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Sommerfield A, Sommerfield D, Bell E, Humphreys S, Taverner F, Lee K, Frank B, von Ungern-Sternberg BS. Consumer research priorities for pediatric anesthesia and perioperative medicine. Paediatr Anaesth 2023; 33:144-153. [PMID: 36178177 PMCID: PMC10092273 DOI: 10.1111/pan.14564] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/06/2022] [Accepted: 09/25/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Consumer-driven research is increasingly being prioritized. AIM Our aim was to partner with consumers to identify the top 10 research priorities for pediatric anesthesia and perioperative medicine. The ACORN (Anesthesia Consumer Research Network) was formed to collaborate with children and families across Australia. METHODS A prospective online survey was developed to generate research ideas from consumers. The survey was developed in Qualtrics, a survey research platform. Consumers were invited to participate through poster advertising, social media posts, via consumer networks at participating hospitals and in addition 35 national consumer/patient representative organizations were approached. We also conducted a similar idea generating survey for clinicians through email invitation and via Twitter. A second round of surveys was conducted to prioritize the long list of research questions and a shortlist of priorities developed. A single consensus meeting was held, and a final consensus list of top 10 priorities emerged. RESULTS A total of 281 research ideas were submitted between 356 consumers in the idea generating survey and from four consumer/patient representative groups. Seventy-five clinicians responded to the clinician idea generation survey. This was consolidated into 20 research ideas/themes for the second survey for each group. 566 responses were received to the consumer prioritization top 10 survey and 525 responses to the clinician survey. The consensus meeting produced the final 10 consumer research priorities. CONCLUSION This study has given Australian consumers the opportunity to shape the anesthesia and perioperative medicine research agenda for pediatric patients both nationally and internationally.
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Affiliation(s)
- Aine Sommerfield
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Western Australia, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - David Sommerfield
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Western Australia, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Western Australia, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Emily Bell
- Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Susan Humphreys
- Department of Anaesthesia, Queensland Children's Hospital, South Brisbane, Queensland, Australia.,Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - Fiona Taverner
- Department of Paediatric Anaesthesia, Women's and Children's Hospital, North Adelaide, South Australia, Australia.,University of Adelaide, Adelaide, South Australia, Australia
| | - Kenneth Lee
- Discipline of Pharmacy, School of Allied Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Belinda Frank
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Britta Sylvia von Ungern-Sternberg
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Western Australia, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Western Australia, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, Western Australia, Australia
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Humphreys S, von Ungern-Sternberg BS, Skowno J, Williams T, Taylor J, Taverner F, Gibbons K, Burgoyne L, Sommerfield D, Stephens P, Hallett B, Vijayasekaran S, Slee N, Burns H, Sowa M, Davidson A, Schibler A. High-flow oxygen for children's airway surgery: rando mi sed controll ed trial protocol (HAMSTER). BMJ Open 2019; 9:e031873. [PMID: 31615801 PMCID: PMC6797255 DOI: 10.1136/bmjopen-2019-031873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Hypoxaemia during anaesthesia for tubeless upper airway surgery in children with abnormal airways is common due to the complexity of balancing adequate depth of anaesthesia with maintenance of spontaneous breathing and providing an uninterrupted field of view of the upper airway for the surgeon. High-flow nasal oxygenation (HIGH-FLOW) can prolong safe apnoea time and be used in children with abnormal airways but to date has not been compared with the alternative technique of low-flow nasal oxygenation (LOW-FLOW). The aim is to investigate if use of HIGH-FLOW can reduce the number of hypoxaemic events requiring rescue oxygenation compared with LOW-FLOW. METHODS AND ANALYSIS: High-flow oxygen for children's airway surgery: randomised controlled trial (HAMSTER) is a multicentre, unmasked, randomised controlled, parallel group, superiority trial comparing two oxygenation techniques during anaesthesia. Children (n=530) aged >37 weeks to 16 years presenting for elective tubeless upper airway surgery who fulfil inclusion but not exclusion criteria will be randomised prior to surgery to HIGH-FLOW or LOW-FLOW post induction of anaesthesia. Maintenance of anaesthesia with HIGH-FLOW requires Total IntraVenous Anaesthesia (TIVA) and with LOW-FLOW, either inhalational or TIVA at discretion of anaesthetist. The primary outcome is the incidence of hypoxaemic events requiring interruption of procedure for rescue oxygenation by positive pressure ventilation and the secondary outcome includes total hypoxaemia time, adverse cardiorespiratory events and unexpected paediatric intensive care admission admission. Hypoxaemia is defined as Sp02 <90%. Analysis will be conducted on an intention-to-treat basis. ETHICS AND DISSEMINATION Ethical approval has been obtained by Children's Health Queensland Human Research Ethics Committee (HREC/18/QRCH/130). The trial commenced recruitment in 2018. The primary manuscript will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER The HAMSTER is registered with the Australia and New Zealand Clinical TrialsRegistry: ACTRN12618000949280.
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Affiliation(s)
- Susan Humphreys
- Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Department of Anaesthesia, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Britta Sylvia von Ungern-Sternberg
- Anaesthesia, Perth Children's Hospital, Nedlands, Queensland, Australia
- University of Western Australia, Crawley, Western Australia, Australia
| | - Justin Skowno
- Department of Anaesthesia, Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Tara Williams
- Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Julia Taylor
- Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Department of Anaesthesia, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Fiona Taverner
- Department of Anaesthesia, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
- University of South Australia, Adelaide, South Australia, Australia
| | - Kristen Gibbons
- Statistics, Mater Medical Research Institute, South Brisbane, Queensland, Australia
| | - Laura Burgoyne
- Department of Anaesthesia, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
- University of South Australia, Adelaide, South Australia, Australia
| | - David Sommerfield
- Anaesthesia, Perth Children's Hospital, Nedlands, Queensland, Australia
- University of Western Australia, Crawley, Western Australia, Australia
| | - Philip Stephens
- Department of Anaesthesia, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Ben Hallett
- Department of Anaesthesia, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Shyan Vijayasekaran
- University of Western Australia, Crawley, Western Australia, Australia
- Ear, Nose and Throat Surgery, Perth Children's Hospital, Nedlands, Queensland, Australia
| | - Nicola Slee
- Department of Surgery; Ear, Nose and Throat, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Hannah Burns
- Department of Surgery; Ear, Nose and Throat, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Marcin Sowa
- Health Economics, The University of Queensland, South Brisbane, Queensland, Australia
| | - Andrew Davidson
- Department of Anaesthesia, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Andreas Schibler
- Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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Darvall J, von Ungern-Sternberg BS, Braat S, Story D, Davidson A, Allen M, Tran-Duy A, Middleton D, Leslie K. Chewing gum to treat postoperative nausea and emesis in female patients (CHEWY): rationale and design for a multicentre randomised trial. BMJ Open 2019; 9:e027505. [PMID: 31196899 PMCID: PMC6575709 DOI: 10.1136/bmjopen-2018-027505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Postoperative nausea, retching and vomiting (PONV) remains one of the most common side effects of general anaesthesia, contributing significantly to patient dissatisfaction, cost and complications. Chewing gum has potential as a novel, drug-free alternative treatment. We aim to conduct a large, definitive randomised controlled trial of the efficacy and safety of peppermint-flavoured chewing gum to treat PONV in the postanaesthesia care unit (PACU). If chewing gum is shown to be as effective as ondansetron, this trial has the potential to significantly improve outcomes for tens of millions of surgical patients around the world each year. METHODS AND ANALYSIS This is a prospective, multicentre, randomised controlled non-inferiority trial. 272 female patients aged ≥12 years having volatile anaesthetic-based general anaesthesia for breast or laparoscopic surgery will be randomised. Patients experiencing nausea, retching or vomiting in PACU will be randomised to 15 min of chewing gum or 4 mg intravenous ondansetron. The primary outcome (complete response) is cessation of PONV within 2 hours of administration, with no recurrence nor rescue medication requirement for 2 hours after administration. ETHICS AND DISSEMINATION The Chewy Trial has been approved by the Human Research Ethics Committees at all sites. Dissemination will be via international and national anaesthesia conferences, and publication in the peer-reviewed literature. TRIAL REGISTRATION NUMBER ACTRN12618000429257; Pre-results.
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Affiliation(s)
- Jai Darvall
- Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Centre for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Britta Sylvia von Ungern-Sternberg
- Department of Anaesthesia and Pain Management, Perth Children’s Hospital, Perth, Western Australia, Australia
- Anaesthesia Unit, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Sabine Braat
- Centre for Epidemiology and Biostatistics and Melbourne Clinical and Translational Science Platform, University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - David Story
- Centre for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Davidson
- Department of Anaesthesia, Royal Children’s Hospital Melbourne, Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Megan Allen
- Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Centre for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - An Tran-Duy
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Dana Middleton
- Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Kate Leslie
- Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Centre for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australia
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