Research Projects
Name: Ling-Qun Hu, MD
Email: LingQun.Hu@osumc.edu
Department: Anesthesiology
Dept Contact Phone: (614) 293-6302
Preferred Method of Contact: Faculty Email
Previous Mentoring: Yes (funded)
Category of research: Clinical
Project: Evaluation of Pain Associated to The Epidural Tuohy Needle Insertion with Prior Administration of Subcutaneous or Intradermal Lidocaine in Parturient Women Requesting Epidural Analgesia for Laboring Pain.
Research Description: Prospective, Single-Center, Randomized, Double-Blind, Clinical Trial. Needle apprehension and needle phobias are serious conditions that pose a significant barrier to providing necessary medical care and may lead to avoidable complications for both the mother and fetus during pregnancy. To minimize pain, healthcare professionals often administer local anesthetic intradermally via fine needles before epidural placement and reduce pain during the insertion of a spinal or epidural needle (Tuohy). The level of painful response to an injection of lidocaine can vary based on several factors such as the size of the needle, the speed of the injection, and the individual’s pain tolerance. While clinicians must minimize pain experienced by the patient, reflexive pain behaviors such as crying or withdrawing from the painful stimuli make it challenging to complete procedures such as epidurals, requiring physicians to reposition the patient and wait until he is calm enough to proceed with the injection. This pilot study aims to explore the differences between the pain associated with epidural Tuohy needle insertion with prior administration of subcutaneous or intradermal lidocaine using two different pain assessment tools, Numeric Pain Rating Scale (NRS) and Critical-Care Pain Observation Tool (CPOT), in parturient women requesting epidural analgesia for laboring pain.
Specific areas of Research Emphasis: Clinical research, anesthesiology, obstetric anesthesia, pain management.
Name: Ling-Qun Hu, MD
Email: LingQun.Hu@osumc.edu
Department: Anesthesiology
Dept Contact Phone: (614) 293-6302
Preferred Method of Contact: Faculty Email
Previous Mentoring: Yes (funded)
Category of research: Clinical
Project: The Association Between Primary Language and Health Care Outcomes in Parturients
Research Description: A retrospective study. Patient language is an understudied sociodemographic factor that is associated with disparities in healthcare, particularly regarding analgesic usage during childbirth. Indeed, Spanish and other-language-speaking women have been found to have significantly higher odds of undergoing cesarean delivery compared to English-speaking women (fully adjusted odds ratio of 1.75), even when other factors such as race/ethnicity, insurance type, maternal age, and more are controlled for. Given that women have described childbirth as severely painful, it is essential to provide appropriate analgesic usage through epidural analgesia, which is considered the gold standard of labor pain management. Additionally, the use of community-based bilingual doulas has been shown to improve the quality of analgesia care for migrant women who do not speak the host language. With the potential discovery of language-matching providers and patients, it may be necessary to reevaluate the way to handle communication among non-English speaking patients and to seek a potential option of bilingual care providers in our medical community.
Specific areas of Research Emphasis: Clinical research, anesthesiology, obstetric anesthesia, pain management.
Name: Suren Soghomonyan, MD, PhD
Email: Suren.Soghomonyan@osumc.edu
Department: Anesthesiology
Dept Contact Phone: (614) 366-4805
Preferred Method of Contact: Faculty Email
Previous Mentoring: Yes (funded)
Category of research: Clinical
Project: ETT 180: Stylet-loaded Endotracheal Tube Rotation before Insertion to Decrease the Risk of Postoperative Sore Throat
Research Description: A randomized, double-blind, prospective study. Intubation with a stylet is the standard of care under general anesthesia to respect potentially difficult intubation and risk to life without the accuracy of its prediction. Serious stylet injury is a well-known airway complication in anesthesia practice and the literature reports indicate that the incidence of post-anesthesia sore throat following insertion of an ETT loaded with a stylet under general anesthesia (GA) reaches 50-62%, which is 5 times higher when compared to intubation without a stylet. The proposed mechanisms of postoperative sore throat after intubation include the load resulting from stylet removal, as well as the high focal pressure on the anterior wall of the trachea from the stylet-loaded ETT during its insertion because of the rigidity of the stylet and poor or impossible alignment of oral-pharyngeal-tracheal axes. A novel maneuver has been described to decrease the insult from stylet named ETT 180; a clockwise rotation of the stylet-loaded ETT 180 degrees on its axis right after the tip of ETT passes the patient’s vocal cords (glottis) before fully inserting the ETT and then, pulling the stylet out and allowing the stylet to match the posterior angulation of the trachea. We aim to compare the new intubation technique (McGrath laryngoscopy combined with ETT 180 maneuver) with the conventional intubation with and without using a stylet.
Specific areas of Research Emphasis: Clinical research, general anesthesia, airway management.
Name: Michelle L Humeidan, MD, PhD
Email: Michelle.Humeidan@osumc.edu
Department: Anesthesiology
Dept Contact Phone: (614) 293-7308
Preferred Method of Contact: Faculty Email
Previous Mentoring: Yes (funded)
Category of research: Clinical
Project: Investigation of a novel quantitative measure of preoperative cognitive reserve in older surgical patients: A Feasibility Study
Research Description: The growing number of US adults over the age of 65, accounts for approximately half of all patients having surgery. Notably, as many as 50% of older postoperative patients experience the alterations in attention and cognition characteristic of delirium, and morbidity and mortality rates are increased in patients with postoperative delirium, bringing significant costs, both personal and financial, to patients, families, and the healthcare system. Patients with diminished cognitive reserve are at increased risk for postoperative delirium, leading to longer hospital length of stay and a lower likelihood of discharge to home. Therefore, an assessment to quantify cognitive reserve and stratify postoperative delirium risk could have several benefits, bringing novel delirium risk stratification opportunities for patients who perform above the cutoff for impairment on standard cognitive testing. In addition to metrics for the quantity and duration of games played in each cognitive domain, the brain exercise application collects data on player performance across the various domains to generate a standardized metric called the Lumosity Performance Index (LPI) to allow for comparison of performance across users. Participants in this feasibility trial will serve as a pilot population to estimate postoperative delirium incidence in patients willing and able to complete the brief, self-directed, brain exercise experience on a portable electronic device in various preoperative encounters, and will provide insight into which preoperative encounters may be more conducive to brief preoperative cognitive evaluations and interventions in future studies
Specific areas of Research Emphasis: Clinical research, preoperative evaluation, and postoperative outcomes.
Name: Erica Stein, MD
Email: Erica.Stein@osumc.edu
Department: Anesthesiology
Dept Contact Phone: (614) 293-8487
Preferred Method of Contact: Faculty Email
Previous Mentoring: Yes (funded)
Category of research: Clinical
Project: Efficacy of Bilateral Pecto-Intercostal Fascial Plane Block on Postoperative Pain in Adult Patients Undergoing Open Heart Surgery.
Research Description: This is a randomized, double-blind, controlled trial. Sternotomy is considered the gold standard surgical technique in open heart surgery because it allows for proper surgical visualization and exposure of the heart to perform various types of thoracic surgeries. The literature reports an incidence of moderate to severe acute post-sternotomy pain as high as 78% during the first 48 hours. This acute pain usually increases during movement, deep breathing, and/or coughing, and it could last up to a week post-surgery. In addition, the presence of chest and mediastinal tubes could trigger parietal pleura and pericardial irritation that enhances the pain intensity. Also, a persistent pain located at the median sternotomy location after open-heart surgery and lasting at least 2 months, has been described as post-sternotomy pain syndrome (PSPS) that could have nociceptive or neuropathic components. Recent studies in regional analgesic techniques for perioperative regimens on cardiac surgery patients, additionally to conventional pain management with nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids are showing favorable outcomes. The ultrasound-guided bilateral pecto-intercostal fascial block (PIFB) is a novel minimally invasive technique that clinicians have been using as a promising nerve block technique as part of a multimodal postoperative analgesia regimen.
Specific areas of Research Emphasis: Clinical research, cardiovascular anesthesia, and pain management.
Name: Jasmine N Ryu, MD
Email: Jasmine.Ryu@osumc.edu
Department: Anesthesiology
Dept Contact Phone: (614) 293-0827
Preferred Method of Contact: Faculty Email
Previous Mentoring: Yes (funded)
Category of research: Clinical
Project: Early Extubation in the Operating Room in Adults with Congenital Heart Disease After Cardiac Surgery.
Research Description: This is a retrospective, single-center study. Adults with congenital heart disease are living longer into adulthood than ever before making cardiac and noncardiac surgery increasingly common in this unique population. These patients historically have continued to receive care at children’s hospitals into adulthood because pediatric cardiothoracic surgeons and anesthesiologists have been more familiar with their physiologies. But, more recently, the care of these patients is moving to adult hospitals where access to age and size-appropriate equipment is more readily available, and clinical and surgical providers have expertise regarding adult-specific comorbid conditions. Despite this, almost half of all adult congenital heart disease (ACHD) patients still experience a gap in care, because of the slow transition from pediatric to adult hospitals. Although early extubation after cardiac surgery has been a common practice in pediatric hospitals, maintaining this practice in adults during the transition to adult hospitals has been difficult due to historical norms in adults undergoing cardiac surgery without congenital disease. Early extubation (EE) of postoperative heart surgery patients further minimizes deleterious ventilation times for all adults undergoing cardiac surgery and has been associated with shorter ICU and overall hospital stays and decreased resource use. In December 2019, our institution implemented a multidisciplinary ACHD cardiac surgery program. Part of this program included the goal of EE in the operating room after surgery. However, in patients with ACHD, little is known about the safety, clinical effectiveness, and healthcare cost implications of EE. This retrospective study of the ACHD patients who underwent cardiac surgical intervention at The Ohio State University Wexner Medical Center since the implementation of the ACHD program between December 2019 and February 2022 to compare the length of stay (LOS) of ACDH patients from the early extubation (EE) and conventional extubation (CE) groups.
Specific areas of Research Emphasis: Clinical research, cardiovascular anesthesia, and postoperative care.
Name: Hamdy Elsayed-Awad, MD
Email: Hamdy.Elsayed-Awad@osumc.edu
Department: Anesthesiology
Dept Contact Phone: (614) 366-9076
Preferred Method of Contact: Faculty Email
Previous Mentoring: Yes (funded)
Category of research: Clinical
Project: Spinal drain for spinal cord injury and paralysis in open and endovascular thoracoabdominal aortic aneurysm repair
Research Description: This is a retrospective, single-center study, using the electronic medical records of patients from the Ohio State University Wexner Medical Center (OSUWMC). Spinal cord injury (SCI) is an important and devastating complication of repair of thoracoabdominal aortic aneurysm (TAAA), with rates as high as 22% in open TAAA repair and 19% in thoracic endovascular aortic repair (TEVAR). Although SCI may present with immediate paralysis at emergence from anesthesia, 66% of SCI in TEVAR present > 24 hours after surgery. The blood supply to the spinal cord is arguably more complex than the blood supply to any other vital organ, and the pathophysiology of SCI after TAAA repair remains incompletely understood. In 2010, the American Heart Association/American College of Cardiology Foundation guidelines recommended cerebral spinal fluid (CSF) drainage for open and endovascular TAAA repair for the prevention of SCI, however, the indications and protocols for the use of CSF drainage during TEVAR vary widely between institutions across the USA and around the globe. While many papers have been published to describe the use and outcomes of CSF drain for the prevention and management of SCI, the optimal timing of drain placement remains uncertain. Practices in current use include drain placement the day before surgery, the day of surgery (to reduce hospital bed utilization and cost), or post-operatively. For patients with delayed SCI, postoperative spinal drain placement within 1-2 hour of onset provides a benefit. The goal of the study is to compare outcomes of patients who underwent open or endovascular repair of TAAA.
Specific areas of Research Emphasis: Clinical research, cardiovascular anesthesia, spinal cord injury, and postoperative care.