Clinical research within the Department of Anesthesiology & Peioperative Care is geared with a single purpose in mind, improving patient outcomes. This is accomplished through different avenues and in diverse patient populations with funding from the department, National Institutes of Health, foundations and industry. Research to improve patient outcomes in chronic pain, acute pain, hemodynamic management and monitoring and pediatric pain and anxiety is accomplished by employing innovative techniques, assessing new monitors and interventions, and looking at how technology can be used to improve patient care.
|Areas of Interest|
|Michelle Fortier, PhD||Zeev N. Kain, MD, MBA|
|Joseph Rinehart, MD|
Regional anesthesia is a hot topic in anesthesiology of late, and the acute pain team at UC Irvine Medical Center is helping contribute to the growing body of research in this area. Comparison of different regional techniques for nerve blocks is a standard subject in this field, but we are also looking at intrinsic differences (for example, between genders and different ethnicities) within our diverse patient populations to assess ways of improving post operative recovery time. Finally, studies looking at epidural efficacy and outcomes are under development.
Investigators within the Center for Pain & Wellness at UC Irvine Health have developed new techniques to educe the amount of pain their patients experience and to improve their quality of life. This includes an array of procedures, investigations on the feasibility, the outcomes of regional techniques, new treatments.
Investigators within the department are leading both single centered and multi-centered studies to optimize patient care using hemodynamic monitoring and goal directed management. Areas of interest include, fluid optimization, and dynamic hemodynamic monitors.
Dr. Maxime Cannesson’s research focuses on the impact of perioperative hemodynamic optimization on postoperative outcome. He is now leading several multi-center outcome studies in moderate and in high-risk surgery patients in addition to leading research projects evaluating new hemodynamic monitors and new hemodynamic indices in the perioperative period. Other interests are the relationship between global and regional circulation, non-invasive cardiac output monitoring, and automation in clinical care, and he has collaborations within and outside the department on this work.
Along those lines, Dr. Joseph Rinehart’s primary clinical research interests are in new technologies and how they can be used to improve patient care. The largest study area currently underway is the development of a novel closed-loop / decision support system for IV fluid administration in the operating room. The goal is to improve physician management of patients through the use of “smart” technologies that can help guide therapy and care.
Several faculty members are involved in the study of new monitoring devices in clinical care. In addition to evaluation of function and performance across a range of patient conditions, we are looking at how these new devices can be used to reduce complications and adverse outcomes. But our work is not limited to third party devices. By using custom software to capture patient data in real-time from a variety of sources, we have begun working with new methods of vital sign analysis, including real-time EKG and arterial line waveform analysis.
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A team of investigators, at the UCI Center on Stress & Health, led by Drs. Zeev Kain and Michelle Fortier, work to reduce the amount of pain and anxiety our pediatric surgical population experience. The focus of the research investigates which behaviors impact a child’s postoperative pain and anxiety while in the postoperative recovery area and at home. They analyze the influence of preoperative behavioral interactions between children, parents and health care providers on children’s anxiety before surgery. They also look at the relationship between cultural and socio-economical variables and preoperative anxiety in children before surgery. They are also looking at how gender and temperament relate to anxiety before surgery.
Other research in this lab focuses on the treatment of pain in children at home, including the relationship of parental misconceptions regarding analgesia for children and practice of administration of pain medication following surgery. Given the diverse population of patients we serve at the hospital, exploration of the impact of cultural influences on children’s pain is also underway. A specific goal of this research is developing evidence-based interventions for pain management of children with cancer.
The incorporation of technology into pain and symptom management is also being examined. For example, new technologies that allow patients and parents to communicate in real time with their treatment team by way of remote symptom monitoring is already showing benefit. Skills training programs delivered via handheld electronic devices for children are also being studied to improve home management of pain and symptoms related to cancer and cancer treatment.
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Research in simulation and educational innovations look towards new ways of training our medical students, residents, faculty and nurses to improve patient care, reduce the amount of time to knowledge acquisition and mastery difficult skills. These activities take place both at the UC Irvine Medical Education Simulation Center, and in the Anesthesia Simulation Center, and within the medical center itself.
The UC Irvine Medical Education Simulation Center is a state-of the-art facility opened in 2010 through which faculty, residents, medical students, and others can engage in high-fidelity case simulations. Part of our mission with the simulation center is to study the efficacy of these sessions in clinical knowledge, crisis response, teamwork, and critical thinking.
Additional educational research taking place focuses on different aspects of residency and success therein. Selection of appropriate candidates is one area of interest, as there is very little evidence that the current interview process has any value in choosing the best applicants.
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