AAGBI/Anaesthesia Departmental Project Grant
The successful applicants for the AAGBI/Anaesthesia Departmental Project Grant were:
Principle Applicant
Professor Donal Buggy
Associate Professor of Anaesthesia, School of Medicine & Medical science, University College Dublin; Consultant in Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland.
Title of Project
The role of NET-1 gene in breast adenocarcinoma cell function, the direct effects of anaesthetic and analgesic drugs on NET1 expression, and the effect of serum from breast cancer patients receiving different anaesthetic techniques on NET1 expression in breast adenocarcinoma cells in vitro
Amount
£25,000
Abstract
The main cause of morbidity and mortality in breast cancer is metastatic disease. Experimental evidence from live animal studies and retrospective clinical data suggests that anaesthetic technique during primary cancer surgery might influence cancer recurrence or metastases. A novel guanine nucleotide exchange factor, NET1, has been identified as a driver of tumour cell proliferation and invasion. Therefore, this project aims to investigate the role of the NET1 gene in breast cancer cellular functions essential to their ability to metastasize, namely, proliferation, migration, invasion and angiogenesis; to evaluate whether the anaesthetic and analgesic agents influence the expression of NET1 and hence breast cancer cell function; and to study the effect of serum collected from patients receiving two distinct anaesthetic techniques on the expression of NET1. Established in vitro assays will be used on oestrogen receptor (ER) positive and ER negative cell lines, with stored serum from patients who received the distinct anaesthetic techniques as appropriate.
NIAA Poster Presentation from Prof D Buggy (364 KB)
Final Report from Prof D Buggy (44 KB)
Principle Applicant
Professor P Hopkins
Professor of Anaesthesia & Honorary Consultant Anaesthetist, Section of Translational Anaesthetic & Surgical Sciences, Leeds Institute of Molecular Medicine, University of Leeds
Title of Project
What is the ED95 dose of bupivacaine 0.5% for ultrasound-guided supraclavicular brachial plexus block?
Amount
£3,000
Abstract
With the availability of ultrasound, the supraclavicular brachial plexus block has become very popular as an anaesthetic for upper-limb surgery but the optimum dose of local anaesthetic for this technique has not been determined. Underestimating the dose can lead to an ineffective block while excessive doses increase the risk of systemic local anaesthetic toxicity. Current evidence only provides a guide as to the ED50 (50% chance of the block working effectively) but no credible evidence has looked at the more useful ED95 value (95% chance of success). We propose a double blind dose finding trial using Continual Reassessment Methodology (already used in oncology drug trials) to estimate the ED95 dose. By finding the ED95 dose we may be able to reduce the dose administered to patients. Any reduction in dose, without loss of efficacy, reduces the risk of toxicity and improves the safety margin of these techniques.
First Year Progress Report from Prof P Hopkins (66 KB)
Final Report from Prof P Hopkins (58 KB)
Principle Applicant
Dr R Sanders
Academic Clinical Fellow, Department of Anaesthetics, Intensive Care and Pain Medicine, Imperial College London
Title of Project
Perioperative Outcome Following Preoperative Stroke: Probing the Hospital Episode Statistics Database
Amount
£11,062
Abstract
Stroke affects 5 per 1000 people in England and Wales, yet despite the prevalence of this disabling condition little is known about the risk imposed by preoperative stroke in the perioperative period. While some preliminary data from cardiac surgery suggest that preoperative stroke increases perioperative risk, data for non-cardiac surgery are not forthcoming. Patients with stroke are known to have increased risk of perioperative cardiovascular morbidity but an independent association with mortality in the setting of non-cardiac surgery has not been established. Furthermore, any association between the timing of stroke preoperatively and perioperative outcomes has not been investigated. We will use hospital episode statistics to probe an independent association of stroke on perioperative mortality and to understand whether any association is influenced by the timing of stroke. These data will be used to enhance perioperative risk stratification and to apply for funding for a larger prospective study of these patients.
Progress Report from Dr R Sanders (61 KB)
Final Report from Dr R Sanders (58 KB)
