American honour for children’s surgery study

Dr Joseph Larvin receiving his prize. Image courtesy of the Society for Pediatric Anesthesia.

An anaesthetic trainee at University Hospital Southampton has taken his research to the international stage.

Dr Joseph Larvin has been recognised by the American Academy of Pediatrics (AAP) for his research into the effects of anaesthesia on children.

The AAP is the largest professional association of paediatricians in the United States.

Dr Larvin, a former NIHR Academic Clinical Fellow, has been honoured with second prize for the John J. Downes Resident Research Award.

As a result, he delivered a presentation on his NIHR Academic Clinical Fellowship research at an international meeting in Orlando, Florida.

Dr Larvin’s research is part of the Perioperative and Critical Care theme at the NIHR Southampton Biomedical Research Centre.

Investigating long-term effects of anaesthesia

There remain unknowns regarding the long-term impacts that anaesthetic drugs may have on children, particularly those under the age of three, and those having long, and/or repeated procedures.

Alongside his training in clinical anaesthesia, Dr Larvin conducted a research project over 2 years to investigate this further.

The EPIVA study compared two common methods for the maintenance of general anaesthesia – inhalation of anaesthetic gas, and administration of anaesthetic drugs through an intravenous (IV) line.

The study was conducted in 16 children, all under the age of three, who were having urology surgery. Half of the children received the inhalational anaesthetic; the other half received the intravenous anaesthetic.

Comparing the effects

Dr Larvin took blood samples before and after surgery, in both groups, in order to look for changes that could indicate potential long-term effects of anaesthesia.  He looked at markers of cell processes involved in cell stress, inflammation and the immune system.

Children in the IV group had more significant changes in their white blood cell numbers, a key part of the immune system. Those who received anaesthetic gas, on the other hand, had more significant changes in inflammation and cell stress markers.

He also looked for changes in signals on DNA, a process called epigenetics, which can switch genes on, off, up, or down. Analysis of these results is ongoing.

Dr Larvin said: “I am delighted to win this award, and it was a brilliant experience to be able to present my work in front of so many experts in this field.

“Further research is still certainly needed - I hope this study will help guide the development of future trials that will ultimately better inform decisions around which type of anaesthesia we give these children.”