News and events
See all Central Clinical School news at http://www.med.monash.edu.au/cecs/headlines/
Nitrous oxide anaesthetic damages leukocyte DNA
Prof Paul Myles, HOD Department of Anaesthesia & Perioperative Medicine, & colleagues have published research showing that the commonly used anaesthetic gas nitrous oxide "is a potent and predictable human genotoxin. The authors observe that maintenance of anesthesia with 70% nitrous oxide and sevoflurane in patients undergoing colorectal surgery doubles the incidence of DNA damage [as measured in a comet assay]" and "that nitrous oxide-induced genotoxicity [to leukocytes] is associated with postoperative wound infection", quoted from editorial writeup by Kirk Hogan. See journal article abstract. Note: the comet assay is so called because the DNA fragments and disperses in a comet shaped pattern. Image: www.libyanjournalofmedicine.net. Posted 27/05/2013.
New Master of Medicine postgraduate program fully subscribed
The Department of Anaesthesia and Perioperative Medicine has launched a Master in Medicine in particular for the area of perioperative medicine. As the course description says, surgical patients are getting older and sicker. Which makes their care more complex, hence the demand for this course. The first unit starting first semester 2013 is fully subscribed with a wait list. See more detail about the course at www.masters.periopmedicine.org.au. The Department has also been running a Short Course in Perioperative Medicine, which is now in its fifth year, and is also highly successful. See more at www.periopmedicine.org.au. Enquiries to Aushra.Saldukas@monash.edu. For further information about Professor Paul Myles, see web page. Posted 13/03/2013
RELIEF study ranked 'outstanding' by NH&MRC
Professor Paul Myles, HOD for the Department of Anaesthesia & Perioperative Medicine, is CIA on the RELIEF (Restrictive versus Liberal Fluid Therapy in Major. Abdominal Surgery) study which the NHMRC awarded approximately $2.3m for project funding starting in 2013. The project was also ranked an outstanding Category 7 score. It is a large, multicentre, randomised, single blind, trial in 2600 surgical patients.
Major surgery can result in serious complications, some of which lead to permanent disability and early death. All patients undergoing major surgery require intravenous fluids to maintain a healthy circulation, but too much fluid can cause tissue swelling (oedema) and "drown" the vital organs. There are probable benefits of a restrictive IV fluid regimen. This could have major benefits to patients having surgery.
Anaesthetists typically manage perioperative hypotension with extra intravenous (IV) fluids. If persistent or more profound hypotension occurs, an IV vasoconstrictor (typically metaraminol bolus prn) is used. Liberal fluid administration may correct or avoid hypotension but can also increase tissue oedema leading to wound breakdown, pulmonary oedema, sepsis and multiorgan failure. Fluid restriction typically necessitates vasoconstrictor or inotropic support. We don’t know whether a “wet” or “dry” approach to perioperative fluid management improves surgical outcome.
The aim of the RELIEF study is to investigate the effectiveness and safety of a restrictive IV fluid regimen in patients undergoing major abdominal surgery. See NH&MRC Project grants starting 2013 for more detail of the grant funding & investigator team. Photo: Cabrini. Posted 05/11/2012