Request for Funding

Medical Student Research Fellowship for Summer 2002

Mentor: Paul F. White, PhD, MD
Department: Anesthesiology & Pain Management
Room number: F2.208
Mail Code: 9068
Phone number: 214-648-6424
E-mail: paul.white@utsouthwestern.edu

2 projects:
Project 1 title: The effect of remifentanil during electroconvulsive therapy (ECT): a randomized, double- blind, placebo-controlled study

Human subjects IRB approved project number (where applicable): 1001-517

Animal subjects IRB approved project number (where applicable):

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects): Patient-based research

Brief Description of Project:

Remifentanil is a potent new rapid and short-acting opioid analgesic which possesses sympatholytic properties and anesthetic-sparing effects. Therefore, we have proposed a placebo-controlled, dose-ranging cross-over study to evaluate the effect of remifentanil on the acute hemodynamic response, the anesthetic requirement, the duration of EEG seizure activity, and the recovery profile of outpatients undergoing electroconvulsive therapy (ECT) procedures for depression. Patients will receive either saline (control), remifentanil 25, 50 or 100 µg IV as an adjuvant to the standard anesthetic drugs for consecutive ECT treatment sessions.

Project 2 title: A prospective, controlled trial to evaluate the efficacy and safety of a fast-track discharge strategy in patients undergoing laparoscopic nephrectomy

Human subjects IRB approved project number (where applicable): pending

Animal subjects IRB approved project number (where applicable):

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects): Patient-based research

Brief Description of Project:

Fast-tracking anesthetic and surgical techniques have been developed to facilitate the perioperative process and allow surgical patients to be discharged earlier from the hospital. We will be evaluating a novel multi-modal regimen for pain management and early resumption of oral alimentation in patients undergoing laparoscopic nephrectomy procedures. Patients will be pre-assigned to either a fast-track or conventional recovery paradigm. The goal of fast-tracking would be to achieve discharge on the morning after surgery (23 h) and outcomes will be compared to a control group undergoing the usual 2-3 days "in hospital" recovery period with respect to postoperative complications, costs, and patient satisfaction.

Previous Research Activities or Publications with Medical Students:

Song D, Singh H, White PF, Gadhiali M, Griffin, JD, Klein KW: Optimal dose of nicardipine for maintenance of hemodynamic stability after tracheal intubation and skin incision. Anesth Analg 1997; 85: 1247-51.

Song D, Heise DA, White PF: Facial electromyography correlates with the level of sedation and pain in outpatients undergoing lithotripsy. Anesthesiology 1998; 89: A928.

Fredman B, d'Etienne BA, Taylor E, Smith I, White PF: Use of low-dose propofol vs methohexital for electroconvulsive therapy. Anesth Analg 1994; 78: S120.

Zarate E, Watcha MF, White PF, Klein KW, Sá Rêgo M, Stewart DG: A comparison of the costs and efficacy of ondansetron versus dolasetron for antiemetic prophylaxis. Anesth Analg 2000 90: 1352-8.

Shao X, Li H, White PF, Klein KW, Kulstad C, Owens A: Bisulfite-containing propofol: is it a cost-effective alternative to DiprivanÔ for induction of anesthesia?. Anesth Analg 2000; 91: 871-5.

Coloma M, Markowitz SD, White PF, Whitten CW, Berrisford SB: Effect of dexamethasone on the prophylactic antiemetic activity of dolasetron. Anesthesiology 2001; 95: A-40.

Kadar AG, Ing CH, White PF, Wakefield CA, Kramer BA, Clark K: Anesthesia for electroconvulsive therapy in obese patients. Anesth Analg 2002; 94: 360-1.

Issioui T, Klein KW, White PF, Watcha MF, Skrivanek GD, Jones SB, Hu J, Marple BF, Ing C: Cost-efficacy of rofecoxib versus acetaminophen for preventing pain after ambulatory surgery. Anesthesiology (in press).

Coloma M, White PF, Markowitz SD, Whitten CW, Macaluso A, Berrisford S, Thornton K: Dexamethasone in combination with dolasetron for prophylaxis in the ambulatory setting: effect on outcome after laparoscopic cholecystectomy. Anesthesiology (in press).

Issioui T, White PF, Jones SB, Coleman JE, Waddle JP, Markowitz SD, Coloma M, Macalusco AD, Skrivanek GD, Ing CH: The comparative efficacy of acustimulation (ReliefBandÒ) and ondansetron (ZofranÒ) in preventing nausea and vomiting after plastic surgery. Anesthesiology (submitted for publication).

Coloma M, White PF, Ogunnaike BO, Markowitz SD, Brown PM, Lee AQ, Jones SB, Jones DB, Berrisford SB, Wakefield CA: Comparison of acustimulation and ondansetron for the treatment of established postoperative nausea and vomiting. Anesthesiology (submitted for publication).

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