Clinical trials

Postoperative pulmonary complications (PPCs), such as pneumonia, atelectasis, and respiratory failure, are major causes of illness, prolonged hospital stays, and intensive care admissions in older patients undergoing elective major abdominal surgery. The American Society of Anesthesiologists Physical Status (ASA-PS) classification is commonly used before surgery to estimate risk. However, ASA-PS does not directly measure nutritional depletion or muscle weakness, which are critical risk factors in geriatric patients. The Geriatric Nutritional Risk Index (GNRI) is a simple, objective screening tool calculated from preoperative serum albumin levels and body weight. The purpose of this observational study is to evaluate the role of GNRI in predicting postoperative pulmonary complications and to determine whether adding GNRI to the standard ASA-PS classification improves the ability to identify older patients at high risk for lung complications after major abdominal surgery.

This prospective observational study aims to evaluate the association between intraoperative perfusion variability and postoperative troponin elevation in geriatric patients undergoing major oncologic surgery. Intraoperative hemodynamic and perfusion-related parameters will be recorded, and postoperative troponin levels will be assessed to investigate whether intraoperative perfusion changes are associated with myocardial injury. Troponin measurements will be obtained preoperatively and at 24 hours after surgery

This prospective observational study aims to evaluate whether the preoperative neutrophil percentage-to-albumin ratio (NPAR) is associated with post-induction hemodynamic vulnerability in adult patients undergoing elective major oncologic surgery under general anesthesia. NPAR will be calculated from routine preoperative laboratory results by dividing the neutrophil percentage by the serum albumin level. No additional laboratory tests, medications, invasive procedures, or changes in anesthesia management will be performed for the purposes of the study. Demographic characteristics, preoperative laboratory values, anesthetic data, and hemodynamic measurements will be recorded prospectively. Hemodynamic status will be evaluated during the period between induction of general anesthesia and surgical incision, with a maximum observation period of 20 minutes. Vasopressor use and administered doses will also be recorded. The study will assess the ability of preoperative NPAR to identify patients who may be more susceptible to early hemodynamic instability following induction of general anesthesia.

This study aims to evaluate the effects of high-flow nasal oxygen therapy on respiratory complications, blood gas parameters, and post-procedural recovery in patients undergoing sedated endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Participants will be assigned to receive either high-flow nasal oxygen therapy or conventional oxygen therapy during the procedure. The incidence of respiratory complications, blood gas changes, and recovery outcomes will be compared between the two groups.

This study investigates how different breathing machine (ventilator) settings affect the energy delivered to the lungs during surgery. Mechanical power is a measure of this energy, and high levels can sometimes lead to lung irritation. In clinical practice, a mode called Pressure-Regulated Volume Control (PRVC) is often used because it lowers the "peak" pressure in the airways, which is generally thought to be safer. However, doctors have noticed that even though the peak pressure goes down in PRVC mode, the total mechanical power displayed on the monitor might actually increase compared to the standard Volume-Controlled Ventilation (VCV) mode. In this study, patients undergoing gallbladder surgery will be monitored using both ventilation modes in a random order. The researchers will compare the machine-calculated mechanical power for both modes to see if the perceived benefit of lower peak pressure in PRVC actually results in lower overall energy transfer to the lungs.

Sleep quality is a key physiological factor influencing immune function, inflammatory response, and pain perception. This prospective observational study aims to evaluate whether preoperative sleep quality predicts postoperative inflammation, pain severity, and analgesic consumption in patients undergoing elective breast cancer surgery. Preoperative sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI). Systemic inflammatory response will be evaluated using the Systemic Immune-Inflammation Index (SII), calculated from routine hematological parameters. Postoperative pain will be assessed using the Visual Analog Scale (VAS), and analgesic consumption will be recorded within the first 24 hours. The study aims to determine whether poor sleep quality is associated with increased inflammatory response, higher pain scores, and greater analgesic requirement.

Postoperative pain remains a significant clinical challenge that directly affects patient recovery, functional outcomes, and overall quality of care. Inadequate pain control in the early postoperative period is associated with delayed mobilization, increased risk of complications, prolonged hospital stay, and the development of chronic pain. The post-anesthesia care unit (PACU) represents a critical phase in which pain is actively assessed and managed, and analgesic consumption during this period serves as an objective indicator of analgesic requirements and effectiveness of perioperative pain strategies. This prospective observational study aims to identify patient-related, surgical, and anesthesia-related factors influencing analgesic consumption in the early postoperative period among adult patients admitted to the PACU following elective surgery. No additional interventions will be performed, and all perioperative management will follow routine clinical practice. Data will be collected prospectively from clinical records, anesthesia charts, and PACU monitoring forms. The primary outcome is total analgesic consumption during the PACU stay. Secondary outcomes include pain intensity assessed using a standardized pain scale at PACU admission and discharge, requirement for rescue analgesia, incidence of postoperative nausea and vomiting, and length of stay in the PACU. The findings of this study are expected to contribute to the identification of patients at higher risk for increased analgesic requirements and to support the development of individualized pain management strategies, ultimately improving perioperative care quality and patient outcomes.

This prospective observational study aims to evaluate whether the use of ultrasound-guided fascial plane blocks is associated with a lower incidence of postoperative pulmonary complications in adult patients undergoing elective major abdominal surgery under general anesthesia. Patients will be observed in two groups based on routine clinical practice: those who receive an ultrasound-guided fascial plane block for postoperative analgesia and those managed with other standard analgesic methods. The choice of analgesic technique will be determined by the responsible anesthesia team and not influenced by the study. Postoperative pulmonary complications occurring within the first 7 days after surgery will be recorded using reopening the European Perioperative Clinical Outcome (EPCO) criteria. Secondary outcomes will include unplanned intensive care unit admission, length of hospital stay, and 30-day mortality. No additional procedures or interventions will be performed for research purposes.

This prospective observational cohort study aims to compare the performance of commonly used perioperative risk scoring systems in predicting postoperative intensive care unit (ICU) requirement among adult patients undergoing oncologic surgery. Accurate prediction of postoperative ICU admission is essential for optimizing patient safety and efficient allocation of limited critical care resources, particularly in high-risk oncologic surgical populations. A total of 500 adult patients scheduled for elective or emergency oncologic surgery will be prospectively enrolled at a single tertiary oncology center. Preoperative clinical and demographic data, intraoperative variables, and perioperative characteristics will be recorded using a standardized data collection form. Risk assessment will include the American Society of Anesthesiologists (ASA) Physical Status classification, Surgical Outcome Risk Tool (SORT), Age-adjusted Charlson Comorbidity Index (CACI), Portsmouth Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (P-POSSUM), Eastern Cooperative Oncology Group (ECOG) performance status, Nutritional Risk Screening 2002 (NRS-2002), and preoperative serum albumin levels. The primary outcome is the need for postoperative ICU admission within the first 24 hours after surgery. Secondary outcomes include unplanned ICU admission, duration of ICU stay, need for mechanical ventilation, hospital length of stay, and 30-day mortality. The predictive performance of each scoring system will be evaluated using receiver operating characteristic (ROC) analysis and multivariable logistic regression models.

Spinal anesthesia is widely preferred for elective cesarean delivery due to its favorable safety profile and superior postoperative analgesia. However, post-spinal hypotension (PSH) remains a common complication, with reported incidence rates ranging from 40% to 70%, potentially compromising maternal hemodynamic stability and uteroplacental perfusion. Early identification of patients at high risk for PSH is therefore of critical clinical importance. This prospective observational study aims to evaluate the predictive performance of preoperative internal jugular vein collapsibility index (IJV-CI), assessed by ultrasonography, and baseline perfusion index (PI), obtained via pulse oximetry, for the development of PSH in patients undergoing elective cesarean section under spinal anesthesia. While IJV-CI reflects intravascular volume status and preload, PI represents peripheral vascular tone; thus, their combined use may improve predictive accuracy. Study Design This is a single-center, prospective observational study conducted in patients scheduled for elective cesarean delivery under spinal anesthesia. No additional intervention will be applied, and all anesthetic management will follow standard clinical practice. Objectives Primary Objective: To assess the ability of preoperative IJV collapsibility index (IJV-CI) and baseline perfusion index (PI) to predict post-spinal hypotension. Secondary Objectives: To evaluate the relationship between IJV-CI and PI with: Duration and number of hypotensive episodes Minimum systolic and mean arterial pressure Total vasopressor requirement Incidence of intraoperative nausea and vomiting Pregnant women aged 18-45 years, ASA II, with singleton pregnancies scheduled for elective cesarean section under spinal anesthesia. Inclusion Criteria Age 18-45 years Elective cesarean section Planned spinal anesthesia ASA physical status II Singleton pregnancy Exclusion Criteria Hypertensive disorders of pregnancy (e.g., preeclampsia, HELLP) Significant cardiac or pulmonary disease Chronic kidney disease Multiple pregnancy Emergency cesarean delivery Conversion to general anesthesia Conditions preventing IJV ultrasonographic assessmentBaseline PI will be recorded preoperatively using standard pulse oximetry. IJV diameters will be measured via ultrasound, and the collapsibility index will be calculated as: IJVI: (Dmax-Dmin/Dmax)X100 Hemodynamic parameters will be recorded at 3-minute intervals from spinal anesthesia administration until delivery. Statistical analysis will include ROC curve analysis, correlation analysis, and logistic regression to evaluate predictive performance.

Spinal anesthesia-induced hypotension is a common and clinically significant complication in elderly patients undergoing oncologic surgery. Early identification of patients at risk for hemodynamic instability remains a major challenge in perioperative management. Skin conductance reflects sympathetic nervous system activity and may provide a noninvasive indicator of autonomic responses. This prospective observational study aims to evaluate whether skin conductance measurements can predict the development of hypotension following spinal anesthesia in geriatric oncology patients undergoing urologic surgery. The findings may contribute to improved perioperative monitoring and early risk stratification in this vulnerable patient population.

This prospective cluster-randomized controlled study aims to evaluate whether visual support material provided in addition to the standard written informed consent form improves patients' comprehension of informed consent and their level of anesthesia awareness in an anesthesia outpatient clinic setting. Patients presenting to the anesthesia outpatient clinic will be allocated in clusters to receive either standard written informed consent alone or standard consent supplemented with structured visual support material. All patients will receive standardized verbal information delivered by the same anesthesiologist. Thirty minutes after the information session, comprehension of informed consent and anesthesia awareness levels will be assessed using a structured questionnaire administered in a standardized manner by a blinded anesthesiologist. The primary objective is to determine whether visual support enhances patient understanding of informed consent. Secondary objectives include evaluating its effect on anesthesia-related risk awareness and overall anesthesia knowledge.

Spinal anesthesia-induced hypotension is a common and clinically significant complication in geriatric patients. Accurate preoperative assessment of intravascular volume status may help identify patients at risk. Internal jugular vein (IJV) ultrasonography is a noninvasive and easily applicable bedside method that reflects venous volume status. This prospective observational study aims to evaluate the role of preoperative IJV ultrasonographic measurements in predicting hypotension following spinal anesthesia in geriatric patients. Patients aged 65 years and older undergoing elective surgery under spinal anesthesia will be included. Preoperative IJV diameter, cross-sectional area, and collapsibility index will be measured using ultrasonography. Hemodynamic parameters will be monitored intraoperatively, and the occurrence of hypotension after spinal anesthesia will be recorded. The predictive value of IJV ultrasonographic parameters for post-spinal hypotension will be analyzed

The erector spinae plane (ESP) block is a widely used regional anesthesia technique for postoperative analgesia in thoracic surgery. The block can be performed in different patient positions, most commonly sitting or lateral decubitus, but the effect of patient position on dermatomal sensory spread and analgesic efficacy has not been clearly established. This prospective, randomized, single-blind clinical trial aims to compare the effects of ESP block performed in sitting versus lateral decubitus position on dermatomal sensory distribution and postoperative analgesic outcomes in patients undergoing video-assisted thoracic surgery.

One-lung ventilation (OLV) is commonly used during thoracic surgery but may negatively affect lung mechanics and gas exchange. Different ventilation strategies are used during OLV, and their effects on respiratory parameters remain an important clinical concern. Flow-controlled ventilation (FCV) is a newer ventilation mode that allows precise control of inspiratory and expiratory flow, potentially improving lung mechanics and gas exchange. Volume-controlled ventilation (VCV) is a widely used conventional ventilation strategy during thoracic anesthesia. The FCVOLVent study is a multicenter, prospective observational study designed to compare the effects of FCV and VCV during one-lung ventilation in adult patients undergoing thoracic surgery. Patients will be ventilated with either FCV or VCV as part of routine clinical practice. The study aims to evaluate respiratory mechanics and oxygenation parameters, including the PaO₂/FiO₂ ratio, airway pressures, lung compliance, and mechanical power during surgery. Data will be collected at predefined time points during one-lung ventilation. The results of this study are expected to provide real-world clinical evidence on the potential advantages and limitations of flow-controlled ventilation compared with volume-controlled ventilation during one-lung ventilation.

This study is a one-time, questionnaire-based survey of adults attending a urology outpatient clinic. The investigators will examine whether patients who use AI chat tools based on large language models (LLMs), such as ChatGPT, before seeking care differ from non-users in (1) anxiety, (2) satisfaction with the clinic visit, and (3) awareness/understanding of their health condition. Participants who provide written informed consent will complete a brief survey during their clinic visit (about 5-7 minutes). The survey includes a standardized anxiety scale (GAD-7), visual analog scales (0-10) for anxiety before and after the visit, satisfaction, and disease awareness, as well as questions about AI/LLM knowledge and use. Treating clinicians will not have access to participants' survey responses, and participation will not affect clinical care.

Traumatic Brain Injury (TBI) is a significant cause of mortality and morbidity worldwide. However, the literature on determining its severity and predicting prognosis is insufficient. This study aimed to examine the differences in metabolite levels between trauma patients with severe TBI and orthopedic trauma patients without brain injury.

This observational study investigates the relationship between the duration of single-lung ventilation (SLV) and the incidence of postoperative pulmonary complications (PPCs) such as pneumonia, pneumothorax, hemothorax, acute lung injury, and acute respiratory distress syndrome (ARDS) in adult patients undergoing thoracic surgery. A total of 134 patients aged 18-85 years, scheduled for thoracic surgery requiring SLV, will be monitored. Data including SLV duration, perioperative parameters, and postoperative pulmonary outcomes will be analyzed.

İn this study will be conducted to evaluate the effect of coconut oil on alopecia in 86 female breast cancer patients treated at Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital between 01.02.2025-31.12.2025.