5 October 2020
2020 CANTAB Research Grant supports research into combined dexmedetomidine / ketamine nasal spray for analgesia
The winner of one of the three 2020 CANTAB Research Grant prizes, Dr Amie Hayley, Swinburne University of Technology explains the impact CANTAB will have on her research: Combined dexmedetomidine/ketamine nasal spray for analgesia: a pilot feasibility and efficacy trial.
First and foremost, I wanted to thank Cambridge Cognition for selecting my application as one of the three winners of the 2020 CANTAB Research Grant! Given the time difference here in Australia, I woke up to the fantastic news that I was successful with my submission, and that I will have the support of the Cambridge Cognition team for my project. As an early career researcher, this support will have an immediate measurable impact on my research capacity and will have long term positive impacts on my future research career.
Why did you choose CANTAB for your research project?
I am an Early Career Research fellow in the field of Psychopharmacology at Swinburne University of Technology. My work looks at the neurocognitive effects of psychoactive substances (both prescription and illicit) and seeks to identify mechanisms by which these changes translate to human behaviour. Therefore, it is critical that I use the gold-standard assessment protocols to examine these neurocognitive and biobehavioural outcomes.
The CANTAB software is recognised as the leading tool for examining many safety-critical neurocognitive endpoints. Using this system will therefore ensure high-quality outcomes for my experimental studies and will maximise translation of research findings into clinical practice. The use of the validated tablet interface will also be a huge advantage, as many of my participants have their movement purposefully restricted during their testing session to ensure continuous safety monitoring.
What is the main aim of your research?
Dexmedetomidine is a short-term sedative used for its ability to provide cooperative or semi-rousable sedation (i.e. patients can respond to verbal instructions). Using dexmedetomidine in Intensive Care settings is also shown to reduce the need for total opioid pain relief, however it can be associated with negative cardiovascular effects such as hypotension. Ketamine is a dissociative anaesthetic medication that provides effective pain relief in small doses. Due to its psychoactive effects (e.g. hallucinations) at higher doses, it too is rarely used as a sole agent for pain relief. A combination of dexmedetomidine and ketamine is shown to reduce the side effects of either drug, however my previous research has shown that moderate-high doses of these drugs when provided intravenously leads to negative and prolonged effects on neurocognition and subjective intoxication.
Intranasal (IN) administration is an attractive needle-free sedative option where intravenous access is unnecessary and is a viable alternative to achieve rapid pain-relief. Separately, both ketamine and dexmedetomidine are efficacious and well tolerated when provided as an IN preparation. However, to our knowledge, very few studies have examined a combined formulation, and no research has yet examined the clinically-relevant neurocognitive safety endpoints under these conditions.
This research will evaluate the neurocognitive effects of combined IN dexmedetomidine and ketamine in healthy adults. This will be vital for ensuring cognitive safety and tolerability of compounds and will support future clinical research development in this area. Importantly, the use of the CANTAB Connect platform will serve to increase the visibility and significance of neurocognitive testing in primary care settings by enabling collaboration and engagement with cross-disciplinary clinical partners.
Dr Amie Hayley, Swinburne University of Technology, Melbourne, Australia.