Clinical research studies in the department of anesthesia

These are voluntary research studies for which you may be approached for participation. If you are not interested you can decline involvement when contacted by research assistants, through anesthesia.research@sw.ca or by calling our research office at 416-480-6100 ext. 689607.

CODEX: Cognitive Outcomes after Dexmedetomidine Sedation in Cardiac Surgery Patients

Postoperative cognitive dysfunction (POCD) is thought to affect a significant proportion of patients after all types of surgeries (up to 10% at 3 months) while cardiac surgeries appear to carry the highest risk. This is a condition that can occur after surgery and anesthesia affecting memory and thought processes. While it is widely assumed that cognition returns to baseline after anesthetics have been eliminated, many patients have persistent memory impairment for weeks to months after surgery. There are no proven preventative or treatment strategies that can reduce the incidence. In this research study we investigate whether the addition of Precedex to usual postoperative care reduces the incidence of POCD three months after surgery and enhances early postoperative recovery in those undergoing open cardiac surgery. This drug is used in clinical practice as a sedative and analgesic. The results of this trial will provide an insight on the efficacy of Precedex in reducing the incidence of POCD after anesthesia and may lead to identification of the first POCD preventative therapeutics.

PROMoTE: Redesigning the Surgical Pathway: Optimizing Preoperative Assessment in Anesthesia Clinic for Adult Surgical Patients

Postoperative delirium (POD) is a state of confusion or ‘brain fog’ that commonly occurs in patients after surgery (up to 10-50%). Patients who have pre-existing cognitive impairments are at a higher risk of developing POD. The aim of this study is to identify patients at risk for delirium using cognitive screening and test the effectiveness of a simple no-medication approach for preventing POD.

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

All major operations have some risks of complications. Especially in people older than 65 years, these complications can sometimes mean that a person will have major disability such as difficulty in taking care of themselves and socializing with family and friends for several months after surgery. At present, doctors cannot easily identify which patients are more likely to develop major disability after surgery. The purpose of this study is to measure how often disability occurs after major surgery, and to identify what types of people are more likely to suffer from disability. This research is being done to help improve care for future older patients who are having surgery.

Self-BAT: Does the Self-administered Bleeding Assessment Tool Score Accurately Predict Perioperative Bleeding?

Bleeding assessment tools (BATs) are often used to assess patients’ bleeding history and require a nurse or physician to complete the screen. Recently, a bleeding assessment tool, Self-BAT, was created allowing patients to complete the screen without help. This tool has been used to identify a common bleeding disorder called von Willebrand
Disease. This study aims to determine if scores on the Self-BAT can predict major bleeding disorder during and after surgery.

PLAN: Prevention of Persistent Pain with Lidocaine Infusions in Breast Cancer Surgery

Surgery is a critical part of breast cancer treatment. A common complication after breast cancer surgery is persistent pain that does not go away after the expected time needed to heal from a surgical procedure (e.g. 3 months). While there are no known interventions that prevent persistent pain after breast cancer surgery, there is published research suggesting that an infusion of lidocaine during surgery can prevent the development of persistent pain. The purpose of this study is to determine if giving lidocaine as an infusion during breast cancer surgery will reduce the amount of pain a patient has when recovering from surgery. This will help us to find out if using lidocaine is better than the current way of managing pain after surgery for breast cancer.

Effect of a Pre-Operative Internet-Based Educational Video, Providing Both Opioid Counselling and Pain Coping Skills, on Post-Operative Opioid Consumption

After hip or knee replacement surgery, most people experience pain, for which they may be given certain medications, including a type of painkiller known as opioids. Taking too many opioids after surgery can be dangerous, slow down recovery and lead to addiction. Also, for many patients these medications will not be enough to completely control their pain. Therefore, it is important to teach patients how to use opioids safely and to find other ways to control pain after surgery. Our study uses an online video which teaches patients both how to safely use opioids and other healthy ways to deal with pain, such as breathing exercises. We are investigating if this video can help to lower pain and the amount of opioids needed after surgery. We will also look at how patients recover after surgery, including any complications and how much time they spend in the hospital. If successful, this video will help patients to better control their pain after hip or knee replacement surgery.

SAVE-ICU: Sedating with Volatile Anesthetics Critically Ill COVID-19 Patients in ICU: Effects on Ventilatory Parameters and Survival

Some critically ill patients, including many patients with COVID-19, require the help of a machine called a mechanical ventilator to help them breath. All patients needing a ventilator also need sedation (or sleep-inducing medications) to keep them calm and comfortable during this process. These medications are usually given through the vein (intravenous or IV), however, when the IV sedatives are stopped after a long period of time, it can take time for the drugs to leave the body, making it harder for patients to wake up, and increasing the chances of complications.

Another way to provide sleep is by using inhaled sedatives, which are breathed in through the breathing tube that is connected to the ventilator. These drugs have several possible benefits for patients which may allow them to recover faster. In this study, we are comparing these two forms of sedation for critically ill patients in the ICU who require mechanical ventilation.