Trial Review

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Trial registered on ANZCTR


Registration number
ACTRN12620001210965
Ethics application status
Approved
Date submitted
7/09/2020
Date registered
13/11/2020
Date last updated
13/11/2020
Date data sharing statement initially provided
13/11/2020
Type of registration
Prospectively registered

Titles & IDs
Public title
“A survey on the perioperative analgesic practice among thoracic anesthesiologists in Australia and New Zealand”
Scientific title
“A survey on the perioperative analgesic practice among thoracic anesthesiologists in Australia and New Zealand”
Secondary ID [1] 301148 0
None
Universal Trial Number (UTN)
U1111-1251-1005
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
thoracic surgery 317263 0
analgesia 317264 0
anesthesia 317265 0
Condition category
Condition code
Anaesthesiology 315395 315395 0 0
Pain management
Surgery 317304 317304 0 0
Other surgery

Intervention/exposure
Study type
Observational
Patient registry
False
Target follow-up duration
Target follow-up type
Description of intervention(s) / exposure
an online survey among anesthesiologists with a special interest in thoracic surgery currently practising in Australia and New Zealand, to understand the current trends in analgesia management for patients undergoing thoracic surgery
INFORMATION COLLECTED-
Current principal place of practice, how many years since working as consultant, whether in private or public hospital, what level of hospital and how many cases provided per week/month, whether enhanced recovery after surgery available and who manages post operative pain
Their opinion regarding opioid free anaesthesia
primary method of intraoperative analgesia for various thoracic procedures
most common regional technique use
whether they will change their selected plan ifthere are changes in external factors
how often they use ultrasound for regional techniques
What medications used for intraoperative pain management
Their experience with phrenic nerve block and its effectiveness for shoulder pain in postop period
What medications used for post-operative pain management

METHOD OF ENROLMENT
The Cardiac Thoracic Vascular Perfusion Special Interest Group (CTVP-SIG) of the ANZ College of Anaesthetists have agreed to distribute the study link to all its currently registered members. It is believed that the majority of ANZ anaesthetists who are actively practising thoracic anaesthesia will be members of the SIG and this registry will be the most representative collection of study participants that could be collected. An email describing the aim and methods of the study and an online link to the survey will be then sent to each anaesthetist through the SIG requesting their kind participation in the survey.
DURATION AND FREQUENCY
The members are expected to complete the survey once only and will take a maximum of 10 minutes. A reminder email will be sent after 4 weeks to increase the response rate.
FEEDBACK
There will be no immediate feedback. Once the data collected are statistically analysed the information extracted will be distributed to all the members of the special interest group as email.
Intervention code [1] 317451 0
Not applicable
Comparator / control treatment
No control group
Control group
Uncontrolled

Outcomes
Primary outcome [1] 323640 0
The study has a composite primary outcome

the primary method of intraoperative analgesia for various thoracic procedures [ thoracotomy/Mini thoracotomy, VATS (video-assisted thoracoscopic surgery) major like lobectomies, VATS Minor like biopsies,sub-xiphoid approaches, Lung volume reduction surgery]

most common regional technique use for the above-listed type of surgeries

whether they will change their selected plan if there are changes in any external factors

how often they use ultrasound for regional techniques

What medications used for intraoperative pain management

Their experience with a phrenic nerve block and its effectiveness for shoulder pain in the postop period

All questions asked by using a study-specific online survey
Timepoint [1] 323640 0
Participants will answer all the questions at only one time when they receive the survey link through email
Secondary outcome [1] 382462 0
What medications used for post-operative pain management

the outcome will be assessed using a study-specific online survey.
Timepoint [1] 382462 0
Participants will answer all the questions at only one time when they receive the survey link through email

Eligibility
Key inclusion criteria
All anaesthetists who usually manage perioperative anaesthetic care of patients undergoing various thoracic surgeries in all hospitals performing thoracic surgeries in Australia and New Zealand
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
Anaesthetists who have not practised thoracic anaesthesia in the previous one year

Study design
Purpose
Screening
Duration
Cross-sectional
Selection
Defined population
Timing
Prospective
Statistical methods / analysis
sample size-All anaesthetists who provide perioperative anaesthetic care of patients undergoing thoracic surgeries in Australia and New Zealand and are currently members of The Cardiac Thoracic Vascular Perfusion Special Interest Group. The aim is to involve as many anaesthetists as possible to ensure that the final assessment is as reflective of the current practice as possible.
The result will be analysed in a descriptive manner with the participant characteristics and outcomes reported using counts and percentages.

Recruitment
Recruitment status
Not yet recruiting
Date of first participant enrolment
Anticipated
1/12/2020
Actual
Date of last participant enrolment
Anticipated
30/06/2021
Actual
Date of last data collection
Anticipated
30/06/2021
Actual
Sample size
Target
500
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
Recruitment outside Australia
Country [1] 22516 0
New Zealand
State/province [1] 22516 0

Funding & Sponsors
Funding source category [1] 307213 0
Self funded/Unfunded
Name [1] 307213 0
Country [1] 307213 0
Primary sponsor type
Individual
Name
Shakeel Kunju
Address
Level1, Department of Anaesthesia,
The Prince Charles Hospital
627 Rode Road
Chermside, QLD, 4032
Australia
Country
Australia
Secondary sponsor category [1] 306004 0
Individual
Name [1] 306004 0
Michael Busser
Address [1] 306004 0
Level1, Department of Anaesthesia,
The Prince Charles Hospital
627 Rode Road
Chermside, QLD, 4032
Australia
Country [1] 306004 0
Australia

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 305890 0
Human Research Ethics Committee, The Prince Charles Hospital
Ethics committee address [1] 305890 0
Human Research Ethics Committee
The Prince Charles Hospital,
627 Rode Road, Chermside 4032, QLD
Ethics committee country [1] 305890 0
Australia
Date submitted for ethics approval [1] 305890 0
07/09/2020
Approval date [1] 305890 0
30/09/2020
Ethics approval number [1] 305890 0
Project ID: 60836

Summary
Brief summary
Thoracic surgery induces severe postoperative pain and has depended on thoracic epidural and opioids in the management of pain in the perioperative period. The increasing availability of ultrasonography to identify fascial layers has led to development of several techniques for analgesia of chest wall with promising results(1). Also, recent studies have hypothesized that opioids may result in an increase in cancer metastases(2) resulting in a trend towards avoiding opioids while utilising more regional techniques.

However, it is not clear to what extent the results of these studies have changed daily clinical practice. Literature search shows that studies looking at perioperative practice in thoracic patients were conducted by Cook et al 1997(3) [post-thoracotomy patients, 24 anaesthetists in Australian Hospitals] and Kotemane (4) 2010 (major thoracic surgery, 240 anaesthetists, United Kingdom). The only recent survey available by Shanthanna (5) 2018 looked only at video -assisted thoracoscopic surgery (VATS) procedures among anaesthetists in Canada (response rate only 19%). We have limited information on the current trends in analgesia management for the patients undergoing thoracic surgery in Australia and New Zealand (ANZ)

We hypothesize that despite the emergence of other regional blocks, thoracic epidural would still be the choice of the majority (> 50%) of the anaesthetists for open thoracotomy. The purpose of this cross-sectional survey across thoracic anaesthetists across ANZ is to understand the current practice and preferred mode of analgesia as well as the perception of anaesthetists towards various modalities of pain management of the patients undergoing thoracic surgery. In addition, it would also act as a benchmark for future studies especially with regards to prevalence of opioid-sparing anaesthetic techniques that might become a standard of practice in the future.
References
(1) Chin KJ. Thoracic wall blocks: from paravertebral to retrolaminar to serratus to erector spinae and back again–a review of the evidence. Best Practice & Research Clinical Anaesthesiology. 2019 Apr 5.
(2) Maher DP, Wong W, White PF, McKenna Jr R, Rosner H, Shamloo B, Louy C, Wender R, Yumul R, Zhang V. Association of increased postoperative opioid administration with non-small-cell lung cancer recurrence: a retrospective analysis. British journal of anaesthesia. 2014 Jul 1;113(suppl_1):i88-94
(3) Cook TM, Riley RH. Analgesia following thoracotomy: a survey of Australian practice. Anaesthesia and intensive care. 1996 Oct;24(5):520-4.
(4) Kotemane NC, Gopinath N, Vaja R. Analgesic techniques following thoracic surgery: a survey of United Kingdom practice. European Journal of Anaesthesiology (EJA). 2010 Oct 1;27(10):897-9.
(5) Shanthanna H, Moisuik P, O’Hare T, Srinathan S, Finley C, Paul J, Slinger P. Survey of postoperative regional analgesia for thoracoscopic surgeries in Canada. Journal of cardiothoracic and vascular anesthes
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 101954 0
Dr Shakeel Kunju
Address 101954 0
Level 1 Department of Anaesthesia
The Prince Charles Hospital,
627 Rode Road
Chermside, 4032, QLD
Country 101954 0
Australia
Phone 101954 0
+61 7 31394000
Fax 101954 0
Email 101954 0
[email protected]
Contact person for public queries
Name 101955 0
Dr Shakeel Kunju
Address 101955 0
Level 1 Department of Anaesthesia
The Prince Charles Hospital
627 Rode Road
Chermside, 4032, QLD
Country 101955 0
Australia
Phone 101955 0
+61 7 31394000
Fax 101955 0
Email 101955 0
[email protected]
Contact person for scientific queries
Name 101956 0
Dr Shakeel Kunju
Address 101956 0
Level 1 Department of Anaesthesia
The Prince Charles Hospital,
627 Rode Road
Chermside, 4032, QLD
Country 101956 0
Australia
Phone 101956 0
+61 7 31394000
Fax 101956 0
Email 101956 0
[email protected]

Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
No/undecided IPD sharing reason/comment


What supporting documents are/will be available?




Results publications and other study-related documents

Documents added manually
No documents have been uploaded by study researchers.

Documents added automatically
SourceTitleYear of PublicationDOI
EmbasePerioperative pain management in thoracic surgery: A survey of practices in Australia and New Zealand.2023https://dx.doi.org/10.1177/0310057X231172787
N.B. These documents automatically identified may not have been verified by the study sponsor.