ANZCTR search results

Despite the development of anaesthesia management guidelines, perioperative respiratory adverse events (PRAE) remain a major cause of morbidity and mortality during paediatric anaesthesia, causing more than three quarters of critical incidents and nearly one third of all perioperative cardiac arrests. In a previous cohort study in over 9000 children, we identified several risk factors (current or recent upper respiratory tract infection, wheezing more than 3 times in the last 12 months, eczema, nocturnal dry cough, a family history of asthma, eczema, rhinitis or passive smoking) which can help in every day clinical practice to identify the children at a particularily high risk for PRAE. A recent large cohort study conducted by the anaesthetic department of Princess Margaret Hospital, “Risk assessment for respiratory complications in paediatric anaesthesia” by von Ungern-Sternberg, Habre, Boda, Rebmann, Johnson, Sly, and Chambers, identified the type of anaesthesia impacted on the risk of RAE occurring. In this observational study, intravenous (i.v.) induction with propofol was associated with a significantly lower incidence of RAE compared with inhalational induction with sevoflurane, particularly with regard to the occurrence of laryngospasm (RR 3.2[2.6-4] p less than 0.0001). However, worldwide inhalational induction of anaesthesia is the most common way of anaesthesia induction in children because it avoids a needle prick in the awake child. The aim of this study is to randomise 300 infants and children (0-8 years) with a high risk for respiratory complications, who are undergoing minor elective surgery, to receive either an i.v. induction with propofol or an inhalational induction with sevoflurane. All patients will be monitored for the occurrence of RAE in the perioperative period. We hypothesize that patients receiving i.v. propofol will demonstrate less respiratory complications (laryngospasm, bronchospasm, desaturation less than 95%, airway obstruction, severe coughing and/or postoperative stridor compared with patients receiving sevoflurane (22% as compared to 38%). These values are based on our previous large cohort study.

Infants undergoing minor elective surgery have their airway managed at the discretion of the anaesthetist in charge with either an endotracheal tube or an laryngeal mask airway. Research already done witin the Princess Margaret Hospital for Children (PMH) Anaesthetic Unit has identified some patients with asthma, eczema, hay fever, a current cold & exposure to smoking have a higher risk of airway complications following their surgery. However, the best practice for the management of an infant's airway is still under debate. The aim of this study is to identify which airway support, laryngeal mask or endotracheal tube, is safer in regards to respiratory problems in the perioperative period for infants (0-12 months) undergoing minor general surgery.

This study will examine the effectiveness of a brief group-based intervention for those with co-occurring mental illness and substance use disorders. It is hypothesised that those who receive the intervention will experience less severity of dependance of substances and decreased impact of psychiatric disorder.

The University of South Australia is conducting a research project looking at the effects of a physical activity program on adults aged between 18 and 60 years who exercise for less than two and a half hours each week. This study is interested in finding out how people change their daily activity patterns and energy expenditure when they are involved in a structured exercise program.’

This project is part of a research program funded by the NHMRC (No. 630560) to develop and evaluate Internet based transdiagnostic treatment programs for people with anxiety and depression. This preliminary project examines the efficacy of a treatment program for people with depression, social phobia and/or panic disorder (with or without agoraphobia) and/or GAD. We expect that people in either immediate or delayed treatment groups will report similar benefit following the active component of their program.

To evaluate whether local anaesthetic running via a catheter in the abdominal wall improves analgesia following abdominal surgery

This study was terminated in July 2011 due to feasibility reasons. Although ethics approval had been obtained, recruitment of participants never commenced.

No studies have been conducted to assess the most appropriate time interval for aspirating gastric tubes. We compared gastric tube aspirations every four hours (usual care) to a variable regimen (up to every eight hours aspirations). This randomized controlled trial (RCT) enrolled patients who stayed in ICU > 48 hours, had a gastric tube, and were likely to receive EN for 3+ days. Patients were randomized (computer-generated randomization) to either control (every four hours) or intervention group (variable regimen). The primary outcome was number of gastric tube aspirations per day from randomization until EN was ceased or up to two weeks post-randomization. Following Institutional Ethics Committee approval, 357 patients were recruited (control group n=179 and intervention group n=178). No differences were found in age, sex, worst APACHE II score or time to start of EN. In the intention to treat analysis, the intervention group had fewer tube aspirations per day (3.4 versus 5.4 in the control group, p<0.001). Vomiting/regurgitation was increased in the intervention group (2.1% versus 3.6%, p=0.02). There were no other differences in complications. This is the first RCT to examine the frequency of gastric tube aspirations. The frequency of gastric tube aspirations was reduced in the variable regimen group with no increase in risk to the patient. Reducing frequency of aspirations saves nursing time, decreases risk of contamination of feeding circuit and minimises risk of body fluid exposure.

Our previous research into Internet based treatment programs have been shown to be effective (e.g the Worry Program for the treatment of generalised anxiety disorder (ACTRN12609000563268). These programs informed the creation of a program for treating GAD, and/or social phobia, and/or panic disorder (the Anxiety Program). Our preliminary research indicated tenative support that the Anxiety Program (ACTRN12609000501246) was effective at helping people to learn to manage their symptoms of anxiety. The study described here aims to find out whether therapist support is required for people to successfully complete the Anxiety Program. We expect that people completing the Anxiety Program without therapist support will still benefit, but not as much as those receiving the usual levels of therapist support.