Royal Perth Hospital - Department of Anaesthesia & Pain Medicine

Royal Perth Hospital is now placing greater emphasis on research by all departments.
The Department of Anaesthesia and Pain Medicine, under the leadership of Dr Leigh Coombs and Professors Teik Oh and Stephan Schug from the University Department, has made a commitment to greatly expand academically.

Since 1999, Professor Teik Oh has held the inaugural Chair of Anaesthesia in Perth, through the Department of Pharmacology, the University of Western Australia. Professor Stephan Schug was appointed Clinical Professor of Anaesthesia and Director of Pain Management in 2001. A pharmacology laboratory has been established. Clinical Associate Professor Michael Paech, a Visiting Specialist, is Director of Research.

Since 2001 there have been two half-time Senior Lecturer positions with the University of WA. These positions offer an ideal opportunity to teach, conduct research and to publish in addition to a clinical commitment.

Current Areas of Investigation

"The B-Aware Trial"

Avoiding awareness during anaesthesia: a randomised controlled trial of the clinical effectiveness of BIS monitoring.
Myles P, Leslie K, McNeil J. RPH Investigators McLoughlin P, Paech M.

This multinational, multicentre trial co-ordinated from Melbourne has been very important in establishing a close collaboration with a very productive and innovate group of investigators. Several exciting collaborative proposals have been developed and are pending research grant applications.

Melatonin and postoperative sleep disturbance

Does the administration of melatonin to patients after cardiopulmonary bypass influence postoperative sleep disturbances?
C. Cokis, Strang T, Chen D, Oh T, Gelavis A.

This double-blind placebo controlled trial has randomised 83 of 120 patients.

Postoperative analgesia

A comparison of intraperitoneal ropivacaine and pethidine, alone or in combination, for postoperative analgesia after abdominal laparoscopic surgery
Imison A, Paech M, Oh T

This multicentre double-blind placebo controlled trial is investigating the efficacy and pharmacokinetics of intraperitoneal pethidine and ropivacaine. Assays are performed by Department of Clinical Pharmacology, UWA and 32 of 220 patients have been randomised.

Bowel recovery after colorectal surgery: a comparison of patient controlled analgesia with tramadol versus morphine.
Schug S, Thornton M, Paech M.

This double-blind parallel group trial compares the recovery of bowel function associated with either PCA tramadol or morphine. Seven patients (of 72, interim analysis 36) have been randomised.

A double-blind, randomized, double-dummy, comparative, parallel group study evaluating the efficacy and safety of Oxycontin tablets 20 mg Q12h to immediate-release oxycodone tablets 10 mg Q6h after outpatient surgery.
Paech M, Schug S.

This Mundipharma sponsored trial has just commenced.

The effect of NMDA anatagonists ketamine and magnesium on postoperative morphine requirement after intraoperative remifentanil.
Gharbi R, Paech M, Oh T.

This double-blind parallel group trial is designed to investigate the issue of acute tolerance to perioperative opioid and has just commenced.

Hypotension after spinal anaesthesia

A comparison of isobaric bupivacaine, with and without fentanyl, for spinal anaesthesia for fractured neck of femur.
Martyr J, Stannard K

This double-blind parallel group trial is investigating the influence of spinal solution on hypotension in elderly patients. Seven patients have been recruited since April 2002.

Airway management

Randomised evaluation of a disposable and a re-usable laryngeal mask airway.
Paech MJ, Garrett W, Gillespie G, Lain J.

This open, randomised trial is one of 3 trials internationally to first evaluate the clinical performance of a new disposable laryngeal mask. Almost 80 of 200 patients have been recruited and completion is anticipated in late 2002.

Postoperative nausea and vomiting

A study to compare the effect of anaesthetic techniques on postoperative nausea and vomiting (PONV) after breast surgery
Gharbi R, Vanden Driesen N, Willsher P, Oh T.

This randomised trial investigates 3 anaesthetic techniques for breast surgery.

Double-blind, double-dummy, randomised parallel-arm equivalence study comparing hydromorphone extended-release capsules to MS Contin tablets, dosed at a ratio of 1:7.5, in cancer or non-cancer patients with a history of moderate to severe pain.
Perlman D.

This Mundipharma study is to commence shortly.

Collaborative Research

A study of the use of BIS monitoring in the emergency department for conscious sedation, unconscious patients and toxicology.
Fatovich D, Daly F, Paech M.

Proposed Future Research

Serious complications of epidural catheterisation: a prospective cohort study.
Gibson P, Paech M, Elliott D, Leslie K

Funding is being sought for project to commence in 2003 and beyond. This large multicentre audit is designed to determine the incidence of various serious complications in an Australasian population and proposes on-line data submission into a central database held at Westmead Hospital in Sydney.

The "Enigma" study.
Myles P, Leslie K, Paech M et al.

Funding is being sought for this large simple randomised trial (sample size 2,000). It is designed to compare the effect of nitrous oxide and oxygen with nitrogen and oxygen intraoperatively on a number of postoperative outcomes, the primary outcome being length of hospital stay.

The "Poise" study
Leslie K, Myles P, Paech M et al.

This large international multicentre study (sample size 10,000) is designed to compare metoprolol and placebo in patients undergoing non-cardiac surgery at moderate to high risk of a perioperative cardiac event. It has attracted Canadian funding and NHMRC funding is being sought locally.