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Dr. Ron George part of study funded by CIHR at $1.3 million (Jan. 31, 2018)

The Canadian Institutes of Health Research (CIHR) recently awarded $1.39 million to support a study where the Department’s Dr. Ron George is a co-investigator.

Dr. George, and his colleagues, will aim to better understand the risks, underlying reasons and impact of a new disability in people who are over 65 years-old and had a major surgery.  The study, based out of St. Michael’s Hospital in Toronto, will include 2,000 patients having major surgery in 10 hospitals across Canada.

The grant proposal ranked third out of 66 in the evaluation process.

The project is titled: The Functional Improvement Trajectories After Surgery (FIT After Surgery) Study: A Multicentre Prospective Cohort Study to Evaluate the Incidence, Trajectories, Risk Factors, Impact and Healthcare Costs Related to Significant New Disability after Major Elective Surgery

Principal Applicants: D. N. Wijeysundera; S. Alibhai; P. Jüni; D. I. McIsaac

Co-Applicants & Collaborators: W. Scott Beattie; R. Breau; V. Chan; P. Choi; S. Choi; H. Clarke; I. Dhalla; H. El Beheiry; R. George; W. Isaranuwatchai; S. Johnson; E. Kennedy; K. Ladha; M. Lalu; G. Lebovic; D. Mazer; S. McCluskey; M. Puts; A. Wei; M. Herridge; W. Morris; A. Nathens

Departure from traditional surgery preparation leads to faster recovery, better patient experience. (Jan. 30, 2018)

The Department of Anesthesia, Pain Management and Perioperative Medicine’s, Dr. Dolores McKeen, is leading the new program that will help patients prepare for surgery, recover faster and shorten hospital stays.  Dr. McKeen is Associate Chief of the Department of Women's & Obstetric Anesthesia and the Associate Director of Women's & Obstetric Research at the IWK Health Centre.

Despite improvements in surgical technique, anesthesia and perioperative care, surgery places a high level of stress on the body before, during and after a procedure. On February 1, 2018 the IWK will become the first health centre in the Maritimes to implement Enhanced Recovery After Surgery (ERAS). The program is designed to help patients prepare for surgery, promote faster recovery and shorten hospital stays. Hospitals where ERAS is used have significantly fewer complications and better patient outcomes and experience.

“ERAS care requires the teamwork of a number of groups of doctors, nurses and health care providers; care that is focused and proven to help patients get ready and recover from surgery,” says Dr. Dolores McKeen, Associate Chief of the Department of Women's & Obstetric Anesthesia and the Associate Director of Women's & Obstetric Research at the IWK Health Centre. “We all have equal and important parts to play helping patients through their perioperative experience, while listening to what patients need and can do themselves, to heal faster."

Drawing from best practices and evidence from around the world, ERAS improves patient care through patient education, nutrition, mobility after surgery, fluid management, anesthesia and pain control. ERAS also makes patients part of the team by asking them to become partners in their care, involving them in preparation for their surgery and post-operative recovery. It helps patients stay strong, improves their outcomes, reduces complication and creates a better patient experience.

The key principles of the ERAS protocol include preoperative counselling and nutrition, the avoidance of fasting, carbohydrate loading up to hours before surgery, standardized anesthetic and analgesic regimens (that emphasizes non-opioid analgesia) and early mobilization of the patient. The program will be applied to a number of surgeries within the women’s program of the health centre including urogynaecology and gynaecology surgeries. Each year, approximately 500 uro-gynaecology surgeries are performed at the IWK.

Dr. Javeria Hashmi awarded $175,500 grant for fibromyalgia research (December, 2017)

Congratulations to Dr. Javeria Hashmi (PhD), Assistant Professor with the Department of Anesthesia, Pain Management and Perioperative Medicine for receiving a $175,000 grant to support her research project titled: “Brain mechanisms of expectation and their role in pain sensitivity and hypervigilance in fibromyalgia”. The grant was provided by the Nova Scotia Health Authority, Research Services, based on an anonymous bequest to the QEII Foundation for a one-time funding competition.

More about the research:

It is estimated that 25% of Canadians suffer from a persistent type of pain called chronic pain that is not relieved with standard analgesics. In people suffering with fibromyalgia (FM), chronic pain occurs in the absence of any specific issue injury. Pain is a primary symptom in chronic pain while any objectively measurable tissue symptoms are generally absent, the subjective nature of chronic pain is problematic for both diagnosis and treatment. This situation can be improved by the identification of reproducible and robust biological measure (biomarker) that can objectively classify a patient based on presence or absence of chronic pain. 

The etiology of FM is unclear and a better understanding of mechanisms will benefit patients and clinicians. Functional brain magnetic resonance imaging (fMRI) offers unique opportunities to understand how the brain contributes to specific clinical features of FM such as hypervigilance and fear avoidance of pain. Prior brain imaging studies of FM have shown changes in the function and structure of the brain. These changes occur particularly within regions that play a central role in altering pain intensity to fit with expectations. Whether dysfunction in these systems results in maladaptive expectations and hypervigilance in FM has not yet been fully investigated.  

The aim of this study is to establish whether FM is associated with a dysfunction in of brain’s systems that control pain intensity in response to expectations. A dysfunction in this system may underlie maladaptive learning and exaggerated anticipatory responses to pain which in turn may result in pain sensitivity and clinical FM pain. We will use an experimental model of associative learning to test how expectations are formed through learning associations, how changes in expectation modify pain intensity and how expectations can be reversed or extinguished in persons with FM and matched controls. We will also map brain responses and brain connectivity using fMRI to observe how the systems that control pain intensity are engaged during our experimental model. To identify aberrant functioning within this system, we will observe how these features differ between FM and healthy participants and how the discriminative features contribute to FM related pain sensitivity, hypervigilance and fear of pain. The long-term goal of our research is to develop fMRI measures of brain connectivity that can serve as diagnostic and prognostic biomarkers for FM and indicators of treatment efficacy.

Researchers Target Cannabinoid Receptors with New Line of Pain-Relief Products (December 18, 2017)

As the clock ticks down to the July 1 deadline when recreational marijuana will be legalized in Canada, governments are scrambling and the controversy is mounting among those who want a say in how it will be grown, sold and regulated.

Meanwhile, tens of thousands of Canadians — people who are living with chronic pain — are wondering when their needs will be met. They are desperate for safe and effective pain treatments that will not turn them into drug addicts.

Pain specialists and scientists at Dalhousie Medical School are on the brink of answering that call. They’ve launched a company, Panag Pharma Inc., through which they’re developing a list of non-addictive pain-relieving products containing cannabinoids and similar compounds found in cannabis and other plants.

FULL STORY - https://www.dal.ca/news/2017/12/18/dal-researchers-target-cannabinoid-receptors-with-new-line-of-pa.html

Arthritis Society funds Dr. Jason McDougall's joint neuropathic pain research December, 2017

Department researcher, Dr. Jason McDougall (PhD), is one of only seven researchers in Canada to receive a 2017 Arthritis Society research grant.

The grant supports Dr. McDougall’s project, "Sex Differences in Joint Neuropathic Pain Involve NaV1.8 Ion Channels” and was valued at $351,100 for 2018-2021.

Dr. McDougall’s project aims to use fundamental science to answer the patient-oriented research question of how to improve pain relief for osteoarthritis. The research may point towards new and sex-specific targets for drugs used to treat joint neuropathic pain.

In early 2017, the Department’s internal Anesthesia Research Fund provided Dr. McDougall with seed funding. This follow-up grant is a testament to the value and importance of supporting Department researchers in the early phases of their research.

The Arthritis Society funds the most scientifically meritorious research proposals that offer the greatest hope for improvements in our ability to diagnose, prevent, treat, repair and lead to a cure for arthritis.

Congratulations Dr. McDougall!