Monday, 9 May 2016

Monash medical student’s research could save millions

Austin Lee
Final year medical student Austin Lee was selected to present two posters at the Australian and New Zealand College of Anaesthetists (ANZCA) Annual Scientific Meeting (ASM) in Auckland last week. 

Austin’s research findings have significant implications for health care costs as well as patient monitoring during sedation.

Undertaken during his Bachelor of Medical Science year, the School of Clinical Sciences at Monash Health (SCS) student was part of a research team that investigated whether pre-operative saline given through a drip can prevent low blood pressure during colonoscopy.

“Patients undergoing this procedure are at risk of low blood pressure because of pre-operative fasting, the dehydrative effect of bowel preparation, and the vasodilatory effect of sedative drugs,” said Austin.

“We undertook at randomised controlled trial, recruiting 150 patients, with either 2 ml/kg or 20 ml/kg of saline given intravenously to each patient.”

The randomised controlled trial found that large amounts of saline made absolutely no difference in blood pressure, thirst or post-operative morbidities including drowsiness, nausea and headaches.

“We estimate that in Australia, the annual cost of intravenous fluids administration during colonoscopy costs $7.14 million,” said Austin.

“Our study has shown that routine administration of fluid is not indicated, and therefore contributes unnecessarily to the cost of care.” 

At the ASM Austin also presented his findings of a survey of anaesthetists who were questioned about their methods of sedation during endoscopy (gastroscopy, colonoscopy and endoscopic retrograde cholangio-pancreatography).

“409 anaesthetists responded to our questions about the drugs they used in sedation, their preferred methods of monitoring patients (blood pressure cuff and pulse oximetry) and their use of intravenous fluids during the perioperative period,” said Austin.

Prof Leslie and Austin
at the conference last week
“The survey found that propofol is the drug of choice for endoscopy sedation administered by specialist anaesthetists in Australia, and that a maximum depth of sedation commensurate with general anaesthesia is routinely targeted by the majority of respondents for all procedures except for elective gastroscopy.” 

Significantly, Austin’s research revealed that blood pressure was not routinely measured by all respondents which is not compliant with ANZCA policy.   

Austin was ‘ecstatic’ to have had his posters accepted at the ASM and is grateful for the support of his supervisors.

“I thoroughly enjoyed the conference; the talks were very relevant and engaging, and I left feeling inspired about research and its impact on evidence-based medicine,” said Austin.

“I’d like to thank my supervisors, Professor Kate Leslie and Dr Megan Allen, for their teaching, guidance, and patience, and for their smiles, laughter, and encouragement that made these research projects an absolute blast.”

“I could not have asked for a better experience, and I highly recommend a BMedSc (Hons) project.” 

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