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Research

Kitamoto lab

The Department of Anesthesia participates in both basic science and clinical investigation. Check out some of our current research and publications below:

Investigating non-invasive techniques to detect spinal cord ischemia

Lovkesh Arora, MBBS, MD, is conducting research to see if non-invasive Near Infrared Spectroscopy (NIRS) can alert anesthesiologists to possible spinal cord ischemia (SCI) during a procedure.
 
SCI remains a major concern during open and endovascular repair of descending thoracic aneurysms and thoracoabdominal aortic aneurysms (TAAAs). It occurs in 8-10 percent of patients and can result in partial or total paralysis that may last hours, days, weeks, or months. Although the etiology of SCI is multifactorial, coverage of large aortic segments, insufficient collaterals, arterial embolization, and systemic hypotension are the main predisposing factors during endovascular TAAAs.

“When a patient gets spinal cord ischemia, our answers are still very vague,” Arora says. “When a family asks how much the patient is going to improve, we don’t know. When they ask how much time it will take to pass off, we don’t know. So I strongly believe the best approach is to prevent this complication, to not let it happen.”
 
One possible way to prevent spinal cord ischemia is to insert a lumbar drain before the procedure to reduce the pressure around the spinal cord. Another method is neuro monitoring, specifically SSEP (SomatoSensory Evoked Potential Monitoring) and MEP (Motor Evoked Potential Monitoring), which can be done during the procedure to immediately recognize SCI and may allow the use of maneuvers to optimize spinal cord perfusion. However, SSEP and MEP are invasive, and their accuracy can be affected by anesthetic agents. Arora is investigating whether he can get the same information from non-invasive NIRS patches.
 
Learn more about this research by watching the video:


"Training" a ventilator to adapt to individual patient needs

David Kaczka, MD, PhD, is the principal investigator on a subaward from the U.S. Department of Defense to develop a computational model for transport ventilators the military uses on patients with a variety of lung injuries.

Kaczka hopes his research will produce a model that can direct time-controlled adaptive ventilation (TCAV) settings on a transport ventilator to provide optimal lung support that is tailored to an individual patient’s pathophysiology.

“There’s no set way to ventilate a lung, and what works for one patient may actually cause more damage to another patient,” Kaczka says. “We hope that we can use our computational model to modify a military transport ventilator so that personnel in far-forward locations have, essentially, an ICU-grade ventilator to help their patients.”

Watch the video to learn more about this project:


Recent publications from the Department:

Campos JH, Seering MS: Does liposomal bupivacaine have any advantage over bupivacaine hydrochloride for intercostal nerve blocks in minimally invasive thoracic surgery? Journal of Cardiothoracic and Vascular Anesthesia 2021; In Press. 

Rodriguez RM, Montoy JC, Hoth KF, Talan DA, Harland KK, Ten Eyck P, Mower W, Krishnadasan A, Santibanez S, Mohr NM: COVID-19-related stress symptoms among emergency department personnel. Annals of Emergency Medicine 2021; In Press. 

Block RI, Jager G, Luijten M, Ramsey NF: Associations of regular marijuana use by adolescent boys with verbal memory and perseveration. Psychological Reports 2021; In Press.

Dexter F, Epstein RH, Loftus RW: Quantifying and interpreting inequality of surgical site infections among operating rooms. Canadian Journal of Anesthesia 2021; In Press.

Miller JL, Tada M, Goto M, Mohr NM, Lee S: Prediction models for severe manifestations and mortality due to COVID-19: a rapid systematic review. medRxiv 2021; In Press.


Clinical investigations occur in subspecialties, including:

  • Cardiothoracic Anesthesia
  • Chronic Pain Medicine
  • Critical Care Medicine
  • Neuroanesthesia
  • Obstetrical Anesthesia
  • Operating Room Management
  • Pediatric Anesthesia
  • Regional Anesthesiology and Acute Pain Medicine

Basic science research topics include:

  • Acute pain
  • Chronic pain after surgery
  • Analgesic pharmacology
  • Novel anesthetic drug synthesis
  • Effects of drugs on learning and memory