ANZCTR - Registration

Please note the ANZCTR will be unattended from Friday 20 December 2024 for the holidays. The Registry will re-open on Tuesday 7 January 2025. Submissions and updates will not be processed during that time.

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To achieve prospective registration, we recommend submitting your trial for registration at the same time as ethics submission.

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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]

None

Universal Trial Number (UTN)

U1111-1251-1005

Trial acronym

Linked study record

Health condition

Health condition(s) or problem(s) studied:

thoracic surgery

analgesia

anesthesia

Condition category

Condition code

Anaesthesiology

Pain management

Surgery

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]

Not applicable

Comparator / control treatment

No control group

Control group

Uncontrolled

Outcomes

Primary outcome [1]

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]

Participants will answer all the questions at only one time when they receive the survey link through email

Secondary outcome [1]

What medications used for post-operative pain management

the outcome will be assessed using a study-specific online survey.

Timepoint [1]

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]

New Zealand

State/province [1]

Funding & Sponsors

Funding source category [1]

Self funded/Unfunded

Name [1]

Address [1]

Country [1]

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]

Individual

Name [1]

Michael Busser

Address [1]

Level1, Department of Anaesthesia,
The Prince Charles Hospital
627 Rode Road
Chermside, QLD, 4032
Australia

Country [1]

Australia

Ethics approval

Ethics application status

Approved

Ethics committee name [1]

Human Research Ethics Committee, The Prince Charles Hospital

Ethics committee address [1]

Human Research Ethics Committee
The Prince Charles Hospital,
627 Rode Road, Chermside 4032, QLD

Ethics committee country [1]

Australia

Date submitted for ethics approval [1]

07/09/2020

Approval date [1]

30/09/2020

Ethics approval number [1]

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

Dr Shakeel Kunju

Address

Level 1 Department of Anaesthesia
The Prince Charles Hospital,
627 Rode Road
Chermside, 4032, QLD

Country

Australia

Phone

+61 7 31394000

Fax

shakeel.kunju@health.qld.gov.au

Contact person for public queries

Name

Shakeel Kunju

Address

Level 1 Department of Anaesthesia
The Prince Charles Hospital
627 Rode Road
Chermside, 4032, QLD

Country

Australia

Phone

+61 7 31394000

Fax

shakeel.kunju@health.qld.gov.au

Contact person for scientific queries

Name

Shakeel Kunju

Address

Level 1 Department of Anaesthesia
The Prince Charles Hospital,
627 Rode Road
Chermside, 4032, QLD

Country

Australia

Phone

+61 7 31394000

Fax

shakeel.kunju@health.qld.gov.au

Data sharing statement

Will individual participant data (IPD) for this trial be available (including data dictionaries)?

No/undecided IPD sharing reason/comment

What supporting documents are/will be available?

Doc. No.	Type	Citation	Link	Email	Other Details	Attachment
9388	Study protocol					379724-(Uploaded-07-10-2020-18-19-25)-Study-related document.docx
9389	Other				Participant letter explaining the study and reques... [More Details]	379724-(Uploaded-07-10-2020-18-21-24)-Study-related document.docx

Results publications and other study-related documents

Documents added manually

No documents have been uploaded by study researchers.

Documents added automatically

Source	Title	Year of Publication	DOI
Embase	Perioperative pain management in thoracic surgery: A survey of practices in Australia and New Zealand.	2023	https://dx.doi.org/10.1177/0310057X231172787

N.B. These documents automatically identified may not have been verified by the study sponsor.

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