Clinical trials

Rapid sequence intubation (RSI) is the standard approach for emergency airway management in critically ill patients requiring endotracheal intubation. Laryngoscopy and tracheal intubation may provoke significant hemodynamic responses, including increases in heart rate and blood pressure, which may adversely affect patients with severe neurological or cardiovascular disease. Although hemodynamic responses during tracheal intubation have been extensively investigated in the anesthesiology literature, evidence from emergency department settings remains limited. Furthermore, previous studies have rarely confirmed whether an adequate depth of anesthesia had been achieved before laryngoscopy, making interpretation of hemodynamic responses difficult. The aim of this prospective observational study is to evaluate hemodynamic responses during rapid sequence intubation in adult emergency department patients after confirming adequate depth of anesthesia using bispectral index (BIS) monitoring. Heart rate and blood pressure will be recorded before induction, during intubation, and after successful endotracheal intubation, allowing objective assessment of the hemodynamic response under confirmed adequate anesthetic depth.

This prospective observational study aims to evaluate the association between anesthetic depth, measured by the Bispectral Index (BIS), and first-pass endotracheal intubation success in adult patients undergoing rapid sequence intubation (RSI) in the emergency department. Endotracheal intubation is one of the most critical procedures performed in emergency medicine. Multiple intubation attempts are associated with an increased risk of adverse events, including hypoxemia, aspiration, cardiovascular complications, and death. Although several factors influence first-pass intubation success, the contribution of anesthetic depth at the time of intubation has not been adequately investigated in the emergency department. Patients for whom the treating emergency physician decides to perform RSI will undergo noninvasive BIS monitoring using a disposable forehead sensor. The physician performing the intubation will remain blinded to the BIS value throughout the procedure and will perform intubation according to routine clinical practice. A separate investigator, who is not involved in patient management, will record the BIS value at the time of intubation. The BIS measurements will not be disclosed to the treating team and will not influence clinical decision-making, medication dosing, or patient management. The study is purely observational and does not evaluate the performance or effectiveness of the BIS device itself. The primary objective is to determine whether patients who achieve first-pass intubation success differ in anesthetic depth from those requiring multiple intubation attempts.

This study aims to compare two different pain management methods in patients undergoing elective lumbar spine surgery. Patients are randomly assigned to receive either an ultrasound-guided erector spinae plane block (ESPB) or intravenous multimodal analgesia. Postoperative pain will be assessed using both clinical pain scores and the Analgesia Nociception Index (ANI), a non-invasive monitoring system that evaluates pain-related responses based on heart rate variability. The goal of this study is to determine which method provides better postoperative pain control.

Fatherhood transition programs led by nurses can positively influence fathers' involvement in infant care, gender roles, and father-infant bonding. These programs encourage fathers to take a more active role in both the prenatal and postnatal periods, enhancing their knowledge and skills related to infant care. Through these programs, fathers gain more information and practical abilities in caring for their babies. The trainings provided by nurses cover essential care topics such as infant and maternal nutrition, sleep routines, diapering, burping, hygiene, and safety. This knowledge enables fathers to participate in infant care more effectively and safely. Traditional gender roles often assume that infant care is primarily the mother's responsibility. However, nurse-led programs emphasize that fathers can and should take an active role in this process. This helps break down stereotypes related to gender roles and strengthens the father's role in childcare. Active participation in infant care from an early stage contributes to the development of a strong emotional bond between father and baby. Quality time spent together, physical contact, and shared activities reinforce this bond. Research shows that a strong father-infant bond has positive effects on a child's emotional and social development. In conclusion, nurse-led fatherhood transition programs significantly contribute to reshaping traditional gender roles and strengthening the emotional bond between fathers and their babies by increasing paternal involvement in infant care. Expanding such programs can lead to long-term positive outcomes for both fathers and children.