The Northern Sydney Anaesthesia Research Institute (NSARI) is an independent not-for profit research organisation affiliated with Royal North Shore Hospital and the University of Sydney.

Our aim is to promote and produce clinically relevant research in the field of anaesthesia. Our vision is to become a premier medical research institute in the field of perioperative medicine.

We also aim to facilitate relationships with other medical specialties to collaborate and integrate research activities and to promote the science of anaesthesia within the community. 

Below is a list and brief outline of NSARI’s current projects:

Sugammadex and Postoperative Respiratory Complications

An NSARI designed and led prospective, randomised controlled trial examining the effect of sugammadex reversal on post-operative pulmonary complications, patient satisfaction and events in the recovery unit. Currently recruiting. More information can be found here.

Recovery Outcome Auditing

Ongoing quality improvement where individual anaesthetists and the department as a whole are measured with respect to post operative complications, nausea and vomiting and pain outcomes.

Intrathecal Morphine in Major Abdominal Surgery

A prospective pilot trial looking at comparing intrathecal morphine and epidural anaesthesia on outcomes in major abdominal surgery. This trial was awarded the Research Foundation Novice Investigator Prize at the ANZCA national CTN conference in 2018

A survey of neuromuscular blockade management

A survey of Australian and New Zealand anaesthetists on their current practice regarding the use of neuromucular blockers and reversal agents.

Sugammadex and critical events in anaesthesia

In association with ANZTADC (the Australian and New Zealand Tripartite Anaesthetic Data Committee ), a retrospective analysis of cases reported to webAIRS is being analysed looking for patterns involving sugammadex and it’s association with critical events. This is being used to delineate factors that can be used as learning points to improve the safety of anaesthesia.

Multicentre ANZCA Trials

We are currently recruiting patients for a number of large multicentre trials, including PADDi and ITACS. Involvement in these trials is improving our research infrastructure and experience with large scale medical research.

Intrathecal Morphine in Total Knee Replacement

An NSARI designed and led prospective randomised controlled trial looking at differences in anaesthetic and functional outcomes following the addition of intrathecal morphine to a standardised anaesthetic regime in primary unilateral total knee replacement

Airway Incidents in NSW

As well as the design and delivery of the ATTAAC airway and NSARI airway courses, members has been actively involved in airway related research, and are currently planning to undertake a review of NSWHealth IIMS data to quantify and summarise the nature and outcomes of airway complications in NSW public hospitals.

Below is a list of recent publications from NSARI members:

Olesnicky BL, Traill C, Marroquin-Harris FB. The effect of routine availability of sugammadex on postoperative respiratory complications: a historical cohort study. Minerva anestesiologica. 2016 Oct 5;83(3):248-54.

Olesnicky BL, Rehak A, Bestic WB, Brock JT, Watterson L. A cadaver study comparing three fibreoptic‐assisted techniques for converting a supraglottic airway to a cuffed tracheal tube. Anaesthesia. 2017 Feb;72(2):223-9.

Olesnicky BL, D’Souza RJ, Jayram D, Kim OO, Rehak A. The establishment of an anaesthetist-managed intraoperative neurophysiological monitoring service and initial outcome data. Anaesthesia and intensive care. 2018 Jan;46(1):74-8.

Olesnicky B. Successful bilateral low dose, low volume supraclavicular block for bilateral shoulder hemiarthroplasty. Anaesthesia Cases. 2016 Jul;4(2):106-8.

Pirie K, Myles PS, Riedel B. A survey of neuraxial analgesic preferences in open and laparoscopic major abdominal surgery amongst anaesthetists in Australia and New Zealand. Anaesthesia and Intensive Care. 2020 Jul;48(4):314-7.

Sanderson BJ, Doane MA. Transversus abdominis plane catheters for analgesia following abdominal surgery in adults. Regional Anesthesia & Pain Medicine. 2018 Jan 1;43(1):5-13.

Parkin CJ, Moritz P, Kirkland O, Doane M, Glover A. Utility of the American College of Surgeons National Surgical Quality Improvement Program surgical risk calculator in predicting mortality in an Australian acute surgical unit. ANZ journal of surgery. 2020 May;90(5):746-51.

 Mak G, Nesbitt C, Shiraev T, Wang C, Doane M, Neale M. Transvenous endovascular repair of symptomatic type II endoleak following endovascular repair of a ruptured common iliac aneurysm with arteriovenous fistula. Journal of Vascular Surgery Cases and Innovative Techniques. 2020 Dec 1;6(4):614-7.

Brewster DJ, Chrimes NC, Do TB, Fraser K, Groombridge CJ, Higgs A, Humar MJ, Leeuwenburg TJ, McGloughlin S, Newman FG, Nickson CP. Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. Med J Aust. 2020 Mar 16;212(10):472-81.

Abbott TE, Ahmad T, Phull MK, Fowler AJ, Hewson R, Biccard BM, Chew MS, Gillies M, Pearse RM, Pearse RM, Beattie S. The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis. British journal of anaesthesia. 2018 Jan 1;120(1):146-55.

Chrimes N, Higgs A, Rehak A. Lost in transition: the challenges of getting airway clinicians to move from the upper airway to the neck during an airway crisis. British Journal of Anaesthesia. 2020 May 28.

Rehak A, Watterson LM. Institutional preparedness to prevent and manage anaesthesia‐related ‘can’t intubate, can’t oxygenate’events in Australian and New Zealand teaching hospitals. Anaesthesia. 2020 Jun;75(6):767-74.

Rehak A. Managing airway trauma: Applying logic and structure to the anaesthetic decision-making process. Australasian Anaesthesia. 2019 Jan(2019):13-24.

Singh S, Granberg D, Wolin E, Warner R, Sissons M, Kolarova T, Goldstein G, Pavel M, Öberg K, Leyden J. Patient-reported burden of a neuroendocrine tumor (NET) diagnosis: results from the first global survey of patients with NETs. Journal of global oncology. 2017 Feb;3(1):43-53.

George D, Gálvez V, Martin D, Kumar D, Leyden J, Hadzi-Pavlovic D, Harper S, Brodaty H, Glue P, Taylor R, Mitchell PB. Pilot randomized controlled trial of titrated subcutaneous ketamine in older patients with treatment-resistant depression. The American Journal of Geriatric Psychiatry. 2017 Nov 1;25(11):1199-209.

Wolin EM, Leyden J, Goldstein G, Kolarova T, Hollander R, Warner RR. Patient-reported experience of diagnosis, management, and burden of neuroendocrine tumors: results from a large patient survey in the United States. Pancreas. 2017 May;46(5):639.

Gordon LG, Elliott TM, Wakelin K, Leyden S, Leyden J, Michael M, Pavlakis N, Mumford J, Segelov E, Wyld DK. The economic impact on Australian patients with neuroendocrine tumours. The Patient-Patient-Centered Outcomes Research. 2020 Jun;13(3):363-73.

Taylor R, Wark H, Leyden J, Simpson B, McGoldrick J, Hadzi-Pavlovic D, Han HK, Nikolin S, Martin D, Loo C. Effects of the Anaesthetic-ECT time interval and ventilation rate on seizure quality in electroconvulsive therapy: A prospective randomised trial. Brain stimulation. 2020 Mar 1;13(2):450-6.

Taylor R, Hadzi-Pavlovic D, Nikolin S, Bull M, Wark H, Leyden J, Harper S, Martin D, Galvez V, Loo C. The anaesthetic-ECT time interval with thiopentone—Impact on seizure quality. Journal of affective disorders. 2019 Jun 1;252:135-40.

Leyden J, Pavlakis N, Chan D, Michael M, Clarke S, Khasraw M, Price T. Patient‐reported experience of the impact and burden of neuroendocrine tumors: Oceania patient results from a large global survey. Asia‐Pacific Journal of Clinical Oncology. 2018 Jun;14(3):256-63.

Bestic B. Advanced Airway Management: A Handbook for Anaesthetists: Who Plans Wins. Dr Bill Bestic, FANZCA; 2020 Oct 5.

Russo M, Brooker C, Cousins MJ, Taylor N, Boesel T, Sullivan R, Holford L, Hanson E, Gmel GE, Shariati NH, Poree L. Sustained long-term outcomes with closed-loop spinal cord stimulation: 12-month results of the prospective, multicenter, open-label Avalon study. Neurosurgery. 2020 Oct;87(4):E485-95.

Nicholas MK, Asghari A, Sharpe L, Beeston L, Brooker C, Glare P, Martin R, Molloy A, Wrigley PJ. Reducing the use of opioids by patients with chronic pain: an effectiveness study with long-term follow-up. Pain. 2020 Mar 1;161(3):509-19.

Finniss D, Nicholas M, Brooker C, Cousins M, Benedetti F. Magnitude, response, and psychological determinants of placebo effects in chronic low-back pain: a randomised, double-blinded, controlled trial. Pain reports. 2019 May;4(3).

Evers AW, Colloca L, Blease C, Gaab J, Jensen KB, Atlas LY, Beedie CJ, Benedetti F, Bingel U, Büchel C, Bussemaker J. What should clinicians tell patients about placebo and nocebo effects? Practical considerations based on expert consensus. Psychotherapy and Psychosomatics. 2021;90(1):49-56.

Finniss DG. Placebo effects: historical and modern evaluation. International review of neurobiology. 2018 Jan 1;139:1-27.

Beales D, Fried K, Nicholas M, Blyth F, Finniss D, Moseley GL. Management of musculoskeletal pain in a compensable environment: Implementation of helpful and unhelpful Models of Care in supporting recovery and return to work. Best Practice & Research Clinical Rheumatology. 2016 Jun 1;30(3):445-67.

Finniss D, Nicholas M, Brooker C, Cousins M, Benedetti F. Magnitude, response, and psychological determinants of placebo effects in chronic low-back pain: a randomised, double-blinded, controlled trial. Pain reports. 2019 May;4(3).

Arnold MH, Finniss D, Luscombe GM, Kerridge I. An Exploration of Knowledge and Attitudes of Medical Students and Rheumatologists to Placebo and Nocebo Effects: Threshold Concepts in Clinical Practice. Journal of Medical Education and Curricular Development. 2020 Jun;7:2382120520930764.

Sanders D, Colloca L, Finniss DG. Influence of placebo analgesia in pharmacological treatment of pain. Future Drug Discovery. 2020 Mar 19;2(2):FDD34.

Pattullo GG, Finniss DG. Evaluating clinical success of the newer field-block catheters: Limitations of case reports. Anaesthesia and intensive care. 2020 Jan;48(1):68.

Arnold MH, Finniss DG, Kerridge I. ‘But What Do You Mean, Doctor?’War Metaphors, Chronic Health Impacts, and Pain Threshold: The Physician as a Talking Placebo or Nocebo. AJOB Neuroscience. 2018 Jul 3;9(3):204-6.

Sharp G, Green S, Rose M. Chlorhexidine‐induced anaphylaxis in surgical patients: a review of the literature. ANZ journal of surgery. 2016 Apr;86(4):237-43.

Li J, Best OG, Rose MA, Green SL, Fulton RB, Capon MJ, Krupowicz BA, Fernando SL. Assessing cross-reactivity to neuromuscular blocking agents by skin and basophil activation tests in patients with neuromuscular blocking agent anaphylaxis. British journal of anaesthesia. 2019 Jul 1;123(1):e144-50.

Li J, Best OG, Rose MA, Green SL, Fulton RB, Fernando SL. Integrating basophil activation tests into evaluation of perioperative anaphylaxis to neuromuscular blocking agents. British journal of anaesthesia. 2019 Jul 1;123(1):e135-43.

Green S, Hicks A, Hilsendager C, Bauer M, Frank GK. An adolescent girl with signs and symptoms of anaphylaxis and negative immunologic workup: a case report. Journal of medical case reports. 2020 Dec;14:1-4.

Anderson J, Fernando SL, Green S, Fulton RB, Yun J, Rose M. ASCIA‐P26: MORPHINE AND PHOLCODINE SPECIFC IGE TESTING HAS LIMITED UTILITY IN THE DIAGNOSIS OF HYPERSENSITIVITY TO BENZYLISOQUINOLINE NEUROMUSCULAR BLOCKING AGENTS. Internal Medicine Journal. 2016 Sep;46:12-.

Gálvez V, Tor PC, Bassa A, Hadzi-Pavlovic D, MacPherson R, Marroquin-Harris M, Loo CK. Does remifentanil improve ECT seizure quality?. European archives of psychiatry and clinical neuroscience. 2016 Dec;266(8):719-24.

Kardell LD, Hilmer SN, Crane JA, MacPherson R, Kim TY, Gnjidic D. Investigation of opioid prescribing in the postoperative setting among opioid‐naïve surgical patients: a 6‐month observational study. Journal of Pharmacy Practice and Research. 2019 Feb;49(1):58-61.

MacPherson R, Pattullo G. Management of postsurgical pain in the community. Australian Prescriber. 2020 Dec;43(6):191.

Bajorek BV, Bakshi R, MacPherson RD, Chow C, Elliott P. Pharmacist charting in the preadmission clinic of a Sydney teaching hospital: a pilot study. Journal of Pharmacy Practice and Research. 2017 Oct;47(5):375-82.

Gardner A, MacPherson R. Preparing candidates for the ANZCA primary examination vivas. Australasian Anaesthesia. 2017 Jan(2017):301-6.

Chua TC, Marroquin-Harris M, Vasica G. Not Just Another Case of Right Iliac Fossa Pain. Gastroenterology. 2016 Oct 1;151(4):599-600.

Rose MA, Garcez T, Savic S, Garvey LH. Chlorhexidine allergy in the perioperative setting: a narrative review. British journal of anaesthesia. 2019 Jul 1;123(1):e95-103.

Garvey LH, Ebo DG, Krøigaard M, Savic S, Clarke R, Cooke P, Dewachter P, Garcez T, Guttormsen AB, Hopkins PM, Hepner DL. The use of drug provocation testing in the investigation of suspected immediate perioperative allergic reactions: current status. British journal of anaesthesia. 2019 Jul 1;123(1):e126-34.

Garvey LH, Dewachter P, Hepner DL, Mertes PM, Voltolini S, Clarke R, Cooke P, Garcez T, Guttormsen AB, Ebo DG, Hopkins PM. Management of suspected immediate perioperative allergic reactions: an international overview and consensus recommendations. British journal of anaesthesia. 2019 Jul 1;123(1):e50-64.

Mertes PM, Ebo DG, Garcez T, Rose M, Sabato V, Takazawa T, Cooke PJ, Clarke RC, Dewachter P, Garvey LH, Guttormsen AB. Comparative epidemiology of suspected perioperative hypersensitivity reactions. British journal of anaesthesia. 2019 Jul 1;123(1):e16-28.

O’Regan S, Molloy E, Watterson L, Nestel D. Observer roles that optimise learning in healthcare simulation education: a systematic review. Advances in Simulation. 2016 Jan;1(1):1-0.

Links MJ, Watterson L, Martin P, O’Regan S, Molloy E. Finding common ground: meta-synthesis of communication frameworks found in patient communication, supervision and simulation literature. BMC medical education. 2020 Dec;20(1):1-6.

Christensen MD, Oestergaard D, Dieckmann P, Watterson L. Learners’ Perceptions During Simulation-Based Training: An Interview Study Comparing Remote Versus Locally Facilitated Simulation-Based Training. Simulation in Healthcare. 2018 Oct 1;13(5):306-15.

O’Regan S, Molloy E, Watterson L, Nestel D. ‘It is a different type of learning’. A survey-based study on how simulation educators see and construct observer roles. BMJ Simulation and Technology Enhanced Learning. 2020 Sep 4:bmjstel-2020.

Pu H, Doig GS, Heighes PT, Allingstrup MJ, Wang A, Brereton J, Pollock C, Chesher D, Bellomo R. Intravenous amino acid therapy for kidney protection in cardiac surgery patients: a pilot randomized controlled trial. The Journal of thoracic and cardiovascular surgery. 2019 Jun 1;157(6):2356-66.

Scolaro RJ, Crilly HM, Maycock EJ, McAleer PT, Nicholls KA, Rose MA, The RH. Australian and New Zealand anaesthetic allergy group perioperative anaphylaxis investigation guidelines. Anaesthesia and intensive care. 2017 Sep;45(5):543-55.

Rose MA, Anderson J, Green SL, Yun J, Fernando SL. Morphine and pholcodine‐specific IgE have limited utility in the diagnosis of anaphylaxis to benzylisoquinolines. Acta Anaesthesiologica Scandinavica. 2018 May;62(5):628-34 

Rose MA. Low end-tidal carbon dioxide as a marker of severe anaesthetic anaphylaxis: the missing piece of the puzzle?. BJA: British Journal of Anaesthesia. 2017 Nov 1;119(5):859-62. 

Vitharana N, Standen J. High hopes for dope: What role does medicinal cannabis play in current clinical practice?. Australasian Anaesthesia. 2019(2019):219.