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Patients undergoing major abdominal surgery require intensive postoperative pain relief for many days. Good pain relief improves recovery and poor pain relief hinders recovery. The conventional choices of pain relief are powerful intravenous drugs or an epidural infusion of local anaesthetic with some morphine like drug (opioid) added. Despite extensive experience with these two techniques it remain unclear in which patients the epidural technique is indicated. In Southern Health and selected other hospitals in Australia a third technique has been in use for 15 years – a continous spinal infusion of pain relieving drugs using a spinal catheter (the ‘intrathecal technique’) . A recent quality assurance audit at Monash medical centre showed that the intrathecal technique was superior to the other two techniques. Patients receiving this had better pain relief than alternative techniques. Unfortunately this work was an unblinded audit comparing 3 groups of patients among whom major differences existed in surgical length, type of surgery and age. This limits what can be concluded from the results. In the proposed project the intention is to recruit patients aged over 50 that are scheduled for gut surgery into a study comparing epidural and intrathecal analgesia postoperatively. The aim is to improve pain relief and quality of recovery after surgery. Other factors that will be studied include length of stay, need for additional pain relieving drugs and time till oral intake. The participants, assessor and data analyst will be blinded to the treatment groups. The hospital staff will not be blinded.

The aim of this study is to see if a new dosing regimen of enoxaparin (an anticoagulant used in the treatment of heart attacks, deep vein thrombosis and pulmonary embolism) if safer than the current method of dosing (designed by the drug company). Patients will agree on being part of the study and then treated using one of the two methods (they will be unaware which group they will be in). The number of bleeding events and large bruises will be recorded for every patient. The two methods of dosing can then be compared at the end of the study to see which one has caused the least bleeding/bruising events). It is hope that the new dosing method will result in less events.

The purpose of this project is to help determine the most effective way to treat the acute pain associated with passage of a kidney stone. Standard treatment for renal colic involves the use of intravenous morphine titrated to effect. This study will involve comparison of intravenous morphine with ketorolac. This agent is a non-steroidal anti-inflammatory drug which will be given intravenously. In this study, patients will be given morphine, ketorolac or a combination of both of these medications. The hypothesis that is being tested is that ketorolac provides superior pain relief to morphine in acute renal colic. This is a double blinded study - both the treating doctors and the patients will be blinded to the interventions administered

The project aims to assess the relationship between initial MRI findings in road trauma patients with non-fracture related neck pain, and physical and functional outcomes at 12 months post injury.

Intensive care patients require many blood tests. Each blood test requires a small amount of blood loss and when added together this can lead to anaemia and the need for a blood transfusion. ICU blood tests are taken through a drip, and an amount of blood must be wasted each time, to clear the drip set and access the patient’s blood. This “discard volume” is important: too little and the blood tests may be inaccurate, too much and the patient loses even more blood unnecessarily. The ideal discard volume for most blood tests is unknown and so hospitals and health professionals take various amounts; it is highly likely that unnecessary blood loss occurs. In our study we plan to identify the minimum discard volume required to obtain accurate results for several of the most common blood tests performed in ICUs. The laboratory scientists (assessors) performing the outcomes measures will be blinded to intervention group of each blood sample.

This study is designed to assess the effectiveness of the Bispectral Index (BIS) monitor in helping nurses to decide if intensive care patient’s are receiving the right amount of sedation medication to keep them comfortable and asleep while they are connected to the ventilator. The BIS monitor is a non-invasive machine that measures electrical brain wave activity, and converts it into a number that indicates if patients are too awake or deeply unresponsive. The study will be conducted in the Intensive Care Unit at the Alfred Hospital. This study is designed as a prospective randomised control trial with parallel design. This means that participants’ will be randomly allocated into either one of two groups – an intervention or control group. Participant’s randomised to the intervention group will receive BIS monitoring. The control group will receive standard ICU sedation assessment and management. To determine if BIS monitoring is useful in ICU, information will be collected by auditing patient charts and determining the average amounts of sedation medication for each nursing shift. In addition, the years of critical care experience and critical care qualification will be recorded for each nurse managing patients recruited to the study.

This is a non-randomised, open-label treatment protocol for patients with advanced renal cell carcinoma, who received previous systemic therapy for advanced disease, and who do not have access to or are not eligible for other clinical trials with sorafenib (BAY 43-9006). Safety data and limited efficacy data will be collected.

The purpose of the protocol is to examine the effects of two levels of commonly used ambient humidity (70% and 80%) in the incubator on 1) body temperature control 2) fluid and electrolyte balance 3)bacterial colonisation and visibility as a result of water condensation in preterm infants born at 28 weeks gestation and less. This information will be used as a basis for a unit protocol for nursing preterm infants in humidity. We hypothesize that in the first two weeks of life after birth, there is no significant difference in body temperature stability when nursing preterm infants in either 70% or 80% incubator humidity.

Patients undergoing cardiac surgery for coronary artery bypass or valve repair/replacement are at risk of a number of complications. One of the most common complications is atrial fibrillation (AF), or abnormal contraction of the upper chamber of the heart, which occurs in about 30% to 55% of patients, depending on the type of surgery. While AF itself is not particularly dangerous, it does lead to increased length of stay in hospital, with associated costs, and also increases the risk of stroke. Patients suffering from post-surgical AF are generally prescribed additional medications, some of which can have unpleasant side effects. The purpose of this study is to determine whether fish oil given prior to surgery reduces the risk of developing AF after surgery. We also plan to investigate a number of mechanisms by which fish oil may exert its cardio-protective properties

To participate in a 14 day, self help programme consisting of a 99 page manual, 2 CD's and workbook with optional teaching if required. A confidential, in depth trial questionnaire to be answered by the participant in order to interpret and analyse the success or otherwise of the programme, taking into account individual criterion of each participant.