research

anaesthesia & pain management

summary

Our research group focuses on improving the quality of care received by children before, during and after their operations. This involves identifying and measuring how patients respond to anaesthesia. Our results can influence change in anaesthesia practice, to pursue clinical excellence. Our group is committed to providing a structured program of teaching and mentoring to ensure future research in this area.

group leader(s)

  AAndrew/Professor Andrew Davidson
  Anaesthesia & Pain Management
  Murdoch Childrens Research Institute
  Royal Children's Hospital
  Flemington Road
  Parkville Victoria 3052
 
  T +61 3 9345 5233
  F +61 3 9345 6003
  E andrew.davidson@rch.org.au

  group leader biography

current research projects

Project 1:   The GAS Study: Outcomes from a randomised controlled trial comparing regional and general anaesthesia for effects on neurodevelopmental outcome in infants.

Animal studies suggest general anaesthetics harm the developing brain. It is unclear if these findings are relevant to humans but the issue has become a major concern. Recent data have found that monkeys exposed to anaesthesia as infants grow up to have slower learning than those not exposed. The aim of this international randomised controlled trial is to determine whether children exposed to general anaesthesia as infants have a poorer neurodevelopmental outcome. Infants are randomised to general or local anaesthesia for hernia repair and then followed up with detailed neuropsychological assessment at two and five years of age.

Project 2:   PINKII: An investigation of implicit memory formation in children during anaesthesia using a word stem completion task.

The aim of this study is to determine if there is evidence of implicit memory formation during anaesthesia in children using our previously validated word-stem completion test.  Implicit memory is remembering something without being aware that you have remembered it. This is an important topic to study because it has been suggested that implicit memory formation during anaesthesia can lead to behavioural disturbances after anaesthesia. There is no strong evidence to date, however, to support or refute this suggestion. Few studies have been done on implicit memory due to the difficulty of measuring it.  This study will include 200 children.

Project 3:   Pharmacokinetics of 0.25% levobupivacaine with adrenaline following caudal epidural administration in children.

Children are often given an injection at the base of the spine for pain relief after they have gone to sleep.  This injection is called caudal analgesia.  The local anaesthetic being used varies, but we commonly use levobupivacaine.  Adrenaline can be added to local anaesthetic injections because it may prolong the duration of pain relief.  The way in which adrenaline interacts with levobupivacaine has not yet been studied. In this study, we aim to find out if adrenaline affects the absorption of levobupivacaine.  We will study 60 children who are to have caudal injections as pain relief for their operations.

Project 4:   Sevoflurane induced changes in infants' quantifiable electroencephalogram parameters.

This study aims to find out how different aspects of the electroencephalogram (EEG) changes during anaesthesia in neonates and infants.  This study is important as our knowledge of the effects of anaesthetic and sedation agents on children's brains is limited. We will recruit 72 healthy children younger than two years of age and EEG data will be collected during and after anaesthesia. The anaesthetic must be sevoflurane with a regional local anaesthetic. The EEG will be analysed using the Bispectral Index, Spectral Edge and Amplitude-Integrated EEG parameters to determine changes that occur consistently between unconscious and waking stages across this age group.

Anaesthesia and Pain Management research group focuses on improving the quality of care received by children before, during and after their operations. This involves identifying and measuring how patients respond to anaesthesia. Our results can influence change in anaesthesia practice, to pursue clinical excellence. Our group is committed to providing a structured program of teaching and mentoring to ensure future research in this area.

team members

  • Leah Brooke - RESEARCH ASSOCIATE
  • Kate Brownlee - Research Assistant
  • George Chalkiadis - RESEARCH ASSOCIATE
  • Rob Eyres - RESEARCH AFFILIATE
  • Geoff Frawley - RESEARCH ASSOCIATE
  • Kaya Gardiner - REGISTERED NURSE
  • Margaret Gibson - Registered Nurse
  • Penelope Hartmann - Research Assistant
  • Bec Heylen - Registered Nurse
  • Alison Lam - Data Entry Assistant
  • Tiffany Lo - Research Administrator
  • Chai-Yin Lo - Research Administrator
  • Stephanie Malarbi - Data Entry
  • Vicky Manikas - Research Psychologist
  • Jessica Martin - PhD Student
  • Jennifer May - Research Assistant
  • Ian Mckenzie - RESEARCH ASSOCIATE
  • David Orme - Research Assistant
  • Gillian Ormond - Project Officer
  • Jennifer Papoutsis - Research Assistant
  • Thushara Perera - PhD Student (LaTrobe Eng&MathSci)
  • xiuzhi Pham - Data Clerk
  • Chengde Pham - Data Entry
  • Philip Ragg - RESEARCH ASSOCIATE
  • Sarah Rossiter - RESEARCH PSYCHOLOGIST
  • Suzette Sheppard - RESEARCH COORDINATOR
  • Hannah Turner - Trial Coordinator
  • Fatima Vally - Data Entry

publications

  • Davidson A. Translational research: what does it mean?. Anesthesiology 115 (5) : 909 - 911(2011) PubMed
  • Davidson A., McKenzie I. Distress at induction: prevention and consequences. CURRENT OPINION IN ANESTHESIOLOGY 24 (3) : 301 - 306(2011) PubMed
  • Davidson AJ. Anesthesia and neurotoxicity to the developing brain: the clinical relevance. PEDIATRIC ANESTHESIA 21 (7) : 716 - 721(2011) PubMed
  • Davidson AJ., Smith KR., van Oud-Alblas HJB., Lopez U., Malviya S., Bannister CF., Galinkin JL., Habre W., Ironfield C., Voepel-Lewis T., Weber F. Awareness in children: a secondary analysis of five cohort studies. ANAESTHESIA 66 (6) : 446 - 454(2011) PubMed
  • Disma N., Frawley G., Mameli L., Pistorio A., Alberighi ODC., Montobbio G., Tuo P. Effect of epidural clonidine on minimum local anesthetic concentration (ED50) of levobupivacaine for caudal block in children. PEDIATRIC ANESTHESIA 21 (2) : 128 - 135(2011) PubMed
  • Howard K., Roberts G., Lim J., Lee KJ., Barre N., Treyvaud K., Cheong J., Hunt RW., Inder TE., Doyle LW., Anderson PJ. Biological and Environmental Factors as Predictors of Language Skills in Very Preterm Children at 5 Years of Age. JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS 32 (3) : 239 - 249(2011) PubMed
  • Malarbi S., Stargatt R., Howard K., Davidson A. Characterizing the behavior of children emerging with delirium from general anesthesia. PEDIATRIC ANESTHESIA 21 (9) : 942 - 950(2011) PubMed
  • Palmer GM., Luk VHY., Smith KR., Prentice EK. Audit of initial use of the ultrasound-guided transversus abdominis plane block in children. ANAESTHESIA AND INTENSIVE CARE 39 (2) : 279 - 286(2011) PubMed
  • Sanders RD., Pandharipande PP., Davidson AJ., Ma DQ., Maze M. Anticipating and managing postoperative delirium and cognitive decline in adults. BRITISH MEDICAL JOURNAL 343 (2011) PubMed
  • Stewart DW., Ragg PG., Sheppard S., Chalkiadis GA. The severity and duration of postoperative pain and analgesia requirements in children after tonsillectomy, orchidopexy, or inguinal hernia repair. PEDIATRIC ANESTHESIA (2011) PubMed

competitive funding

National Health & Medical Research Council
Australian and New Zealand College of Anaesthetists (ANZCA)
Foundation for Children
Canadian Institute of Health Research

collaborations & affiliations

Children's Hospital Boston, USA
Royal Hospital for Sick Children Glasgow Scotland
Gaslini Children's Hospital Genoa Italy
Montreal Children's Hospital, Montreal, Quebec
University Medical Centre Utrecht, Utrecht , The Netherlands