opaque, sealed envelopes. Upon enrollment of each patient, the next numbered envelope was opened to determine group assignment. Patients who did not complete the study protocol or did not receive the allocated medication were excluded from the analysis, and a per-protocol analysis approach was applied. The randomization list was kept confidential and was accessible only to authorized statistical personnel. Patients were followed in two groups: the Control Group (Group C) and the Morphine Group (Group M). All procedures were performed at the Istanbul University-Cerrahpaşa Cardiology Institute. After obtaining written informed consent, all patients were transferred to the operating room, where an 18G intravenous cannula was inserted, followed by premedication with midazolam 0.03 mg/kg (IV). Standard monitoring included 5-lead electrocardiography (ECG), heart rate measurement, invasive arterial blood pressure monitoring, and peripheral oxygen saturation assessment. Anesthesia induction was standardized for all patients using midazolam 0.15 mg/kg, fentanyl 10 µg/kg, and rocuronium 0.6 mg/kg (IV). Orotracheal intubation was performed using an endotracheal tube of appropriate size according to the patient's age and sex. Following intubation, mechanical ventilation was initiated and adjusted to maintain end-tidal carbon dioxide (EtCO₂) levels between 35 and 45 mmHg. Anesthesia maintenance was achieved using a total intravenous anesthesia (TIVA) technique with continuous infusions of propofol (1-10 mg/kg/h), fentanyl (2-4 µg/kg/h), and rocuronium (20 mg/h), targeting a bispectral index (BIS) value between 40 and 60. Prior to surgical incision, patients in the Morphine Group (Group M) received 5 mg intravenous morphine, administered with careful consideration of their hemodynamic status. During surgery, all patients were placed on cardiopulmonary bypass (CPB). After completion of graft anastomoses and stabilization of vital signs, patients were weaned from CPB. At this stage, patients in Group M received an additional 5 mg intravenous morphine. In contrast, patients in the Control Group (Group K) continued to receive perioperative fentanyl infusion. Postoperatively, patients were transferred to the intensive care unit (ICU) while intubated and mechanically ventilated. Extubation was performed according to clinical criteria. In the ICU, all patients received intravenous paracetamol 1000 mg every 6 hours and tramadol 100 mg intravenously. Pain intensity was assessed using the Numerical Rating Scale (NRS) / Visual Analog Scale (VAS). If the pain score exceeded 4, 3 mg intravenous morphine was administered, and total morphine consumption was recorded. Preoperative variables collected included age, sex, height, weight, body mass index (BMI), and American Society of Anesthesiologists Physical Status (ASA PS) classification. Intraoperative variables included administered drug doses, duration of surgery, cardiopulmonary bypass time, and total anesthesia duration. In the postoperative period, the duration of mechanical ventilation in the intensive care unit (ICU), the presence of nausea and vomiting, postoperative ileus, and respiratory depression will be recorded. In addition, pain intensity at the thoracic tube insertion site, sternum, and saphenous vein graft incision will be assessed at the 1st, 2nd, 4th, 8th, and 24th hours following extubation using the Numerical Rating Scale (NRS) / Visual Analog Scale (VAS). All pain assessments will be performed and recorded by a blinded observer. Pain associated with the urinary catheter will also be evaluated using the NRS. Prolonged postoperative ileus will be defined as the presence of abdominal distension and absence of bowel sounds in a patient without mechanical intestinal obstruction who experiences nausea or vomiting and fails to pass flatus or stool for more than three postoperative days. The severity and frequency of postoperative nausea and vomiting (PONV) will be assessed. Respiratory depression will be defined as a suppressed ventilatory response to hypercapnia or hypoxemia.

Prospective Cohort of patients who are scheduled for a Robot Assisted Total Knee Arthroplasty (RATKA). A prospective survey of patient reported outcome measures (Numeric Rating Scale) will be obtained postoperatively of 72 hours, as well as at the postoperative opioid consumption after 72 hours.

The goal of this clinical trial is to learn if melatonin will decrease pain after C.S. The main questions it aims to answer are: Does melatonin lower the number of times participants need to use a rescue analgesia? What medical problems do participants have when taking melatonin? Researchers will compare different doses of melatonin to see the ideal dose to decrease pain after C.S. Participants will: Take melatonin 30 min before C.S and will be observed for 24 hours for pain and consumption of other analgesia