Department of Anesthesiology

News & Events

Dr. Jacek Wojtczak Publishes in Journal of Anesthesiology & Clinical Science

October 30th, 2014

Dr. Jacek Wojtczak, together with Dr. Davide Cattano and his group, have published the article, “External neck landmark identification and measurement correlation in a normal weight cohort” in Volume 3, Article 7 of the Journal of Anesthesiology & Clinical Science

Abstract:

Background:  Airway management, including proper airway devices sizing, is dependent on airway features, which ultimately should correlate with body features: unfortunately such correlation has been inconsistent.  The aim of this study was to determine the correlation of normal values of several external neck landmark (airway features) measurements with age, gender, height and weight (body features) for normal weight adult subjects to establish a consistent correlation.

Methods:  After IRB approval, 200 subjects (100 male and 100 female) were enrolled.  External neck landmarks were measured using a measuring tape.  Measurements were also assessed by digital caliper to compare marginal errors.  Only non-obese (BMI <30 kg/m2) adults presenting for preoperative anesthesia assessment were screened.

Results:  A total of 200 subjects completed the study.  The difference between female and male hyocricoid distance (6.0+1.3 cm and 6.5+1.4 cm; P<0.01) and thyroid width (4.9+0.8 cm and 5.3+ 0.7 cm; P<0.001) was statistically significant.  Univariate regression analysis demonstrated ENLs measurements were correlated with different physical characteristics except the occipital distance which did not provide any correlation with the airway anatomical variables.

Conclusion:  There was a significant correlation between: thyromental, hyoidcricoid and thyroid width distances with height and weight (P<0.0001); thyroid height and throcricoid distances with height (P=0.027 and P=0.008, respectively); hyoidmental with age (P=0.037), and sternomental distance with height and age (P<0.0001).  Results from multivariate regression provided interesting insight into the association between each ENL, airway features and physical characteristics.  These findings may be useful to determine prediction models of important neck landmarks measurements when actual measurements are not feasible.

 

Dr. Zana Borovcanin Recipient of 2014 MCIC “Risk Reduction Awards Program” Grant

October 23rd, 2014

Dr. Zana Borovcanin has been awarded a $50,000 grant from the MCIC Risk Reduction Awards Program.  MCIC Vermont, Inc. is the medical malpractice carrier for the University of Rochester Medical Center.  Part of the MCIC mission is to prevent harm that leads to litigation.  As a part of the MCIC 2014 strategic plan, funding is available for projects that propose innovative ways in reducing risk.  Dr. Borovcanin’s project, “Implementation and Evaluation of URMC Difficult Airway Response Team (DART)”, will help establish a DART team at URMC, which will be capable of delivering the highest-quality and safest care during difficult airway management at our institution. 

 

Congratulations to Dr. Borovcanin and co-investigators:  Janine Shapiro, MD, Sarah Peyre, EdD, Oren Harary, MBA, MPH, and Changyong Feng, PhD

 

 

 

Residency Program 1st Place in Lifebox Challenge!

October 16th, 2014

Announced in October, 2013, the first Annual Resident Lifebox Challenge is an initiative of the ASA Resident Component to engage U.S. anesthesiology residents in support of the global safe surgery program of the Lifebox Foundation.  ASA's Charitable Foundation serves as the platform for the resident fundraising activities. 

At the 2014 ASA annual meeting in New Orleans, it was announced that the University of Rochester Residency Program swept the competition (11 other academic programs participated) in both total contributions and per resident giving!  In addition, by raising the largest absolute dollar contribution, our program is eligible for a matching gift to increase our gift to Lifebox.  

Congratulations and thanks to all who donated!

 

Drs. Gewandter, Smith, Pawlowski, Poli, Rothstein, Williams & Dworkin Publish Article in Pain

October 2nd, 2014

Dr. Jennifer Gewandter (right), and co-authors, including Anesthesiology residents, Drs. Joseph Pawlowski, Daniel Rothstein, and Mark Williams, former resident, Dr. Joseph Poli, Dr. Shannon Smith, and Dr. Robert Dworkin published an article describing the reporting of intention-to-treat analyses in analgesic clinical trials.  The study found that the phrase “intention-to-treat” is frequently used to describe analyses that exclude randomized participants.  Recommendations to use the term “intention-to-treat” consistently to facilitate interpretation of RCTs are provided.

 

Jennifer S. Gewandter, Michael P. McDermott, Andrew McKeown, Shannon M. Smith, Joseph R. Pawlowski, Joseph J. Poli, Daniel Rothstein, Mark R. Williams, Shay Bujanover, John T. Farrar, Ian Gilron, Nathaniel P. Katz, Michael C. Rowbotham, Dennis C. Turk, Robert H. Dworkin.  Reporting of intention-to-treat analyses in recent analgesic clinical trials: ACTTION systematic review and recommendations.  Pain. In press.

 

Dr. Daryl Smith Publishes in Case Reports in Emergency Medicine

September 29th, 2014

Dr. Daryl Smith has published an article in Vol. 2014 of Case Reports in Emergency Medicine, titled “Treatment of Acute Flares of Chronic Pancreatitis Pain with Ultrasound Guided Transversus Abdominis Plane Block: A Novel Application of a Pain Management Technique in the Acute Care Setting”.  Doi:10.1155/2014/759508

Drs. Daryl Smith, Sarah Kralovic, and Garret Morris Article Accepted to ASAIO Journal

September 19th, 2014

Drs. Daryl Smith, Sarah Kralovic, Garret Morris (left) and colleagues have had their paper accepted for publication in the ASAIO Journal.  Their article is titled, “Trial Ultrasound Guided Continuous Left Stellate Ganglion Blockade Prior to Surgical Gangliolysis in a Patient with a Left Ventricular Assist Device and Intractable Ventricular Tachycardia:  A Pain Control Application to a Complex Hemodynamic Condition”.

 

Drs. Glance and Wissler's Article Featured in Several News Outlets, Including an Interview with NPR

September 11, 2014

Drs. Laurent Glance and Richard Wissler's article in Health Affairs on obstetrical outcomes has been featured in several media outlets. 

Titled, “Study: Wide hospital quality gap on maternity care”, it was featured with the Associated Press, ABC News, FoxNews, HealthDay, Intelihealth, KWTX, Medbroadcast, Medscape, North Dallas Gazette, San Francisco Chronicle, US News & World Report, Washington Post, Health Affairs blog, WBUR Boston, and Fosters Daily Democrat.

Dr. Glance was also interviewed by NPR.

Link to the interview

 

Residents, Drs. Pereira and Williams Publish in Pain

September 2, 14

Dr. Anthony Pereira first-authored a literature review on the implications for chronic pain treatment of antidepressant-associated suicidal ideation and behavior that has just been accepted for publication by Pain. Dr. Mark Williams served as co-author of a literature review on acute and chronic pain associated with Lyme borreliosis that was just published in Pain. References to both of these articles appear below:

Zimering JH, Williams MR, Eiras ME, Fallon BA, Logigian EL, Dworkin RH. Acute and chronic pain associated with Lyme borreliosis: clinical characteristics and pathophysiologic mechanisms. Pain, 2014;155:1435-1438.

Pereira A, Conwell Y, Gitlin MJ, Dworkin RH. Suicidal ideation and behavior associated with antidepressant medications: implications for the treatment of chronic pain. Pain, in press.

Dr. Papadakos Grand Rounds Speaker at Drexel School of Medicine

August 14, 2014

Dr. Peter Papadakos was the Visiting Professor at the Drexel School of Medicine’s Hahnemann University Hospital in Philadelphia on July 29th.  His Perioperative Medicine Grand Rounds presentation for the Departments of Anesthesiology, Surgery and Nursing was titled, “Distracted Doctoring a Major Health Care Safety Concern”.

Dr. Papadakos Letter to Editor in Chest

August 11, 2014

Dr. Peter Papadakos published a commentary in the August issue of Chest, the journal of the American College of Chest Physicians.  In his role as Chairman of the Board of Medical Advisors which provides oversight to the American Association of Respiratory Therapists, Dr. Papadakos’ letter is in support of legislation HR 2619 before Congress to allow respiratory therapists to practice independently under the supervision of a physician to aid in the care of patients with complex respiratory diseases.  This collaboration would greatly aid in the predicted shortage of pulmonary physicians and hopefully impact on the rate of readmissions to hospitals and thus impact on health care costs.

Papadakos PJ. Board of Medical Advisors Supports HR 2619. Chest. 2014;146(2):e61-e62.

Link to Article

Drs. Glance, Wissler, and Marroquin Publish Paper in Health Affairs

August 7, 2014

Drs. Laurent Glance, Richard Wissler, Bridget Marroquin, and colleagues Drs. Dick, Glantz, Qian, Mukamel and Kellermann have published the paper, “Rates of Major Obstetrical Complications Vary Almost Fivefold Among US Hospitals”, in Health Affairs (Health Aff [Millwood]. 2014 Aug 1;33(8):1330-6. doi: 10.1377/hlthaff.2013.1359.)

Author information

  • Laurent G. Glance is vice chair for research and a professor of anesthesiology and public health sciences at the School of Medicine and Dentistry, University of Rochester, in New York.
  • Andrew W. Dick is a senior economist at the RAND Corporation in Boston, Massachusetts.
  • J. Christopher Glantz is a professor of obstetrics and gynecology at the School of Medicine and Dentistry, University of Rochester.
  • Richard N. Wissler is a professor of anesthesiology at the School of Medicine and Dentistry, University of Rochester.
  • Feng Qian is an assistant professor of health policy and management, School of Public Health, University at Albany, in New York.
  • Bridget M. Marroquin is an assistant professor of anesthesiology at the School of Medicine and Dentistry, University of Rochester.
  • Dana B. Mukamel is a professor in the Department of Medicine, University of California, Irvine.
  • Arthur L. Kellermann is a professor in and dean of the F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, in Bethesda, Maryland.

Abstract

Of the approximately four million women who give birth each year in the United States, nearly 13 percent experience one or more major complications. But the extent to which the rates of major obstetrical complications vary across hospitals in the United States is unknown. We used multivariable logistic regression models to examine the variation in obstetrical complication outcomes across US hospitals among a large, nationally representative sample of more than 750,000 obstetrical deliveries in 2010. We found that 22.55 percent of patients delivering vaginally at low-performing hospitals experienced major complications, compared to 10.42 percent of similar patients delivering vaginally at high-performing hospitals. Hospitals were classified as having low, average, or high performance based on a calculation of the relative risk that a patient would experience a major complication. Patients undergoing a cesarean delivery at low-performing hospitals had nearly five times the rate of major complications that patients undergoing a cesarean delivery at high-performing hospitals had (20.93 percent compared to 4.37 percent). Our finding that the rate of major obstetrical complications varies markedly across US hospitals should prompt clinicians and policy makers to develop comprehensive quality metrics for obstetrical care and focus on improving obstetrical outcomes.

Project HOPE—The People-to-People Health Foundation, Inc.

URMC Newsroom Article

Dr. Papadakos Publishes in Respiratory Care

July 30, 2014

Dr. Peter Papadakos’ article titled, “Electronic Distractions of the Respiratory Therapist and Their Impact on Patient Safety”, was published in the August 2014 issue of Respiratory Care.  [Respir Care 2014;59(8):1306-1309]

Dr. Papadakos’ Article on URMC Select Major News Coverage

July 10, 2014

Dr. Peter Papadakos, who was quoted in the NY Times article Google Glass Enters the Operating Room, has also been featured in URMC Select Major News Coverage.

"The display can also be used to see email and surf the web, potentially allowing doctors to take multitasking to dangerous new levels, said  Peter J. Papadakos at the University of Rochester Medical Center, who has published articles on electronic distractions in medicine."

URMC Select Major News Coverage

Dr. Lerman honored at "Sixth Salute to UB Authors"

July 2, 2014Dr. Lerman

Jerrold Lerman, MD, Chief of Clinical Research & Professor of Anesthesiology, University at Buffalo and Women & Children’s Hospital of Buffalo, was recognized by the University at Buffalo on May 5, 2014 at “An Anthology of Recognition: The Sixth Salute to UB Authors.”

The event, which honors UB authors who have published full-length scholarly books over the course of the past two years — from January 2012 through December 2013, paid tribute to more than 105 authors, contributing authors and editors.

Dr. Lerman was honored for the 5th Edition of his new textbook, “A Practice of Anesthesia for Infants and Children,” which provides complete coverage of the safe, effective administration of general and regional anesthesia to infants and children - covering standard techniques as well as the very latest advances.

Dr. Lerman has authored three textbooks with the third coming out later this year.

Congratulations, Dr. Lerman!

Click to read this article on kaleidahealth.

Dr. David Stern Mentioned in The Wall Street Journal

July 2, 2014

Excerpt: 'He points to David Stern, who is 63. Dr. Stern, an associate professor of anesthesiology at the University of Rochester Medical Center, took up the violin at age 55 when he began playing with the Rochester New Horizons orchestra. When he started, Dr. Stern recalls, he produced a sound "that the cat hated worse than the vacuum cleaner." But the same nimble fingers that allowed him to insert catheters into patients served him well on the violin.'  Read the full article from The Wall Street Journal

Dr. Jennifer Gewandter First Author on Article Pubished in PAIN

June 25, 2014

Dr. Jennifer Gewandter and co-authors published a systematic review that identified deficiencies in reporting of missing data and methods to accommodate them in analgesic clinical trials. The article provides a review of methods to accommodate missing data that are recommended by statisticians and regulators, and provides recommendations for authors, reviewers, and editors pertaining to reporting of these important statistical details.

Jennifer S. Gewandter, Michael P. McDermott, Andrew McKeown, Shannon M. Smith, Mark R. Williams, Matthew Hunsinger, John T. Farrar, Dennis C. Turk, Robert H. Dworkin

Dr. Peter Papadakos Quoted in New York Times Article and Featured on Reporte Indigo

June 4, 2014

Dr. Peter Papadakos was quoted in the Sunday, June 1st, edition of the NY Times. In an article titled, "Google Glass Enters the Operating Room", Dr. Papadakos comments, "Being able to see your laparoscopic images when you're operating face to face instead of looking across the room at a projection screen is just mind-bogglingly fantastic," he said. "But the downside is you don't want that same surgeon interacting with social media while he's operating." To read the entire article, visit the New York Times.

Dr. Papadakos was also featured on Reporte Indigo titled "Tweezers, scalpel, Smartphone?" discussing electronic distration in the operating room: 
(Translated from Spanish)

A survey of perfusionists revealed 55 percent used their cell phone during cardiac surgery.

Currently, some of the medical negligence is due to “distracted doctoring”, a phenomenon in which doctors do not release their mobile devices, even in the operating room.  Campaigns exist that talk about the risks of driving and texting at the same time . There is also talk of distraction between parents and children who are absorbed in the screens of their mobile devices.  But not enough attention is paid to another scenario where the use of mobile devices can compromise the health and endanger the lives of others:  the operating room.

To read the entire article, visit Reporte Indigo.

Dr. Jennifer Gewandter Pubishes Article in PAIN

May 27,2014

Dr. Jennifer Gewandter and co-authors published an article describing research design considerations for proof-of-concept (POC) chronic pain clinical trials, addressing both exploratory and preliminary efficacy objectives. General considerations regarding POC trials, as well as major POC trial designs and their advantages and limitations are discussed. Designs that maximize statistical power by decreasing variability in outcomes, maximizing effect size, or minimizing participant withdrawal are reviewed. This article communicates consensus recommendations from an IMMPACT (Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials) meeting of pain research experts from around the world. 

Jennifer S. Gewandter, Robert H. Dworkin, Dennis C. Turk, Michael P. McDermott, Ralf Baron, Marc R. Gastonguay, Ian Gilron, Nathaniel P. Katz, Cyrus Mehta, Srinivasa N. Raja, Stephen Senn, Charles Taylor, Penney Cowan, Paul Desjardins, Rozalina Dimitrova, Raymond Dionne, John T. Farrar, David J. Hewitt, Smriti Iyengar, Gary W. Jayr, Eija Kalso, Robert D. Kerns, Richard Leff, Michael Leong, Karin L. Petersen, Bernard M. Ravina, Christine Rauschkolb, Andrew S. C. Rice, Michael C. Rowbotham, Cristina Sampaio, Søren H. Sindrup, Joseph W. Stauffer, Ilona Steigerwald, Jonathan Stewart, Jeffrey Tobias, Rolf-Detlef Treede, Mark Wallace, Richard E. White. Research designs for proof-of-concept chronic pain clinical trials: IMMPACT recommendations. Pain, In press.

Third Annual Lawrence Educational Symposium: Focus on Sedation

May 12, 2014

Lawrence Day GroupThe third annual Lawrence Educational Symposium took place on May 8th with over 60 participants! This year’s theme was “Focus on Sedation” and 13 abstracts representing sedation cases and challenges were presented. The panel featured Drs. Michael Nead (Medicine), Joel Pasternack (Emergency Medicine), Rajbala Thakur (Anesthesiology) and Elise Van der Jagt (Pediatrics). The discussion was moderated by Dr. Suzanne Karan. Awards were presented at the end of the evening for:

  • Most novel poster presentation:  Drs. Bryce Yerman and Henry Tran for “Sedation in a minivan”
  • Poster with most academic value:  Drs. Williams, Kothari and Karan for “Challenging sedation in a patient with sickle cell disease on chronic opioid therapy

Thank you to Dr. Ruth Lawrence and her family for endowing the funds that allow our department to host this annual event in the memory of her late husband, Dr. Robert Lawrence, who was our department’s first anesthesiology resident.

Difficult Airway Workshop conducted on March 6th and May 3rd

May 8, 2014

Difficult Airway Workshop

The Difficult Airway Workshop, which is organized by Dr. Zana Borovcanin, is designed to provide residents with state-of-the-art information and hands-on experience with a wide range of established and novel airway techniques. This all-day educational activity is divided in two parts: didactic sessions in the morning followed up with hands-on workshop with eight stations in the afternoon. The last two difficult airway workshops covered multiple skill stations which included adult flexible fiberoptic intubation, airway anesthesia for awake intubation, airway exchange catheters, fiberoptic intubation via supraglottic airway using Aintree catheter, video laryngoscopes and fiberoptic stylets. There was a special station for pediatric difficult airway management covering pediatric flexible fiberoptic intubation and video laryngoscopy. Retrograde wire intubation and surgical airway - cricothyrotomy were performed in simulated airway scenarios. A percutaneous cricothyrotomy was practiced in a pig trachea lab, and conducted by Dr. Lyons. The Workshop also focused on use of endobronchial blockers and fiberoptic lung separation in the difficult airway management.

Many aspects of difficult airway management in a variety of clinical settings were highlighted during the Workshop. The goal of the Difficult Airway Workshop is also to learn to appropriately apply the ASA Difficult Airway Algorithm and to develop an understanding of the critical decision points in the course of the difficult airway management.

A special thanks to Drs. Dooley, Gloff, Kaminski, Karan, Kolano, Lyons, Tran, Tzimas, Subrahmanian and Sekhar for their participation and teaching in the last two Difficult Airway Workshops. We are grateful to Cook Medical, Karl Storz Endoscopy and Verathon Medical that provided us with their products and demonstrations.

For the full slide show of the Difficult Airway Workshop photos (March 6th and May 3rd) go to the URMC Department of Anesthesiology Facebook page.

Dr. Gail Johnson Awarded $250,000 Grant

May 8, 2014

Dr. Gail Johnson has been awarded a $250K grant from the BrightFocus Foundation for her research titled, “Nrf2 regulates tau clearance: an AD treatment strategy”. It was also featured on the Research@URMC Blog, titled: “Could Cabbage and Broccoli Help in the Fight Against Alzheimer’s?”.

Dr. Papadakos Featured in ASA Article

May 8, 2014

In a May 2014 article on the American Society of Anesthesiologists’ web site titled, “Situational Awareness, Multitasking, and Distraction in the O.R.”, Dr. Peter Papadakos was featured.  The authors state, “Recently, it was suggested by Dr. Papadakos in Anesthesia and Clinical Research that a modified CAGE questionnaire (traditionally used to assess risk factors for alcohol abuse, Table 1) could be used to identify those with a significant addiction to their personal electronic devices (PED). In effect, it would help identify those at risk of being distracted by their own actions before they entered the O.R.”

Dr. Marcin Karcz Approved for FAER Grant

April 30, 2014

Marcin KarczDr. Marcin Karcz has been approved for a Foundation for Anesthesia Education Research (FAER) Research Fellowship Grant.  His application was titled, “The role of antihistamines and nicotine metabolites in cardioprotection.”
Congratulations, Marcin!  

Dr. Jacek Wojtczak To Present At Transthoracic Ultrasound Workshop

April 21, 2014

Dr. Jacek Wojtczak will be presenting at transthoracic ultrasound workshops during the Harvard Ultrasound Course for Intensivists and Emergency Medicine Clinicians, being held April 25-27, 2014 at the Carl J. Shapiro Clinical Center at Beth Israel Decsoness Medical Center.

Specifically designed for Critical Care and Emergency Medicine Physicians, the course covers all current application of critical care ultrasound.  The course covers basic use of Transthoracic Echocardiography (TTE) in the setting of cardiac arrest/peri-resuscitation, and in the management of the patient in shock.  In addition, the course will cover emeging topics in critical care ultrasound, such as lung ultrasound for the diagnosis of pneuomothorax, pulmonary edema and pneumonia, it will review in detail the FAST Protocol, the international standard ultrasound protocol for the management of the patient with trauma.

For additional information, visit www.cme.hms.harvard.edu/courses/echocardiography.

Dr. Papadakos Assists with AORN Policy and Cited in Pacific Standard Magazine

April 21, 2014

Dr. Peter Papadakos, a leader in electronic distraction prevention, helped develop the AORN policy, "AORN Position Statement on Managing Distractions and Noise During Perioperative Patient Care", to deal with electronic distraction in the perioperative environment.  The policy was released 4/15/14 and can be found on the AORN webpage.

Dr. Papadakos was also featured in the Pacific Standard: The Science of Society in an article titled, "The Dangerous Rise of Social Media in the Operating Room."

Dr. Glance Publishes Editorial in the New England Journal of Medicine

April 10, 2014

Dr. Laurent Glance has co-authored an editorial titled, "Redesigning Surgical Decision Making for High-Risk Patients", which was published in the April 10th issue of The New England Journal of Medicine.

Glance LG, Osler TM, Neuman MD. Redesigning Surgical Decision Making for High-Risk Patients. N Engl J Med 370:15;1379-1381

Alastair J. Gillies, MD 1924-2014

April 7, 2014

Alastair Gillies

Dr. Alastair J. Gillies, the first Chair of the Department of Anesthesiology, passed away recently at the age of 89.

Dr. Gillies was educated at the University of Edinburgh and trained at the Royal Infirmary in Edinburgh.  He served on the medical staff in the RAF during the war.  As a physician, he followed in the footsteps of his father, an anesthesiologist for the Royal Family in the UK around WWII.  He joined the faculty at the University of Rochester in 1959.

During his tenure as Chair from 1969 – 1983 he helped to develop and nurture a robust department, focusing on recruitment, education, curriculum development, and research.  The Gillies Library is named for him. 

Members Of Anesthesiology Department Attend Society Of Cardiovascular Anesthesiologists Annual Meeting

April 2, 2014

This past week (March 28-April 2), Drs. Ari Balofsky, Paul Nandra, Yaser Rad, and Tarun Subrahmanian represented our department at the Society of Cardiovascular Anesthesiologists annual meeting in New Orleans, LA, and presented cases at the Complex Case Discussion session.

Dr. Rad, Dr. Subrahmanian, Dr. Carol Ann Diachun, and Dr. Andy Sifain presented the Anesthetic Management of Pre-Term Delivery in a Patient with Decompensated, Non-Ischemic Cardiomyopathy, Biventricular ICD and Bioprosthetic Tricuspid Valve.

Dr. Nandra, Dr. Subrahmanian, and Dr. Sifain presented a case of Iatrogenic Tricuspid Valve Stenosis Following a Bentall Procedure.

Dr. Balofsky, Dr. Subrahmanian, Dr. Janine Shapiro, Dr. Michael Schwartz, Dr. Todd Massey, and Dr. Sifain presented a case of Syncardia Total Artificial Heart following a Total Cardiectomy in an Orthotopic Heart Transplantation with Cardiogenic Shock.

Drs. Konstantine Tzimas, Laurent Glance, David Stern, and Michael Eaton were also in attendance.