On this side of the Tasman a specialist anaesthetist is leading a study centred on the life-saving blood clot removing procedure. While on the other side an Australasian-funded, anaesthetist-led trial is underway of a chocolate-based, child-friendly, pain relief tablet.
Both anaesthetists’ work are being highlighted to mark National Anaesthesia Day which this year has the theme Anaesthesia is not sleep. It’s so much deeper to challenge the common public misconception that being anaesthetised is effectively the same as being asleep.
The Australian and New Zealand College of Anaesthetists (ANZCA) – which organises the day to mark the October 16 1846 anniversary of the first time ether anaesthetic was publicly demonstrated in Boston – points out that anaesthetised patients are actually under a carefully monitored state of unconsciousness that is adjusted to meet individual needs.
Auckland City Hospital specialist anaesthetist Dr Doug Campbell is researching the optimum blood pressure for stroke patients undergoing life-saving blood clot retrieval in a study in collaboration with other anaesthetists, radiologists and neurologists in Auckland, Wellington and Christchurch hospitals.
He says it is the first multi-centre trial in the world to look at the impact on blood pressure of the relatively new procedure where the clot is removed through a mesh-like retrieval device inserted through the femoral artery in the groin to the brain. The new procedure has expanded the “golden window” – when doctors can minimise or prevent permanent damage by removing the clots directly from the brain – from six hours to 24 hours following a stroke.
Most clot-removal procedures in New Zealand are performed under a general anaesthetic and maintaining the optimum blood pressure of the patient during surgery is vital to recovery, says Campbell.
He says patients in the study will be monitored for three months after the surgery to gauge recovery and the study hopes to reveal where blood pressure should be maintained during surgery for the best recovery results.
Meanwhile across the Tasman a study, that the Australian and New Zealand College of Anaesthetists (ANZCA) Research Foundation helped fund, is trialling a chocolate-flavoured version of tramadol, common pain medication for moderate to severe pain.
Paediatric anaesthetist and researcher Professor Britta Regli-von Ungern-Sternberg and medicinal product formulation researcher Professor Lee Yong Lim developed the child-friendly pain tablet. It follows an earlier study, recently published by Regli-von Ungern-Sternberg in the journal Anaesthesia, which trialled a chocolate based tablet of the sedative midazolam (which is used to help prepare children before an anaesthetic) and found that it was both effective and children preferred the chocolate tablet.
The tramadol study, now underway at the Perth Children’s Hospital, involves 150 children aged between 3 and 16 years.
The chocolate works to mask the bitterness of the medication. The tablet is taken in chewable form without the need for water, and can also be mixed with hot water to make a liquid chocolate drink.
Professor Regli-von Ungern-Sternberg hopes the outcomes of her study will lead to the manufacture of chocolate-based tramadol tablets for use in paediatric hospital wards and for elderly patients.
“Tramadol is a very strong pain killer that is used after surgery or for chronic or cancer pain. It’s considered very safe but there’s no single, smaller dose formulation for children. This study means we can give children a very accurate dose in a nice tasting way,” she said.
“This really could revolutionise pain management for children. The children really like it and for many of them it is their first contact with the health system.
Hospitals throughout New Zealand were supporting National Anaesthesia Day 2018 with foyer displays and activities aimed at informing patients and their families about anaesthesia.