Anaesthesia and Pain Medicine

Contacts

Prof Britta von Ungern-Sternberg | Consultant Anaesthetist and Chair of Paediatric Anaesthesia 
Britta.Regli-VonUngern@health.wa.gov.au

A/Prof David Sommerfield | Consultant Anaesthetist and Complex Pain Specialist
David.Sommerfield@health.wa.gov.au

A/Prof Neil Hauser | Consultant Anaesthetist
Neil.Hauser@health.wa.gov.au

Lliana Slevin and Aine Sommerfield | Clinical Research Managers
Lliana.Slevin@health.wa.gov.au | Aine.Sommerfield@health.wa.gov.au

The PCH Department of Anaesthesia and Pain Medicine provides the only tertiary paediatric Anaesthesia and Pain Medicine service in Western Australia.

The Anaesthesia and Pain Medicine research team, led by Professor Britta Regli-von Ungern-Sternberg, also leads the most active paediatric anaesthesia research program in Australasia.

The team works within a large interdisciplinary network and is actively involved in several international and collaborative networks.

Locally, it collaborates with multiple departments within PCH (ENT, General surgery, Sleep and Respiratory Medicine, Neonates, Pharmacy), The University of Western Australia, Telethon Kids Institute, Curtin University and other local non-government agencies in Western Australia.

The team conducts research on all aspects of clinical care, focusing not only on anaesthesia and pain medicine but also on perioperative outcomes and improving the care of our young patients.

In 2019, the team established an Anaesthetic Research Consumer panel, comprising of 14 caregivers/parents to provide insight and invaluable information on their perioperative experience. They are the link between consumers, the community and researchers. The following studies are a brief overview of the team’s work.

Selection of Current Research Projects

Preoperative Risk Stratification

• OSATS:  Investigating alternative ways to predict OSA and perioperative outcomes in children having tonsillectomies
• NIGHTOWL:  Sleep study carried out on the ward to assess patient’s respiratory efforts during the first postoperative night of a tonsillectomy
• ECHIDNA: Investigating the respiratory profiles of babies undergoing hernia repair surgery
• OCTOPUS: Investigating the respiratory profiles of children undergoing cleft palate surgery
• PUFFIN: investigating if peak cough flow is a useful predictor for respiratory adverse events in children undergoing general anaesthesia

Anaesthesia Management

• OPTIMISE-2: LaryngOscoPy for neonaTal and Infant aIrway Management wIth Supplemental oxygEn at different flow rates: a multi-center, non-inferiority, prospective randomized controlled trial
• POSSUM: investigating the impact of patient positioning before and after surgery and the occurrence of perioperative respiratory adverse events
• Aerosols – improved delivery devices
• CRICKET: Critical events in anaesthetised kids undergoing tracheal intubation – a prospective, multi-centre observational study

Physiological Studies

• HAMSTER: A randomised controlled trial to compare High-Flow with Low-Flow as the mode of oxygen delivery, during microlaryngoscopy in infants and children
• OASIS: Effect of different lung recruitment strategies in anaesthetized children on oscillatory mechanics
• COMET: Investigating changes of lung mechanics after gas insufflation during laparoscopic appendectomy procedures
• SAGA: Improving safety for young children with asthma undergoing general anaesthesia
• BUFFALO: Investigating the use of high flow versus low flow oxygen administration in bronchoscopy surgeries
• GIRAFFE: Investigating the use of high flow versus low flow oxygen administration in gastroscopy surgeries

Anaesthesia and the Brain

• TREX: Comparing two anaesthesia management plans (sevoflurane vs low-dose sevoflurane with dexmedetomidine and remifentanil) and assessing neurodevelopmental outcomes
• NIRS EEG: Investigating the incidence of perioperative cerebral desaturation in neonates undergoing selective surgeries
• PEAD: Pre-attentive effectiveness of auditory displays for monitoring vital signs

Pain Medicine

• Bee Pain Free:  Multi-centre, double-blinded, RCT to investigate honey use to reduce pain for children post-tonsillectomy
• GAP:  Gabapentin use to manage post tonsillectomy pain
• CHIMP: Clonidine to help improve the management of pain post-tonsillectomy
• POPSICLE: Multi-site study investigating the prevalence, risk factors, and consequences of chronic pain following common paediatric surgeries
• RAPID: Paediatric chronic pain management – understanding medication efficacy and burden of adverse effects
  

Postoperative Outcomes

• CHEWY:  Randomized trial of chewing gum versus ondansetron to treat postoperative nausea and vomiting in female patients after breast or laparoscopic surgery
• SNAKES:  Trial of jelly snakes to prevent postoperative nausea and vomiting in kids after ENT surgery
• MATES: Melatonin After Tonsillectomy to Enhance Sleep and Recovery in children
• EUROFAST: Multicentre audit of the incidence of pulmonary aspiration with different fasting regimens
• The PREVENT AGITATION trial II: Children ≤1 year