Trajectories of Recovery after Intravenous Propofol vs. Inhaled VolatilE Anesthesia
THRIVE is a research study that aims to compare patient recovery experiences after two common types of general anesthesia. General anesthesia has a long history of safe and effective medical use. Total intravenous anesthesia (TIVA) and inhaled volatile anesthesia are the most common anesthetic techniques. The purpose of the THRIVE research study is to compare the two types of anesthesia in order to determine which one results in a better patient recovery experience.
Both types of anesthesia are safe and are used regularly, but there are things anesthesiologists don’t know about patients’ recovery after receiving anesthesia.
THRIVE Background
The Study
THRIVE is a type of research study called a pragmatic comparative effectiveness randomized control trial. A pragmatic trial means the researchers want to know how these treatments work in real life, not in artificial research setting. So, we are working with real doctors and real patients at lots of different hospitals to see what really happens. Comparative effectiveness is a scientific way of saying we are comparing two different treatments that are already in use, and patients are randomized (like flipping a coin) to see which of the two treatments they will receive.
The study is led by Co-Principal Investigators Michael Avidan, MBBCH, FCASA of Washington University in St. Louis and Sachin Kheterpal, MD, MBA of the University of Michigan.
Two Types of Anesthesia
Total intravenous anesthesia uses a medication called propofol which has been in use since the 1980s. Propofol works quickly, has few side effects, and is given through a vein
Inhaled volatile anesthesia uses modern versions of older medications such as ether. The patient breathes these medications in and out during anesthesia
Why Is It Being Done?
While we know some things about patients’ recovery after anesthesia, there are gaps in our knowledge. We aim to learn things like which anesthesia technique has a stronger effect on patients getting back to their usual activities, their cognitive recovery, and their pain after surgery.
How The Study Works
Adults 18 years of age or older, having scheduled surgery not involving the heart, that will require having general anesthesia with unconsciousness for their surgery may be eligible for this study.
Study participants will be randomized to either of the two types of general anesthesia. Participants will be given a series of short surveys both before and after their surgery. Each survey requires a time commitment of 2-3 minutes and will involve questions about:
- Overall well-being
- Mood
- Activities of daily living
- Confusion
- Memories of waking during surgery
Participant-reported survey data is collected up to 1-year postoperatively.
Project Timeline
Participants enrollment is planned for 4 years with follow-up surveys being completed up to 1 year postoperatively leading to a trial duration of 5 years.
The THRIVE Team
The people involved in making the THRIVE study possible work all across the country and different hospitals and institutions. Study directors and program managers at the coordinating centers, Washington University in St. Louis, University of Michigan, University of Pennsylvania, and Stanford University guide study activities. Study teams at over 20 hospitals recruit patients to participate in the study.
Study Directors and Program Managers
Study Directors
- Bethany Pennington, PharmD, BCPS
- Douglas Colquhoun, MB ChB, MSc, MPH
- Allison Janda, MD
- Mark Neuman, MD MSc
Program Managers
- Laura Swisher, MS
- Chelsea Cloyd, MBA
- Mara Bollini, MHA, BSN, RN, CPPS
- Shelley Vaughn, MPH
- Nicole Eyrich, MPH
Participating Hospitals and Site Principal Investigators
- Brigham and Women’s Hospital, Luigino Nascimben, MD
- Dartmouth-Hitchcock, Stacie Deiner, MD, MS
- Duke University Hospital, Kamrouz Ghadimi, MD
- Henry Ford Detroit, Anoop Chhina, MD
- Massachusetts General Hospital, Amit Bardia, MBBS
- MD Anderson Cancer Center, Juan Cata, MD
- NYU Langone Medical Center, Simon Tom, MD
- Oregon Health & Science University, Mike Aziz, MD
- Stanford University, David Drover, MD
- University of Arkansas, Geoff Muller, MD
- University of California San Francisco, Lee-lynn Chen, MD
- University of Michigan, Allison Janda, MD
- University of Pennsylvania, Caoimhe Duffy, MD
- University of Utah, Emily Drennan, MD
- University of Virginia, Bhiken Naik, MD
- University of Washington, Karen Domino, MD,
- Wake Forest University, Ashish Khanna, MD
- Washington University in St. Louis, Stephen Gregory, MD
- Weill Cornell Medicine, Kane Pryor, MD
- Yale School of Medicine, Jaime Hyman, MD
Engagement and Collaboration
Patient & Caregiver Engagement
Patient and caregiver partnership is essential to keep THRIVE thriving. A central structure of patient and caregiver partners drives the patient and caregiver voice across THRIVE as members of the research team. Our patient and caregiver partners regularly review documents for participants in the study and advise the central study team on study processes.
Stakeholder Engagement
The national healthcare landscape plays an instrumental role in influencing policy and driving practice. As a result, key stakeholders across the field of anesthesiology, surgery, and advocacy groups for equitable care across populations have been called on as partners of THRIVE.
Michigan Medicine – Department of Medicine, Division of Infectious Diseases | Preeti Malani, MD, MS, MSJ |
ASA – American Society of Anesthesiologists | Don Arnold, MD, FACHE, FASA |
APSF – Anesthesia Patient Safety Foundation | Dan Cole, MD |
BCBSM – Blue Cross Blue Shield of Michigan | Fari Amad, Md, MBA, FACOG |
AANA – American Association of Nurse Anesthesiology | Maria Van Pelt, PhD, CRNA, FAAN, FAANA |
AUA – Association of University Anesthesiologists | Julie Freed, MD, PhD |
IARS – International Anesthesia Research Society | Beverly Orser, MD, PhD, FRCPC |
SBAS – Society of Black Academic Surgeons | Dineo Khabele, MD |
Funding
The THRIVE trial is being funded by the Patient-Centered Outcomes Research Institute (PCORI). PCORI is a non-profit organization which funds projects that aim to answer important clinical questions that are most relevant to patients. It deeply values patient input and requires that patients act as partners throughout the process of study design and implementation.
The THRIVE Study is a clinical trial, so it is listed on ClinicalTrials.gov. This website is a database of clinical research studies and their results.
If you are a patient currently participating in THRIVE, please see your consent document for your local hospital’s study contact information.
For all other inquiries, please email askthrive@umich.edu