ROCKet trial at GV Health hits a century

By Lachlan Durling

Aug 1, 2021

Goulburn Valley Health has reached a milestone in an international chronic pain trial, with 100 people taking part locally.

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The Reduction of Chronic Post-surgical Pain with Ketamine (ROCKet) trial led by Dr Nigel Dunk at GV Health, is a randomised trial of 4884 people to test if the earlier introduction of ketamine as pain relief during surgery can reduce the incidences of chronic pain.

GV Health is one of 34 sites taking part in the voluntary trial, which began in 2018 and could mean improved outcomes for patients.

“Chronic post-surgical pain is a known phenomenon, it’s common and it’s debilitating as a post-operative complication,” GV Health anaesthetic research co-ordinator Natasha Pearson said.

“It occurs in roughly 12 per cent of patients, which is quite a high number.

“With this trial, what we’re looking at is reducing those rates by bringing the drug ketamine to the forefront and asking patients to report their experiences of pain at three and 12 months post surgery.

“This allows the ROCKet trial to assess the effectiveness of ketamine as a preventative therapy and hopefully reducing the incidences of post-operative chronic pain.

“It’s a well-known drug that is approved for anaesthetic use and it is currently commonly used as an anaesthetic agent. The study is designed with a flexible approach, allowing the dosing to be adjusted to the patient, therefore fitting the patient’s needs.

The trial is led by Professor Philip Peyton at the University of Melbourne and Austin Health.

Patients who are having elective surgery involving a skin incision at least 8 cm in length, including open hernia, mastectomy and major orthopaedic surgeries, have been recruited for the trial.

“This trial gives us evidence that using ketamine as a pain medication could be worth doing — and could potentially change some people's practice on how they provide pain relief,” Ms Pearson said.

“The body uses drugs in different ways. Ketamine has unique pharmacologic and powerful analegesic properties, [and] for these reasons was selected as the most appropriate drug to be used in this study.”

The ROCKet trial is one of four trials of which the GV Health Anaesthetic Research Team is currently a part.

The research team is recruiting for VAPOR-C (Volatile Anaesthesia and Perioperative Outcomes related to Cancer) trial NATO (Non-anemiairon deficiency and treatment outcomes), with POISE-3 (PeriOperative Ischemic Evaluation 2) recently coming to an end.

The team has also expressed interest in being part of Lolipop (Long-term Outcomes of Lidocaine Infusion for Post-Operative Pain) and TRIG (Tranexamic acid and surgical site infections in Gastrointestinal surgery).

These are all voluntary trials, which are held to international and Australian ethical standards.

Ms Pearson said she would like to thank all patients and staff who had made this milestone achievable; without patients volunteering and staff helping behind the scenes this would not have been possible at this time.

Ms Pearson said if anyone who was due to have surgery thought they may be eligible to take part in one of the trials to contact her on natasha.pearson@gvhealth.org.au