Development And Clinical Evaluation Of A Depth Of Anaesthesia Monitor
Funder
National Health and Medical Research Council
Funding Amount
$424,785.00
Summary
Waking up during surgery (awareness under anaesthesia) is a frightening reality for some patients. Although uncommon (occurring in about 1 in 1000 operations), it remains one of the main concerns of patients before their surgery. Recent studies (including our own) have demonstrated that processed EEG monitoring using bispectral index (BIS) can markedly reduce the risk of awareness. Other EEG monitors are being developed, but each have weaknesses. As approximately two million Australians have a g ....Waking up during surgery (awareness under anaesthesia) is a frightening reality for some patients. Although uncommon (occurring in about 1 in 1000 operations), it remains one of the main concerns of patients before their surgery. Recent studies (including our own) have demonstrated that processed EEG monitoring using bispectral index (BIS) can markedly reduce the risk of awareness. Other EEG monitors are being developed, but each have weaknesses. As approximately two million Australians have a general anaesthetic each year, about 2000 will suffer an episode of awareness. More than 60 million people around the world have an anaesthetic, and so the problem is substantial. This suggests the potential benefits (health outcomes, commercial gains) are very great. In 2000 less than 5% of US hospitals used BIS monitoring; the current figure in the US is about 69% of the best-rated hospitals (US News and World Report) and 78% of teaching hospitals. A similar rapid growth is occurring in Australia and Europe. We are working with a successful Australian Company (Compumedics Ltd) to develop a better awareness monitor. We plan studies in groups of patients have surgery.Read moreRead less
This study is testing two drugs in people having heart surgery, to see whether either can reduce serious complications such as heart attack, stroke or death. Aspirin thins the blood and can reduce these risks but it increases bleeding during surgery. Another drug can reduce bleeding, but it may counteract the benefits of aspirin. The study is being done at more than 20 hospitals in Australia and around the world.
Commercial Testing Of A Physiologically Based Theory Of Oscillatory Brain Electrical Activity In Anaesthesia Monitoring
Funder
National Health and Medical Research Council
Funding Amount
$191,165.00
Summary
While the mechanisms of local anaesthesia are comparatively well known, the mechanisms whereby anaesthetics impair consciousness remain unresolved. This lack of understanding has implications in our ability to monitor the level of anaesthesia while anaesthetic consumption and side effects are minimized. Despite this a number of devices have been developed that attempt to monitor the depth of anaesthesia by quantifying the brains electrical activity. All monitors analyse the activity using a set ....While the mechanisms of local anaesthesia are comparatively well known, the mechanisms whereby anaesthetics impair consciousness remain unresolved. This lack of understanding has implications in our ability to monitor the level of anaesthesia while anaesthetic consumption and side effects are minimized. Despite this a number of devices have been developed that attempt to monitor the depth of anaesthesia by quantifying the brains electrical activity. All monitors analyse the activity using a set of criteria that have been developed by trial and error. The research of Dr David Liley and his team, at Swinburne University of Technology, has resulted in a detailed understanding of the physiological mechanisms that generate brain electrical activity. The outcome is a practical means to carry out a System Based Analysis of Brain Electrical Response (SABER). In 2004, Dr Liley began working with Cortical Dynamics, a company involved in the commercialisation of medical devices. This collaboration incorporated the SABER system into a new prototype device called the Brain Anaesthesia Response (BAR) monitor. In 2004 Dr Liley and Associate Professor Kate Leslie collaborated in a trial, at the Royal Melbourne Hospital to test the sensitivity of the SABER system in quantifying the effect that various levels of nitrous oxide have on measures of anaesthetic depth. The Australian and New Zealand College of Anaesthetists supported this study. Initial results obtained with sevoflurane and 3 levels of nitrous oxide showed the ability to differentiate between conscious and unconscious states of patients based on two physiological characterizations of higher brain dynamic state. The next step requires commercial product validation (ie scale up) and further clinical efficacy in testing beta stage depth of anaesthesia BAR units. Completion of this will help the technology move away from a low volume prototype system into a commercially applicable device.Read moreRead less
IV Iron For Treatment Of Anaemia Before Cardiac Surgery (ITACS Trial)
Funder
National Health and Medical Research Council
Funding Amount
$2,285,290.00
Summary
Our aim is to evaluate intravenous iron to treat anaemia in 1000 patients waiting for their cardiac surgery. This could reduce the risks of the operation and enable patients to recover faster and can go home earlier.
Reduction Of Chronic Post-surgical Pain With Ketamine - ROCKet Study
Funder
National Health and Medical Research Council
Funding Amount
$4,823,395.00
Summary
Chronic post-surgical pain (CPSP) is a common complication of major surgery, and a significant burden on quality of life and ongoing health costs. Ketamine is a drug used by anaesthetists to treat severe acute surgical pain. Various small studies suggest that it may be unique in its ability to reduce the risk of CPSP. We propose a large trial of ketamine during & after anaesthesia for major surgery to test this. Demonstration of effectiveness would promote widespread change in clinical practice.
Improving The Impact Of Perioperative Clinical Trials
Funder
National Health and Medical Research Council
Funding Amount
$494,733.00
Summary
This research focuses on (i) Designing and conducting large multicentre trials in anaesthesia and surgery, (ii) Confirming new patient-centred outcome measures in surgery, such as patient-rated quality of recovery, returning home after surgery, and disability-free survival; and (iii) Innovative trial designs to improve the efficiency (less burden, lower costs) of trials.
Restrictive Versus Liberal Fluid Therapy In Major Abdominal Surgery: The RELIEF Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,477,820.00
Summary
Major surgery can result in serious complications, some of which lead to permanent disability and early death. All patients undergoing major surgery require intravenous fluids to maintain a healthy circulation, but too much fluid can cause tissue swelling (oedema) and "drown" the vital organs. There are probable benefits of a restrictive IV fluid regimen. This could have major benefits to patients having surgery.
Perioperative Administration Of Dexamethasone And Infection- The PADDI Trial
Funder
National Health and Medical Research Council
Funding Amount
$4,832,815.00
Summary
The PADDI Trial is a large (8,800 patients) international, multicentre, randomised, controlled, non-inferiority safety and effectiveness study that will run for five years. It will examine the benefits and complications of administering 8mg of a steroid drug (dexamethasone) to adult patients undergoing non-urgent surgical procedures who receive general anaesthesia. The main outcome is surgical site infection 30 days after surgery. The influence of diabetes will also be investigated.