OAA Project Grant
The successful applicants for the OAA Project Grant were:
Principal Applicant
Dr N Beale
Consultant Anaesthetist, Nuffield Department of Anaesthesia, John Radcliffe Hospital, Headley Way, Oxford
Title
To evaluate the incidence and contributing factors of chronic pain one year after elective caesarean section
Amount
£50,140
Abstract
Chronic pain is a worldwide problem affecting 20% of the adult population, costing 200 billion Euros per annum. It has a major impact on quality of life, as many of the drugs used in its treatment are ineffective. Postoperative pain persisting for many months after surgery is an increasingly recognised source of chronic pain. Nearly a quarter of women currently give birth by caesarean section which is now one of the most frequently performed operations in the UK. It has been estimated that at least 15% of women experience pain for at least one year after caesarean section and, given the large number of women undergoing surgery, this represents a significant problem. A number of mechanisms for the development of chronic pain are likely and include patient factors, anaesthetic technique, the surgical procedure and post-operative analgesic management. This longitudinal prospective study aims to identify the incidence of persisting pain, still requiring analgesia, one year after surgery, in women undergoing elective caesarean section. We shall collect data on all aspects of the patient and their treatment to investigate which factors are predictive of chronic pain.
First Year Progress Report from Dr N Beale (44 KB)
Second Year Progress Report for Dr N Beale (38 KB)
Principal Applicant
Professor P Hopkins
Professor of Anaesthesia and Honorary Consultant Anaesthetist, Academic Unit of Anaesthesia, Clinical Sciences Building, St James's University Hospital, University of Leeds
Title
Comparison of the ED95 dose of 0.075% and 0.1% bupivacaine for labour analgesia in primigravida
Amount
£4,334
Abstract
Local anaesthetics are highly toxic drugs. The risk of toxicity when performing regional anaesthesia is reduced by injecting the optimal amount of local anaesthetic in the correct site. Until now the methodology commonly used in dose-finding studies in anaesthesia is up and down method of Dixon and colleagues which provides an indication of the ED50 (dose which will be effective in 50% patients). However, the ED50 has little clinical utility whereas the ED95 dose would provide a much better guide to the optimal dose for routine clinical practice. The estimates of the ED95 dose from the up and down method are erroneous and can be completely misleading. The Continual Reassessment Method (CRM) allows calculation of the ED95 dose directly and has been successfully used to find out either the ED95 or maximum tolerated dose for newer drugs. The methodology has other potential advantages such as the relatively small number of patients required, no placebo group is necessary and the dose allocated to each patient is supposedly close to the optimal dose. The aim of this randomised, double blind trial is to test the null hypothesis that the two concentrations have no effect on the dose required for labour epidural analgesia.
