SleepTalker October 2022

SleepTalker
Volume 38 Number 4 Stony Brook, NY  <       October 2022     
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Dr. Bennett-Guerrero Receives Award ASA Meeting Presentations Appointments and Promotions Dr. Costa attends Hispanic Leadership Institute
Dr. Kozlowski Fellowship Pediatric Anesthesiology News A Peek Behind the Pub New Publications
Where on Campus is That?
Dr. Bennett-Guerrero Receives Senior Research Excellence Award

James P. Dilger, PhD

   Dr. Elliott Bennett-Guerrero been selected as a recipient of the 2022 Senior Research Excellence Award by the Renaissance School of Medicine at Stony Brook University! The purpose of Faculty Awards such as this is to recognize and reward excellence among faculty in the various mission areas of the medical school. In her letter of notification, Vice Dean for Faculty Affairs Dr. Stella Tsirka wrote "Being considered by your colleagues as deserving of this award is a great professional accomplishment and an indication that you are highly regarded." Congratulations!

   Dr. Bennett-Guerrero is Vice Chair for Clinical Research and Innovation and the Medical Director, Perioperative Quality and Patient Safety in our department. He has been involved in many quality improvement initiatives including VTE, sepsis, mortality, diabetes, NSQIP/ERAS, readmissions, and appropriate coding and documentation of patient risk.

   During the spring 2020 COVID-19 pandemic “surge” in NY, when most clinical research was paused, Dr. Bennett-Guerrero quickly assembled several research teams to address COVID-19 related research questions. One study measured antibodies to SARS-CoV-2 in over 450 health care workers (HCW) at Stony Brook. It found that HCW with higher exposure rates were not more likely to have been infected with COVID-19, which suggests that infection of HCW results from exposure in the community rather than at work. Dr. Bennett-Guerrero also developed a multidisciplinary team at Stony Brook involving over 50 researchers including 8 medical students, to collect convalescent plasma in several hundred qualifying donors. and then randomize patients with COVID-19 infection to convalescent plasma or standard plasma. This trial was the first peer reviewed report of convalescent plasma in the United States and was published in the official journal of the Society of Critical Care Medicine. As part of these efforts, he also led published work assessing neutralizing antibodies to SARS-CoV-2, using the gold standard plaque reduction assay as well as an assay using a pseudovirus. He has authored four peer-reviews publications on his COVID-19 research.
ASA 2022 Presentations

   This year, members of our department will be presenting 13 abstracts, 23 medically challenging cases, 1 QA/QI, and 8 additional oral presentations. Notably, residents played a role 7 Abstracts and 21 Medically Challenging Cases!

Featured Abstracts
  • Jane Ahn, Zhaosheng Jin, Jerry Cuenca, Jun Lin, Tong J. Gan. Quadratus Lumborum Block for Analgesia after Renal Surgeries - A Systematic Review and Meta-analysis
  • Tiffany Angelo, Morgane Factor, Bahaa E. Daoud, Reona Kimura, Ayesha Khan, Jamie Romeiser, Elliott Bennett-Guerrero. Randomized Double-blind Clinical Trial of Oxytocin Bolus vs Infusion in Elective Cesarean Section - Inbox Study
  • Michael Hafeman, Yujie Jiang, Zhaosheng Jin, Christopher Seiter, Giacomo Frank Scorsese, Seth Greenspan, Jun Lin. Thoracic Epidural vs. Continuous Paravertebral Block for Analgesia after VATS: a Meta-analysis
  • Zhaosheng Jin, Seth Greenspan, Yujie Jiang, Christopher Seiter, Giacomo Scorsese, Jun Lin. Thoracic Paravertebral Block Versus Erector Spinae Block for Postoperative Analgesia after Video Assisted Thoracoscopic Surgery
  • Reona Kimura, Jonathon A. Schwartz, Jamie Romeiser, Darcy Halper, Lisa Senzel, Elliott Bennett-Guerrero. The Effect of Chamomile Intake on Blood Coagulation Tests in Healthy Volunteers
Abstracts
  • Jerry Cuenca, Zhaosheng Jin, Jane Ahn, Shaji P. Poovathoor, Jun Lin. Efficacy of Remimazolam for Procedural Sedation Compared to Midazolam - A Systematic Review and Meta-analysis
  • Jin Z, Lee C, Zhang K, Richman D. Utilization of wearable pedometer devices in the perioperative period- a systematic review.
  • Ana Mavarez-Martinez, Kerri Stafford, Jason Rosenfeld, Jamie Romeiser, Sergio D. Bergese, Tong J. Gan. Efficacy of Amisulpride for Treatment of Postoperative Nausea and Vomiting in Post Anesthesia Care Unit
  • Shruti Parikh, Giacomo Frank Scorsese, Shayla Mena, Kathleen Cervo, Patrick Diamond, Paul Kozlowski, Christopher Seiter, Aria Shafai, Elliot Turkiew, Morgane Giordano Factor. The Effects of Pyxis Location on the Narcotic Waste Process
  • Barbara Rogers, Nicoleta Stoicea, Wiebke Ackermann, Alberto A. Uribe, Mahmoud Abdel-Rasoul, Emery N. Brown, Sergio D. Bergese. Active Emergence from Isoflurane General Anesthesia Induced by Methylphenidate: A Randomized Placebo Controlled Pilot Trial
  • Sunitha Singh, Syed Azim, Cynthia Murtha, Lauren Walsh, Lauren Antonelli, Donna Hoffman, James Nicholson, Elliott Bennett-Guerrero. Using an ERAS Joint Replacement Pathway To Improve Urinary Management in Elective Surgical Patients
  • Sunitha Singh, Syed Azim, Cynthia Murtha, Lauren Walsh, Lauren Antonelli, Donna Hoffman, James Nicholson, Elliott Bennett-Guerrero. Adapting our Total Joint Replacement Enhanced Recovery after Surgery Program to Improve Surgical Care During a Pandemic
  • Mingxi Zhu, Paul Kozlowski, Zhaosheng Jin, Syed A. Azim, Tong J. Gan. Recovery after Spinal Anesthesia with Mepivacaine vs Bupivacaine, A Systematic Review and Meta-analysis
Medically Challenging Cases
  • Kathleen Cervo, Matthew Giuca. A Difficult Airway And Complex Pulmonary History Undergoing High Risk Surgery: How To Proceed?
  • Alexa Christophides, Victoria Redmond, Vahe S. Tateosian. Anesthetic Management of Pediatric Cerebral Aneurysm Intervention
  • Alexa Christophides, Victoria Redmond, Vahe S. Tateosian. Preoperative Predictors of Postoperative Complications in the Pediatric Population with Obstructive Sleep Apnea
  • Jerry Cuenca, Giacomo Frank Scorsese, Jeremy S. Poppers. Left Main Coronary Artery Disease Complicated by Retroperitoneal Hemorrhage with Mixed Hemorrhagic, Cardiogenic and Septic Shock
  • Jerry Cuenca, Allison McLarty, Igor Izrailtyan. Mechanical Circulatory Support for High-risk Coronary Artery Bypass Grafting
  • Neil Christopher Daksla, Tiffany E. Angelo. Perioperative Management for Cesarean Section in a Patient with Takayasu Arteritis and Mechanical Aortic Valve
  • Patrick Diamond, Christopher Gidicsin. Anesthetic Management for Thrombectomy of Saddle Pulmonary Embolism
  • Murad Elias, Ramanjot S. Kang, Amit K. Kaushal. Treatment of Umbilical Hernia Pain with Ultrasound-guided Abdominal Botox Injections
  • Carlos Figueroa, Zachary Zerrahn, Ronald C. Jasiewicz. Recurarization in an 8-week-old Infant Following Suggamadex Reversal of Rocuronium
  • Michael Hafeman, Amruta G. Desai, Robert P. Moore. High Thoracic Erector Spinae Plane (ESP) Block for Humeral Osteotomy
  • Zhaosheng Jin, Karim Shuaib, Tiffany E. Angelo. Anesthetic Management of an Alpha-gal Allergy in a Jehovah’s Witness Receiving a Total Abdominal Hysterectomy
  • Ramanjot Kang, Jerry Cuenca, David Landau, David Schulsinger, Igor Izrailtyan. Anesthetic Management of a Patient with an Infected Aortic Graft
  • Paul Kozlowski, Elliot Turkiew, Amruta G. Desai, Lesley A. Bennici, Robert P. Moore. Opioid Free Thoracolumbar Fusion in a Pediatric Patient with a Polysubstance Abuse History
  • Christopher Lee, Bahaa E. Daoud, Tiffany E. Angelo, Morgane Factor. Management of Unexpected Anaphylaxis in the Parturient
  • Shayla Mena, Ramanjot S. Kang, William M. Caldwell. Spinal Cord Stimulation for Sciatic Pain in Seronegative Neuromyelitis Optica Spectrum Disorder
  • Giacomo Scorsese, Austin Hake, Jorge Balaguer, Igor Izrailtyan. Anesthetic Management and Considerations in Prosthetic Valve Endocarditis
  • Giacomo Scorsese, Emiliya Rakhamimova, Jeremy S. Poppers. Anesthetic Management and Considerations for Debakey Type I Aortic Dissection in a Jehovah's Witness
  • Christopher Seiter, Josue Gutierrez, Angela Mironis, Jonathon A. Schwartz. Critical Care Management of Refractory Status Asthmaticus Beyond the Use of Conventional Pharmacologic Agents in an Active Smoker
  • Aria Shafai, Ryan Williams, Ankit Dhamija, Igor Izrailtyan. Intercostal Cryoablation for Post-Thoracotomy Pain
  • Aria Shafai, Eman Nada. The Use of External Oblique Intercostal Nerve Block for Post-operative Pain Control in a Patient Undergoing Radical Nephrectomy
  • Elliot Turkiew, Paul Kozlowski, Robert P. Moore. Application of a Hybrid Perioperative Medical-surgical Home Model to Achieve Care Goals for a Complex Pediatric Patient
  • Mingxi Zhu, Ankit Dhamija, Aaron Sasson, Igor Izrailtyan. Successful Intubation of Patient with Obstructive Squamous Cell Carcinoma with the Assistance of an Airway Exchange Catheter
  • Mingxi Zhu, Eman Nada. Application of Fascia Plane Blocks for Subcutaneous Implantable Defibrillator Pain
QA/QI
  • Faiza Qureshi, Xiaoxiang Zhang, Ramon E. Abola. Implementation of Automated Reporting of Anesthesia Quality Measures-phase 1
Platform Sessions
  • Eman Nada. Novel Techniques in Pain Management for Spine Surgery: Quadratus Lumborum (QL) block for Lumbar Spine Surgery
  • Eman Nada. Moderator - "Is There an Optimal Anesthetic Technique for Carotid Endarterectomy?"
  • Eman Nada. Want to do research and don't know where to start?: Writing a research protocol, background, hypothesis, and methods.
  • Deborah C. Richman. To Give or Not to Give: Perioperative Management of Medications, Substances of Abuse and Hematologic Issues: Untangling the preoperative confusion: when patients continue to take medications that should be stopped and stop essential therapies that need to be continued.
  • Sergio D. Bergese. Moderator - "Common Substance Abuse Disorders and What the Perioperative Physician Should Know"
  • Morgane G. Factor, Bahaa E. Daoud. Pain Management Strategies For The Opioid Dependent Parturient
  • Bahaa E. Daoud, Morgane Factor. A Parturient With Multiple Sclerosis Experiences The Highs And Lows Of Local Anesthetics
  • Ana Costa. Common Substance Abuse Disorders and What the Perioperative Physician Should Know: Postoperative alcohol withdrawal syndrome. What’s new?
Appointments and Promotions

Sergio D. Bergese, MD, CBA, FASA
     
   I am delighted to announce the appointment of Dr. Stephen Probst to the role of Vice Chair of Clinical Operations in the Department of Anesthesiology.

   Dr. Probst received his B.S. in biology/chemistry from Mount St. Mary College in Newburgh, New York, and his M.D. from Stony Brook. He completed a residency program in Anesthesiology at Stony Brook, joining the Department of Anesthesiology as an Assistant Professor in 2008.

   In 2012, Dr. Probst was appointed Division Chief of the Neurosurgical and ENT Anesthesiology. In 2013, he became an Operating Room Clinical Coordinator. During this time, he developed a dedicated cerebrovascular anesthesia team. His leadership and managerial skills led to his recent appointment as the Department of Anesthesiology Director of Clinical Affairs and Associate Director of Perioperative Services.

   I have asked Dr. Sofia Geralemou to serve as an interim Division Chief of Neurosurgical Anesthesiology and Dr. Saleem Zaidi to be Section Chief of the Critical Care ICU.

     
   I have two recent promotions in rank to announce. Dr. Robert P. Moore has been promoted to Professor of Clinical Anesthesiology. Dr. Moore is the Division Chief of Pediatric Anesthesiology. Dr. Ana Costa has been promoted to Associate Professor of Clinical Anesthesiology. Dr. Costa is the Associate Residency Program Director of the department and the Chair of Admissions for the Academy of Clinical and Educational Scholars at the Renaissance School of Medicine.
Dr. Costa Attends Hispanic Leadership Institute


Dr. Costa and Dr. Havidán Rodriguez,
Executive Director of the
Hispanic Leadership Institute and
President of SUNY Albany.

   Upon the request of the President of Stony Brook University, Dr. Maurie McInnis, Dr. Ana Costa represented Stony Brook at the Hispanic Leadership Institute's 5th year celebration in Albany in September 2022. The SUNY Hispanic Leadership Institute is designed to identify, develop and recruit, and ultimately support, retain and foster the success of Hispanic/Latinx leaders in higher education. SUNY, Stony Brook University and the Department of Anesthesiology at the Renaissance School of Medicine are committed to the recruitment and retention of underrepresented faculty in medicine and have demonstrated commitment to their professional development and success.
Dr. Kozlowski Fellowship Match



   Dr. Paul Kozlowski has matched into the pediatric anesthesiology fellowship program at Montefiore.
Pediatric Anesthesiology Division News
Robert Moore, MD

   The Division has wonderful news that two Residents will be pursuing fellowship training in pediatric anesthesia - Dr. Paul Kozlowski at Montefiore and Dr. Elliot Turkiew at Columbia. I think we can all agree that they will make an outstanding pediatric anesthesiologists.

   Some of our outstanding residents will be presenting posters related to pediatric anesthesia
  1. Michael Hafeman – October 24 High Thoracic Erector Spinae Plane (ESP) Block for Humeral Osteotomy.
  2. Elliot Turkiew / Paul Kozlowski – October 22 - Application of a Hybrid Perioperative Medical-surgical Home Model to Achieve Care Goals for a Complex Pediatric Patient.
  3. Elliot Turkiew / Paul Kozlowski – October 22- Opioid Free Thoracolumbar Fusion in a Pediatric Patient with a Polysubstance Abuse History.
   I just published an article in Regional Anesthesia and Pain Medicine that examines the pain experience and impact of continuous regional analgesia on children with spina bifida presenting for major abdominal surgery. I am happy to share and hope that our results will fill a key gap in the literature.

Moore RP, et al. Evaluating the role for regional analgesia in children with spina bifida: a retrospective observational study comparing the efficacy of regional versus systemic analgesia protocols following major urological surgery. Reg Anesth Pain Med. 2022 Sep 27

   Classically, it has been assumed that the presence of atypical innervation associated with spina bifida would limit pain following abdominal surgery. There is limited data to address this assumption and these children tend to have worse outcomes than most.

   Our group examined data collected from seven pediatric centers as part of the PURSUE trial examining ERAS pathways for urologic reconstructive surgery. In this cohort, children treated with systemic analgesia consumed substantially more opioid than those treated with a pathway centered on continuous regional analgesia. This reduction in opioid consumption seen with regional analgesia occurred despite an accelerated return to activity and was not associated with any increase in pain scores. Our data would suggest both the presence of discomfort and a benefit for regional analgesia. In fact, the practice has become standard of care at study sites for similar surgeries often involving the use of ESP catheters.
A Peek Behind the Pub

Eman Nada MBBCH, PhD

   It was a great experience to be part of a group of experts from all over the world to contribute to the International Consensus Statement on Obstructive Sleep Apnea. The group was led by Dr. Cheng an Associate Professor of Otolaryngology, Head and Neck Surgery and Chief of the Division of Sleep Surgery at the University of California, San Francisco. Authors from 10 countries all over the world, from different medical specialties collaborated to produce the consensus based on the highest evidence.

   I had the pleasure to write the section on preoperative evaluation and diagnosis of sleep apnea using screening tests, appraising the evidence, and whether this impacted the outcome. It was an interesting experience that took 1.5 years of back-and-forth communication and exchanging knowledge.

Chang JL, et al. International consensus statement on obstructive sleep apnea. Int Forum Allergy Rhinol. 2022 Sep 6
New Publications


Figure from Qureshi et al
  • Chang JL, Goldberg AN, ... , Nada EM, ... , Zeidler M, Rosen IM. International consensus statement on obstructive sleep apnea. Int Forum Allergy Rhinol. 2022 Sep 6
  • Qureshi F, Romeiser JL, Murphy PF, Go R, Abola R. A Quality Assurance Initiative on Improving Cefazolin Peri-operative Redose Compliance. Int J Qual Health Care. 2022 Sep 14
  • Moore RP, Burjek NE, Brockel MA, Strine AC, Acks A, Boxley PJ, Chidambaran V, Vricella GJ, Chu DI, Sankaran-Raval M, Zee RS, Cladis FP, Chaudhry R, O'Reilly-Shah VN, Ahn JJ, Rove KO; PURSUE Study Group. Evaluating the role for regional analgesia in children with spina bifida: a retrospective observational study comparing the efficacy of regional versus systemic analgesia protocols following major urological surgery. Reg Anesth Pain Med. 2022 Sep 27
Where on Campus is That?


University Hospital under construction in the late 1970s. Source

Click here to read about the history of Stony Brook Hospital.

Visit the Where on Campus is That? webpage!
SleepTalker, the Stony Brook Anesthesiology Newsletter is published by the Department of Anesthesiology
Stony Brook Medicine, Stony Brook, NY
Sergio D. Bergese, MD, CBA, FASA, Interim Chairman
Editorial Board: James P. Dilger, PhD; Ana Costa, MD; Murad Elias, MD