| Title | PI |
|---|---|
| A randomized controlled trial comparing intrathecal morphine with quadratus lumborum block as part of a multimodal analgesia strategy for post-cesarean delivery analgesia Details ClinicalTrials.gov | Dr. Vishal Uppal |
| A novel approach to Optimize Programmed Intermittent Epidural Bolus (PIEB) delivery for labour analgesia Details ClinicalTrials.gov | Dr. Allana Munro |
| Title | PI |
| Title | PI |
|---|---|
| Brain Imaging Study on Biomarkers for Fibromyalgia Details ClinicalTrials.gov | Dr. Javeria Hashmi |
| Investigation of Light Therapy in the Treatment Of Pain Caused By Osteoarthritis Of The Knee: A One-way Crossover Trial Details ClinicalTrials.gov | Dr. Karim Mukhida |
| Brain Imaging Study on Biomarkers for Chronic Back Pain Details ClinicalTrials.gov | Dr. Javeria Hashmi |
| Title | PI |
| Title | PI |
|---|---|
| A New And Innovative Method For CO2 Removal In Anesthesia Circuits: Replacing Chemical Granulate Absorbers Details ClinicalTrials.gov | Dr. Orlando Hung |
| REBOUND: Preventing Rebound Pain after Arthroscopic Shoulder Surgery under General Anesthesia and Interscalene Block: A Two-center Randomized Controlled Trial of Pre-emptive Opioid Treatment Compared to Placebo Details ClinicalTrials.gov | Dr. Vishal Uppal |
| Benzodiazepine-free Cardiac Anesthesia for Reduction of Postoperative Delirium (B-Free) Details ClinicalTrials.gov | Dr. Edmund Tan |
| FIT After Surgery: The Functional Improvement Trajectories After Surgery Study: A Multicentre Prospective Cohort Study to Evaluate the Incidence, Trajectories, Risk Factors, Impact and Healthcare Costs Related to Significant New Disability after Major Elective Surgery Details ClinicalTrials.gov | Dr. David MacDonald |
| Title | PI |
Cesarean delivery (CD) is a major surgical procedure after which there is postoperative pain. Despite standard pain management, severe postoperative pain is experienced by 20% of women in the first 24 hours after CD. There are suggestions that aggressive management of acute pain may reduce the development of chronic postoperative pain.
With increasing CD rates in Canada, we need to focus our efforts not only on improving pain control but also to provide new acceptable options for pain control after CD births. The quadratus lumborum block (QLB) is one of these options. This block may reduce pain and the amount of opioid medications required in women having a CD, and in turn, reduce the side-effects experienced from taking opioid medications. A QLB block uses a needle to inject local anesthetic or “freezing” next to one of the muscles in the back. In this area of the back are nerves that can detect pain and cause pain to be felt in the abdomen region where the incision from a CD is. By putting the freezing in this area, the nerves to your abdomen are frozen at the surgery site. The anesthesiologist uses an ultrasound probe to make sure the needle is positioned correctly between the muscle layers.
This study has been designed to determine if women undergoing CD with spinal anesthesia including the morphine in the spinal medication and routine pain management have equal pain relief and a better quality of recovery than women who don’t have the morphine included in the spinal medication but receive a QLB. Also to see if a combination of these methods would be of benefit.
Analgesia (pain relief) for labour can be provided by an epidural. An epidural involves the injection of medication into the space in your back where nerves are located to reduce sensation. An epidural involves the insertion of a catheter (slim plastic tubing) between the bones of your lower spine and the injection of medication into this space. This tubing provides pain relief throughout your labour by using an Epidural Pump that provides a small amount of medication at regularly timed intervals. This delivery technique is called Programmed Intermittent Epidural Bolus (PIEB). A bolus is a dose of medication that is given over a specific timeframe. The use of this pump is the usual care for labour pain here at the IWK Health Center. This study is a way for the Researcher’s to look more closely at what settings are used on this pump for the best treatment of labour pain.
The Researchers hope to find the best timing for the first bolus of medication that is given after the epidural catheter is placed, the best time interval to deliver the ongoing boluses throughout labour and the best amount of medication that should be delivered as the bolus throughout labour. Overall, the Researchers hope to find the best combination of pump settings to give you the best possible pain control while minimizing side effects.
Drugs used for managing Fibromyalgia pain have not proven to be effective and pain continues to cost Canadians $60 billion a year without truly helping those who suffer. The study proposes to investigate the factors related to a person that can enhance or reduce the effectiveness of pain treatments in people suffering with Fibromyalgia pain. Treatment response to painkillers in a person may be related to their brain, social, and psychological makeup. The investigators aim to study these factors to identify and develop feasible and robust indicators based on a person's biological makeup (also called biomarkers). These biomarkers will allow doctors and researchers to predict more accurately which treatment and prevention strategies for a particular disease will work in which groups of people. These measures will offer new opportunities for improving treatment such as by tailoring treatment to meet the specific needs of each patient based on his/her biological and psychological makeup. Towards the specific aim, data will first be collected in several experimental domains for studying treatment expectations (cognitive, psychosocial, brain-related). These 'experimental' data will be compared between Fibromyalgia (FM) and healthy participants to yield new understanding of the factors that govern treatment response. At the end of experimental data collection, the investigators will collect data in the 'clinical' domain. Hence, at the end of the experimental sessions, a subset of FM participants will receive a mock drug (placebo disguised as an approved pain treatment) and another subset will provide pain ratings only and hence serve as a waiting list control for the placebo trial. Data will be studied in steps to understand factors that mediate treatment outcomes and finally the investigators will use advanced computational tools used for big data analysis and aim to identify factors that can be used as biomarkers and precision medicine tools.
Note: Currently Not Recruiting
Osteoarthritis (OA) is a progressive joint disease that affects 13% of Canadians. Managing joint pain is one of the main goals for treating OA and other musculoskeletal disorders. There is growing interest in the use of non-pharmacological approaches to managing pain. This study is investigating whether the use of visual light therapy can provide pain relief for people living with painful knee OA.
Note: This study is currently recruiting. For more information, please contact: research@nsanesthesia.ca
Drugs used for managing chronic pain have not proven to be effective and chronic pain continues to cost Canadians $60 billion a year without truly helping those who suffer. The study proposes to investigate the factors related to a person that can enhance or reduce the effectiveness of pain treatments in people suffering with chronic pain. Treatment response to pain killers in a person may be related to their brain, genetics, social, and psychological makeup. The investigators aim to study these factors to identify and develop feasible and robust indicators based on a person's biological makeup (also called biomarkers). These biomarkers will allow doctors and researchers to predict more accurately which treatment and prevention strategies for a particular disease will work in which groups of people. These measures will offer new opportunities for improving treatment such as by tailoring treatment to meet the specific needs of each patient based on his/her biological and psychological makeup.
Note: Recruitment Completed for this study
The study is designed to directly compare the memsorb filter device with currently used chemical granulate absorbers used at Nova Scotia Health Authority in elective surgeries.The primary objective of this analysis will demonstrate that memsorb can maintain safe levels of CO2, measured at the end of expiration throughout the duration of anesthesia in patients of varying weight and ventilation requirementsduring different surgical procedures.
CO2 removal is a mandatory part of modern anesthesia systems. Current chemical absorbers pose problems as the chemical granulate reacts not only with the CO2but also the anesthetic drugs, producing organ toxic substances. The proposed CO2filter, memsorb, provides a solution to the problem of organ-toxin production in anesthetic circuits.memsorbcan be easily integrated into any anesthesia circuit, and can effectively remove CO2without reacting with anesthetic drugs, thus eliminating organ-toxic by-products.memsorbuses advanced membrane technology to separate gas flows within the circuit, separating the expensive anesthetic vapors from the CO2(the main by-product of metabolism). Anesthetic vapors thus remain in the closed loop circuit, while CO2is separated and exhausted to the atmosphere, rather than being absorbed through a chemical reaction.
Arthroscopic shoulder rotator cuff repair and acromioplasty are associated with severe postoperative pain. The interscalene block (ISB) is commonly used for this type of surgery, providing analgesia by anesthetizing the nerves that supply the shoulder. Although the nerve block provides extremely effective analgesia for the first 6-8 hours, patients experience severe pain once its effect has regressed. This study will assess whether a single dose of oral hydromorphone controlled release, given to overlap the waning of the ISB, will improve postoperative pain control and reduce the incidence of rebound pain.
Note: Recruitment Completed for this study
Delirium, an acute state of confusion, occurs in approximately 1 in 5 adults after open heart surgery. Even though it is a temporary state, patients who experience delirium are at increased risk of serious problems that last after the delirium has resolved. These problems include decreases in thinking, mobility, self-care, and the ability to live independently in a community setting. Patients who experience delirium have longer stays in hospital, are more likely to be discharged to a nursing home, and are more likely to die. Benzodiazepines are a sedative and amnestic medication that may be associated with delirium. As such, benzodiazepines are rarely used for sedation in the intensive care unit after cardiac surgery. However, benzodiazepines continue to be used frequently in the operating room by anesthesiologists during open heart surgery because of their amnestic effects and limited impact on blood pressure. Nevertheless, practice is divided among cardiac anesthesiologists, with some never using benzodiazepines and others using them for nearly all patients.
Because the best approach (routine benzodiazepines or restricted benzodiazepines) remains uncertain, we will compare the effect of a hospital policy of intraoperative medication use that includes benzodiazepines to a policy that uses alternative medications and no benzodiazepines on the incidence of delirium after open heart surgery. The findings of the study have the potential to improve the outcomes of tens of thousands of patients around the world and will provide the basis for cardiac anesthesiology practice guidelines.
Note: Recruitment Completed for this study
About 190 million adult patients undergo major surgery in economically developed countries every year. In Canada, people older than 65 years are the fastest growing demographic. Therefore, our surgical patients are becoming increasingly older and frailer with increased co-morbidity. With older, sicker people routinely presenting for surgery, a substantial re-evaluation of how patients, clinicians, researchers and administrators determine whether older adults recover optimally after surgery is urgently needed. The current approach in Canada to determining whether older adults recover optimally after surgery involves determining whether an individual died or suffered a major complication in the 30 days after surgery, with patient centered and patient-reported outcomes rarely being collected. This study proposes that freedom from sustained new disability is an ideal global outcome measure to assess the adequacy of intermediate-to-long recovery from surgery in older patients. Despite postoperative disability being an important, patient-centred and feasibly-measured outcome, there are very limited generalizable data on sustained new disability following major surgery. To address this important deficiency in healthcare research, the FIT After Surgery study will evaluate the incidence, trajectories, risk factors, and impact of new sustained disability after major elective surgery in a large generalizable cohort of older Canadians.
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Study Population: |
Older adults aged ≥65 years who are undergoing major elective inpatient non-cardiac surgery |
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Inclusion Criteria: |
1. Age ≥65 years 2. Elective non-cardiac surgery with expected post-surgery stay ≥2 days 3. Working knowledge of English and/or French |
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Exclusion Criteria: |
1. Endovascular surgery 2. Total joint replacement surgery 3. Intra-cranial neurosurgical procedure 4. Surgery with no curative intent 5. Known severe dementia |
Note: Recruitment Completed for this study
For more information on Anesthesia, Pain Management and Perioperative Medicine's research program please contact the Office of Research research@nsanesthesia.ca.