The Influence Of Anaesthetic Depth On Patient Outcome After Major Surgery
Funder
National Health and Medical Research Council
Funding Amount
$2,893,795.00
Summary
Millions of high-risk patients have general anaesthesia for major surgery worldwide every year, but the optimal depth of anaesthesia for these patients is not known. The aim of this large randomised trial is to determine the impact of light versus deep general anaesthesia on survival at one year postoperatively in 6,500 older patients. If light anaesthesia is associated with better survival, this result will be immediately implementable, will save lives and will reduce the costs of care.
It is known that about 10% of patients over the age of 55 have difficulty with cognition and thinking 3 months after surgery and anaesthesia. Over 2 million operations involving anaesthesia are administered in Australia every year and increasingly the patients are elderly and thus exposed to the risk of cognitive decline after surgery. We have preliminary data showing that people who have mild changes in cognitive function before the surgery (known as mild cognitive impairment) are susceptible t ....It is known that about 10% of patients over the age of 55 have difficulty with cognition and thinking 3 months after surgery and anaesthesia. Over 2 million operations involving anaesthesia are administered in Australia every year and increasingly the patients are elderly and thus exposed to the risk of cognitive decline after surgery. We have preliminary data showing that people who have mild changes in cognitive function before the surgery (known as mild cognitive impairment) are susceptible to further cognitive decline after anaesthesia and surgery. In order to explore the relationship between preoperative cognitive function and postoperative cognitive decline we plan to measure cognition in patients scheduled for elective hip replacement surgery. This is done by asking patients to complete a standard battery of cognitive tests. We will be then able to identify those patients who already have mild cognitive impairment before surgery and by repeated testing after the operation will be able to demonstrate if preoperative cognitive status is a determinant of postoperative cognitive dysfunction. The primary aim of the research is to test whether cognitive impairment before surgery leads to cognitive deficit after surgery in patients over the age of 65 undergoing total hip replacement surgery. The study will also establish the prevalence of pre-operative mild cognitive impairment and the magnitude of postoperative cognitive dysfunction after surgery in this patient group. The study will explore the relationship between preoperative cognitive status and postoperative cognitive deficit , providing information about the incidence, natural history and risk factors of postoperative cognitive deficit. This work will enable further research to isolate specific causative factors and identify therapeutic and prophylactic strategies.Read moreRead less
‘Granny was never the same after her operation’ is a strong public perception. These reports of persistent memory and concentration loss following surgery are now supported by a body of scientific research recording an incidence of ‘postoperative cognitive decline’ (POCD) as high as 75% in cardiac surgery patients. At present the cause is unknown but recently anaesthesia has been implicated. Our research team will investigate these claims.
Outcomes From A Multi-site Randomised Controlled Trial Comparing Regional And General Anaesthesia For Effects On Neurodevelopmental Outcome And Apnoea In Infants
Funder
National Health and Medical Research Council
Funding Amount
$757,831.00
Summary
Animal studies suggest general anaesthetics harm the developing brain. It is unclear if these findings are relevant to humans. The aim of this international randomised controlled trial is to determine whether children exposed to general anaesthesia as an infant have a poorer neurodevelopmental outcome. A previous NHMRC grant funded the first phase of the trial along with substantial funding from overseas. The trial will tell us if general anaesthetics affect the developing brain in children.