Principal Investigator: Dr. Geoff Bellingham
Co-investigators: Dr. Q. Tawfic, Dr. R. Grewal, Dr. W. Schulz, Dr. C. Clarke & Dr. J. Murkin
Study Title: Near-infrared Spectroscopic Measurement of Tissue Oxygen Saturation and the Vascular Occlusion Test During Immobilization, Carpal Tunnel Syndrome, and Pre and Post- Stellate Ganglion Blockade for CRPS
A previous study we conducted using near-infrared spectroscopy (NIRS) revealed that the deep tissue oxygen saturation (StO2) in the hands of patients with Complex Regional Pain Syndrome (CRPS 1) is significantly lowered compared to their unaffected hands. The proposed project will aim to determine if this finding is specific to CRPS 1, and if pain relief is accompanied by an improvement in oxygenation. The project will investigate the role that immobilization and pain itself play in altering microvascular function as possible confounding variables, in addition to observing the changes in tissue oxygen saturation brought about through the pain relieving effects of stellate ganglion blockade. Establishing low oxygen saturation as a feature unique to CRPS 1 will help to establish StO2 as a novel quantifiable variable for this syndrome.
Principal Investigator: Dr. Rakesh Sondekoppam Vijayashankar
Co-investigators: Dr. S. Ganapathy, Dr. V. Uppal, Dr. J. Brookes, Dr. R. Giffin & Dr. R. Litchfield
Study Title: Comparison of efficacy and safety of perihamstring local anesthetic injection to obturator nerve block when combined with subsartorial saphenous block for Anterior Cruciate Ligament repair. A randomized double blinded study.
Patients undergoing arthroscopic anterior cruciate ligament (ACL) repair will receive a block of the nerves to the knee joint in the thigh combined with freezing of the muscles from which the graft is taken or freezing of the nerve to these muscles. This study evaluates the best technique to reduce pain from the graft donor site.
Principal Investigator: Dr. Qutaiba Amir Tawfic
Co-investigators: Dr. P. Morley-Forster, Dr. C. Railton, Dr. B. Urquhart & Dr. G. Bellingham
Study Title: Low Dose Oral Ketamine Adjuvant Therapy in Chronic Pain Patients – A pilot study to assess safety
Oral ketamine is used by some clinicians to reduce the amount of opioid analgesic consumed and improve chronic pain management. Ketamine is a hallucinogen and has significant safety concerns associated with its’ usage in chronic therapy. This is true especially when an out-patient may engage in activities where cognitive impairment is dangerous,such as driving. This study is designed to measure the plasma concentrations of ketamine and its active metabolite, norketamine, in people taking low dose oral ketamine for chronic pain. The goal of the study is to verify that low dose oral ketamine can be safely used for the treatment of chronic pain and produces plasma concentrations below that associated with toxic symptoms. Our eventual goal is to conduct a clinical trial of low dose oral ketamine in chronic pain patients. Information gained in this pilot study will help us design the future study and support a grant application.
Principal Investigator: Dr. Ramesh Vedagiri Sai
Co-investigators: Dr. I. Singh, Dr. P. Jones, Dr. D. Nguyen & Ms. R. Adam
Study Title: Onset of labor epidural analgesia with low dose bupivacaine and different doses of fentanyl: a randomized double blinded clinical trial
Low concentrations of local anesthetic in combination with opioids are commonly used in labor epidural solutions to provide pain relief and they have been shown to decrease motor block without affecting labor pain relief, although they have a slower onset of pain relief. There is some evidence that the addition of more fentanyl to the initial epidural bolus of local anesthetic at the start of labor epidural analgesia can speed onset of pain relief. This study compares the onset of labor epidural analgesia when using low dose bupivacaine with 3 different doses of fentanyl in laboring healthy pregnant patients at term gestational age with healthy singleton fetuses.
Principal Investigator: Dr. Ray Jian Zhou
Co-investigators: Dr. C. Clarke, Dr. G. Nicolaou & Dr. T. Forbes
Study Title: Comparing Transcutaneous to Transdural Near-Infrared Spectroscopy for Detection of Regional Spinal Cord Ischemia in a Porcine model
Spinal cord ischemia leading to paralysis is a dreaded complication after thoracoabdominal aortic and spine column surgeries. Near-infrared spectroscopy (NIRS) has been shown in some animal studies and human case reports to be have the potential to be efficacious at measuring spinal cord oxygenation. If a decrease in oxygenation is detected anesthesia and surgery may be able to intervene to improve oxygenation. The goal of this study is to determine the usefulness of the NIRS monitor for determining cord ischemia when applied to the skin overlying the spinal cord by comparing it to monitors placed directly on the spinal cord in experimental pigs.
Principal Investigator: Dr. Shalini Dhir
Co-investigators: Dr. R. Sharma
Study Title: Incidence of hemidiaphragmatic palsy after single shot interscalene block for pain relief in shoulder surgery
Interscalene block (ISB) is routinely performed on patients booked for shoulder procedures and planned for same day discharge as a single shot technique. There is a high incidence of phrenic nerve involvement after an ISB resulting in paralysis of half of the diaphragm. This will be an observational study to find out the incidence of hemi-diaphragmatic palsy associated with interscalene block done under ultrasound guidance.
Principal Investigator: Dr. Chris Harle
Co-investigators: Dr. B. Sischek, Dr. D. Cheng, Dr. G. Nicolaou, Dr. P. Jones & Ms. S. Jansen
Study Title: A survey of the management of narcotics in the operating rooms of Canadian academic health sciences centres
Federal legislation exists regarding the storage, administration, documentation and return of unused narcotics. This legislation is not explicit with regards to the OR environment, and is poorly understood. We aim to survey Canadian Academic Health Sciences Centres to get a snap shot of current practices to aid in suggesting national guidelines. We will also survey these centers to define the incidence of narcotic diversion in the operating.
Principal Investigator: Dr. Ahmed Hegazy
Co-investigators: Dr. P. Jones, Dr. L. Champion, Dr. C. Benson, Dr. A. Igric, Dr. S. Thayapararojah & Dr. B. Young
Study Title: Therapeutic hypothermia after PEA cardiac arrest, does it work? A case-control study
1. After successful resuscitation from certain types of cardiac arrest, total body cooling is now a well established treatment that improves the chances of the brain recovering. This however, has only been definitively proven after a certain type of cardiac arrest that is “ventricular fibrillation / ventricular tachycardia”. The purpose of this study is to explore if total body cooling is beneficial for patients recovering from another type of cardiac arrest that is “pulseless electrical activity”.
2. After successful resuscitation from cardiac arrest, cooling the whole body is a well established treatment that improves the chances of the brain recovering. This however, has to be done within a certain time-frame from the arrest. The purpose of this study is to explore the best way of dosing the muscle relaxing medications that are given during the cooling process.
Principal Investigator: Dr. Arif Al-Areibi
Co-investigators: Dr. N. Badner & Dr. J. Landry
Study Title: Aortic stenosis and non-cardiac surgery: are clinical or echocardiographic findings more predictive of post-operative outcomes?
Principal Investigator: Dr. Shalini Dhir
Co-investigators: Dr. P. Mack & Dr. Jon Brookes
Study Title: A randomized comparison of infraclavicular and supraclavicular block for elbow surgery: a randomized single blinded study
Principal Investigator: Dr. Mohammed Ismail
Co-investigators: Dr. J. Murkin
Study Title: A randomized study comparing low does vasopressin infusion or placebo on (NIRS) and (VOT) in cardiac patients during CPB
Principal Investigator: Dr. Kamal Kumar
Co-investigators: Dr. I. Singh, Dr. P. Jones, Dr. K. Marmai & Ms. S. Rehole
Study Title: Efficacy of two doses of epidural morphine for analgesia after traumatic vaginal delivery
Principal Investigator: Dr. Radhakrishnan Muthuchellappan
Co-investigators: Dr. R. Craen, Dr. R. Lavi, Dr. D. Bainbridge, Dr. C. Romagnoli, Dr. A. Hegazy & Dr. M. Banasch
Study Title: Gastric volume assessment with 2D & 3D ultrasound - a feasibility study
Principal Investigator: Dr. Craig Railton
Study Title: Is there an adverse drug reaction between renin-angiotensin blockade and inhaled anesthetics?