During a visit for day-case surgery, we may approach patients and their families with an opportunity to participate in one of our studies. Click on the study title below for more information.
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- Intra-nasal Dexmedetomidine for children undergoing MRI imaging
Principal Investigator: Dr. Mark Ansermino
Short Title: Dexmed MRI
Many children undergo general anesthesia for many types of procedures, including MRI, at BCCH each year. It is the aim of every anesthesiologist to make sure that their patient is as comfortable and calm as possible and we use a variety of techniques and medications to achieve this goal.
One particular medicine, called dexmedetomidine, is a useful medication that helps with sedation and recovery. Specifically, it provides sedation without affecting breathing and reduces agitation during waking up. It also reduces shivering, which can happen after some anesthetics.
Recent studies have shown successful sedation and completion of MRI scans in children of varying age groups using intranasal Dexmedetomidine (IN-dex). However, we do not yet know the optimal dose of IN-dex for older age groups and for children who need a mild to moderate sedation.
We wish to examine whether dexmedetomidine, delivered as a nasal spray, can be used as the sole agent in aiding the successful completion of a MRI scan in children. We also plan to find the optimal dose of IN-dex as the sole agent that provides sedation to help facilitate completion of MRI scans.
We are currently recruiting 180 participants.
- Anesthetic sparing effect of dexmedetomidine during TIVA with propofol and remifentanil for children undergoing dental procedures
Principal Investigator: Dr. Simon Whyte
Short title: Dexmed-PRS
Many children undergo general anesthesia for different procedures every year at BCCH. During and after these procedures, the anesthesiologists use a variety of techniques and medications to ensure that their patient is as calm and comfortable as possible. Dexmedetomidine, a regularly utilized anesthetic, is especially useful and helps with many aspects of recovery. Specifically, it provides pain relief while reducing agitation during waking up. It also reduces shivering, which can happen after some anesthetics. It also reduces the use of medication with agents in the morphine family (opioids), which are associated with side-effects like excessive sedation, nausea and vomiting, and decreased breathing.
From clinical experience, using dexmedetomidine also seems to decrease the amount of other anesthetics needed during surgery. However, this has not yet been formally measured.
We wish to examine whether dexmedetomidine allows for a reduction in the amount of other medications required during a procedure. We also hope to quantify this reduction if found.
We are currently recruiting 88 patients for this study.
- Genetic differences in pharmacodynamic safety endpoints with propofol anesthesia in children
Principal Investigator: Dr. Simon Whyte
Short title: Genes2ED50
Sedation and anesthesia are important parts of care for children undergoing surgery or other procedures or investigations that are painful, uncomfortable, or that require them to lie still for a long time.
Propofol is a drug that is widely used, in this hospital and elsewhere, for sedation and general anesthesia. Propofol has to be given in carefully measured doses as there is only a small difference in the amount required to make somebody unconscious and the amount that will make them stop breathing. There is also a lot of difference between patients in the amount of this drug that is needed to get to these ‘pharmacodynamic endpoints’.
In the past, anesthesiologists have always been the ones to sedate and anesthetize children. But increasing demand means that sedation is now sometimes given by non-anesthesia doctors. Given that different patients need different amounts of propofol to lose consciousness and to stop breathing, its use by a non-anesthesia doctor could cause problems if even a little too much propofol is given to a particular patient.
There are many different reasons why people need different amounts of propofol, but researchers have found that adults with different genetic ancestry can require very different amounts of propofol to lose consciousness or stop breathing. This idea has not been properly studied in children.
The purpose of this study is to investigate the doses of propofol needed to make children (a) become unconscious and (b) stop breathing. Both of these points are normal and desired occurrences when an anesthesiologist is preparing a patient for a procedure.
We also aim to identify genetic differences that will help us to understand why some children need more propofol and some need less. Self reported ancestry will be compared to genomic ancestry to see if this will be a useful measure for physicians planning their care.
We are currently recruiting 360 patients for this study.
- Perioperative multimodal analgesia including intravenous lidocaine infusion for pain management following idiopathic scoliosis correction surgery in children
Principal Investigator: Dr. Gillian Lauder
Short title: P-IVLT
Many adolescents undergo corrective procedures for scoliosis at BCCH each year. It is the aim of every anesthesiologist to make sure that their patient is as comfortable and calm as possible after the surgery and we use a variety of techniques and medications to achieve this goal.
Multimodal analgesia is the name given to the combination of these techniques and medications for pain management. One medication often given as part of this multimodal therapy is opioids (morphine like drugs) that help control pain. Opioids have a number of side effects that get worse as higher doses are used. Reducing the amount of opioids needed by using alternate medications (with fewer side effects) and other non-drug techniques is preferred.
One alternative medication of interest is lidocaine, a common local anesthetic used in many procedures including dental work. Lidocaine can be given as an intravenous (IV) infusion and is useful for its analgesic (decreases pain), anti-inflammatory (decreases inflammation), and anti-hyperalgesic (decreases sensitivity to pain) properties. Some studies have shown that, when compared to placebo (an inactive substance used for comparison), lidocaine given as an infusion along with other medications can reduce the amount of pain that patients experience while recovering from their surgeries.
The purpose of this study is to determine if an IV infusion of lidocaine, started during surgery and continued for 48 hours, will reduce the amount of morphine needed after surgery. We also hope to determine if this improves the ability for scoliosis patients to get moving sooner in recovery.
We are currently recruiting 48 patients for this study.
- Studies which are actively recruiting participants and/or collecting data
Study PI Study Type Acute Pain Service Audit Dr. Ridgway Process/Quality Improvement Bronchial Blocker in a pulmonary hemorrhage simulation Dr. Purdy Simulation study of a new device Cricoid Pressure Survey Drs. Malherbe & Badenhorst Survey of Canadian anesthesia clinical practice Cranioacial Surgery Database Dr. Nigel Barker Registry for quality improvement Difficult Airway Response Team Dr. Peters Process improvement Intranasal Dexmedetomidine for MRI scans Dr. Ansermino Drug efficacy and dose finding Anesthetic Sparing Effects of Dexmedetomidine Dr. Whyte Randomized control trial Diabetes Management During Surgery Drs. Whyte & Polderman Audit Genetic Ancestry and Anesthetic Sensitivity Dr. Whyte Pharmacogenomic High Frequency Jet Ventilation in TEF Repair Dr. Traynor Process improvement Negative Pressure Airway Chamber Dr. Purdy Device validation Programmed Intermittent Epidural Bolus Dr. Burns Drug safety and efficacy Perioperative IV Lidocaine Therapy in Scoliosis Repair Dr. Lauder Randomized control trial Post-operative Follow Up Dr. Froese Process improvement
Recently Completed Studies
- Studies that have recently completed their recruitment and data collection, and are undergoing analysis and manuscript preparation
Study PI Study Type Adolescent Scoliosis Pain Management Drs. Brown & Lin Audit Blood Pressure Nomograms Dr. Görges Data Analysis A Novel Bronchial Blocker Dr. Purdy Device simulation testing Anesthesia for Inguinal Hernia Repair in Neonates and Infants Drs. Malherbe & Krishnan Audit Effects of Dexmeditomidine on Recovery Room and Hospital Discharge Dr. Malherbe Audit Efficacy of Epidurals on the Acute Pain Service Dr. Ridgway Audit Efficacy of IV Induction at BC Children's Hospital Dr. Reimer Prospective Audit Pharmacokinetics of oral morphine and pharmacogenomics of CYP2D6 and UGT2B7 Drs. Whyte & Carleton Pharmacogenomics Bundling of Neonates and Infants for MRI Dr. Scheepers Audit Non-invasive Microcirculation Monitoring using NIRS during Scoliosis Correction Dr. Brown Observational Effectiveness of Pain Ease Spray Combined with Topical Anesthetic to Reduce Discomfort for IV Insertion Drs. Malherbe & Scheepers Randomized control trial Blood Transfusions in Scoliosis Correction Surgeries Dr. Brown Audit