Translational Medical Research Commons^™

Identifying The Roadblocks To Successful Pediatric Imaging Without Sedation Or Anesthesia, Iman Soliman, Ammie M. White, Md, J. Christopher Edgar, Phd, Laura Cadge, Ccls, Margaret Hamel-Daymon, Crnp, Sandra Saade-Lemus, Md, Rochelle Bagatell, Md, Elizabeth T. Drum, Md, Lisa States, Md

Phase 1

Background: Modern imaging modalities allow for assessment of a wide array of medical conditions. Because it is difficult for young children to remain still during lengthy imaging studies, there is a need for sedation and general anesthesia (GA). A growing literature, however, suggests that there may be deleterious neurocognitive effects of sedation/GA in young children. As such, it is in our patients’ best interest to critically evaluate the use of sedation/GA.

Objective: To identify the roadblocks to obtaining clinical pediatric magnetic resonance imaging (MRI) exams without sedation/GA.

Materials and Methods: Participants included 63 parents/guardians of 5- to 9-year-old patients who …

Zero Tolerance – Mitigating The Opioid Epidemic Amongst Minimally Invasive Urologic Patients, Daniella Wong, Thenappan Chandrasekar, Md, Costas Lallas, Md

Phase 1

Introduction: Opioids are routinely prescribed following minimally invasive surgery (MIS), yet the majority of medication remains unused. However, the literature is lacking evidence for non-narcotic analgesia in MIS urologic procedures. The purpose of this study is to evaluate the efficacy of a non-narcotic postoperative pain management regimen in reducing opioid use following MIS urologic procedures.

Methods: In this prospective study, 51 MIS urologic patients were recruited over two months. Patients in the first month cohort (P1) were managed with the established pain management standard-of-care, while patients in the second month (P2) followed a non-narcotic postoperative pain management protocol that …

Transdermal Lidocaine For Perioperative Pain: A Systematic Review Of The Literature, Alexa Cohen, Jordan Smoker, Mohammad R. Rasouli, Eric S. Schwenk

Phase 1

Introduction: Recent data have shown that the risk of taking chronic opioids after surgery increases after about 5 days of postoperative opioid therapy. Alternatives to opioids are desirable, and transdermal lidocaine is one such perioperative multimodal agent. This review provides a summary of the perioperative studies that have examined transdermal lidocaine as an analgesic in the perioperative period.

Methods: We conducted searches of PubMed and Scopus databases. Studies involving patients who were undergoing surgery and were given either transdermal lidocaine, placebo, or active comparator in the perioperative period with the primary endpoint of improvement in pain were included in …

The Effects Of Total Intravenous Versus Inhalational Anesthesia On Fluid Balance For Patients Undergoing Pancreaticoduodenectomy, Jaime Eberle-Singh, David Maguire, Md, Harish Lavu, Md

Phase 1

Introduction: Pancreaticoduodenectomy (PD), the most common surgical treatment for pancreatic cancer, is a complex procedure with a morbidity of 45-60%. Recent studies indicate that intraoperative use of total intravenous anesthesia (TIVA) may reduce post-operative complications for PD patients, when compared to inhalational anesthesia (INHA). We hypothesized that patients who receive TIVA may have a more favorable fluid balance, which is known to reduce postoperative complications in PD patients.

Methods: We carried out a retrospective analysis of patients who underwent PD at Thomas Jefferson University Hospital and were administered TIVA or INHA during surgery between April 2017 and January 2019. …

Adoption Of Perioperative Lidocaine Infusion For The Reduction Of Postoperative Pain, Brandon Scott Figueiredo

Doctoral Projects

Laparoscopic capability provides numerous benefits to patients requiring abdominal surgical procedures. However, the use of these techniques has presented the anesthesia provider with a unique set of challenges in terms of perioperative management and postoperative pain reduction. No standardized method has existed to reduce postoperative pain and improve recovery following these procedures. There were three primary goals of this project. The first goal was to conduct a meta-analysis of randomized controlled trials to determine the benefit of the use of intravenous lidocaine infusions to reduce postoperative pain in laparoscopic abdominal surgery. Twelve articles were included in the meta-analysis that pertained …

Patient Safety: What Can Be Done About It?, Steven Dain

Steven L Dain

Much is said and written about patient safety. In Canada, a small group of dedicated physicians, nurses and engineers participates in the Canadian Standards Association and Standards Council of Canada Advisory Committees writing basic safety and essential performance requirements for a large range of anesthesia, respiratory care and critical care equipment. Over the past several years, in recognition of the globalization of trade and the international nature of medical device design and manufacturing, Canadian Anesthesiologists’ Society members Dr Steven Dain, Dr Karen Brown, Dr Matt Kurrek, Dr Ken LeDez, and Dr Jeremy Sloan have primarily participated in Organization for International …