Support teaching, research, and patient care.
1. Acute and Chronic Pain Management: Focused Ultrasound for Peripheral NeuromodulationPoorly controlled acute and chronic pain are common and significant sources of patient morbidity. Inadequate control of postoperative pain is a risk factor for worsened patient outcomes, and 5% to 80% of patients will develop chronic pain after surgery. Novel, safe, and effective methods to improve and prevent acute and chronic pain are needed. Focused ultrasound (FUS) can modulate central and peripheral nervous system structures. Most FUS research is concentrated on its utility for transcranial modulation of neural structures and ablation of tissues. However, there is evidence that it can also alter peripheral nerve conduction, including compound action potential depression in a manner similar to local anesthetics. However, no work has yet been published assessing its effects on acute or chronic pain, nor whether it is able to differentially modulate different classes of nerve fibers. We are interested in the potential of focused ultrasound to modulate peripheral nerves and improve both acute and chronic pain.2. Pediatric Perioperative OutcomesChronic pain and opioid use are major public health issues in the United States and internationally. Those who use opioids chronically and patients with chronic pain are more likely to have worsened health and require more medical care. Both adults and children who undergo surgery are at increased risk of prolonged opioid use after surgery and chronic post-surgical pain. While these issues have been well-studied in adult patients, far fewer studies exist in pediatric surgical populations. As more than six million inpatient and outpatient pediatric surgical procedures take place in the U.S. each year, it is imperative to understand the risk of prolonged opioid use and chronic pain after surgery in this vulnerable and understudied population and to design and investigate interventions to decrease these risks. We are working with several healthcare datasets assessing the risk of prolonged opioid use after surgery and chronic post-surgical pain in children. Our goal is to understand how various perioperative pain management strategies affect outcomes in children who undergo surgery. We are further interested in whether disparities exist in the perioperative pain management of children of different races, ethnicities, and socioeconomic status.