Scientist lauded for painkiller breakthrough

By SIMON COLLINS science reporter

A Hamilton-born engineering student has developed a system of delivering painkillers which may help thousands of accident victims recover faster and save the world billions of dollars in wasted drugs.

The automated system delivers just the right amount of painkillers to keep a patient comfortable, then reduces the amount gradually as the pain subsides so that the patient can come off expensive life support systems and start breathing normally as soon as possible.

Andrew Rudge, 25, the Canterbury University doctoral student who developed the system, was named the first MacDiarmid Young Scientist of the Year at a ceremony led by Nobel Prize-winning scientist Alan MacDiarmid in Auckland last night.

Another former Hamiltonian, food scientist Nicola Turner, 27, was the runner-up.

Thirteen organisations led by Fisher & Paykel Appliances are sponsoring the new annual awards designed to recognise New Zealand's top young scientists.

Dr Geoff Shaw, an intensive care specialist at Christchurch Hospital and one of two supervisors of Mr Rudge's research, said the new system was the first time anyone in the world had found a solution to "inappropriate sedation" of critically injured patients.

In New Zealand alone, about 12,000 patients need intensive care every year, and 60 to 70 per cent of them need to breathe through tubes stuck down their throats for an average of about two days.

Between 4 and 7 per cent of them "come to" while on full life support, panic, and tear the tubes out.

"If it's there to sustain life and they take the tube out, they will die if they don't get someone intervening immediately," Dr Shaw said.

"It causes a degree of stress and anxiety and a flurry of activity where people have to sedate a patient who has literally gone ballistic in bed.

"That is every nurse's worst nightmare. Therefore nursing staff will, with justification, give extra sedation to the patient to keep them settled. It's the negative impact of the extra sedation that causes excess drugs to be used and causes patients to stay in intensive care longer."

Dr Shaw believes the new system will cut about 10 per cent off the $70 million to $100 million that New Zealand spends on intensive care units (ICUs) every year. "Multiply that by, say, 1000 for the world and there are potentially billions of dollars in savings if the right sedation was applied," he said.

The idea of an automated system came out of "some musings I had on an ICU round three years ago". He sought help from a mechanical engineer at Canterbury University, Dr Geoff Chase.

Dr Chase brought in applied maths professor Graeme Wake and another colleague, and they translated Dr Shaw's problem into a mathematical framework.

Mr Rudge started with a mountain of data which Dr Shaw had already gathered from a sensor developed by another doctoral student to determine whether a patient was agitated.

He developed what he calls a "cruise-control" system which uses the agitation data to work out the effect of a painkilling drug on each patient, compute an appropriate rate of administering the drug, and then actually administer the drug at that rate - subject to an "override" by a nurse if necessary.

"This device is still very, very much in the development stages. We anticipate another three to five years before it can be commercialised," Mr Rudge said.

His initial results were published yesterday in a poster at the Young Scientists of the Year event.

Dr Shaw said that if the system worked as expected and allowed ICU patients to recover faster, it would free up resources that were desperately needed for less urgent surgery.

Relieving pain

* A NZ-developed system helps ensure the right amount of painkiller is administered to critically ill patients.

* Up to 70 per cent of 12,000 patients in intensive care need to breathe through tubes in their throats for an average of about two days.

* Between 4 and 7 per cent of them "come to" while on full life support, panic, and tear the tubes out.