Major Research Themes

Our faculty members with expertise in pain research encompass the entire translational continuum. The Chronic Pain and Fatigue Research Center is lead by Dr. Dan Clauw (Director) and Dr. David Williams (Associate Director); it is widely acknowledged as being one of the most successful clinical and translational research groups in the pain field. The group has been particularly instrumental in using functional and chemical neuroimaging and quantitative sensory testing to elucidate the important roles that the central nervous system plays in pain processing, especially in chronic pain states. Dr. Harris is recognized as a rising star in the field of functional and chemical neuroimaging; he is currently the principal investigator of two RO1s. Dr. Brummett completed his Anesthesiology Residency at UM and his subspecialty fellowship training in Pain Medicine at Johns Hopkins. He returned to become the Director of Pain Research; Dr. Brummett is R01-funded and also plays an institutional role in the Michigan Genomics Initiative. Finally, Dr. Green is the world’s pre-eminent researcher of health disparities in pain care.  

Anesthesiology research at UM spans the entire continuum of bench-to-bedside-to-practice research in the area of sleep. Dr. Gina Poe is an NIH-funded neuroscientist who studies learning and memory during rapid eye movement sleep. She has active collaborations with Dr. George Mashour to compare hippocampal theta activity, critical for memory and a target for anesthesia-induced amnesia, during sleep and general anesthesia. Both Dr. Poe and Dr. Mashour have had successful collaborations with Dr. Victoria Booth, a NIH/NSF-funded computational neuroscientist and mathematician who models sleep-wake regulation. At the other end of the translational continuum is Dr. Satya-Krishna Ramachandran, who examines the role of sleep apnea and other sleep disorders in augmenting perioperative adverse respiratory events. Working with members of the Center for Sleep Science at UM, Dr. Ramachandran has developed and validated an instrument for predicting obstructive sleep apnea in the perioperative period. 

In 2001, the UM Department of Anesthesiology became one of the first centers in the world to use a comprehensive electronic medical record for all anesthesiology documentation. These systems, known as anesthesia information management systems (AIMS), integrate hospital electronic medical record information, automated intraoperative physiologic data, medication administration, surgical procedure data, and patient long term outcomes. This vital and comprehensive database has been used by the department to publish extensively on the relationship between perioperative management and patient outcomes.

In addition, the Department of Anesthesiology is the coordinating center for the Multicenter Perioperative Outcomes Group (MPOG) under the leadership of Dr. Kevin Tremper and Dr. Sachin Kheterpal. MPOG is a consortium of more than 30 medical centers collaborating to integrate observational data for clinical research. With more than 1 million surgical cases aggregated across these centers, our faculty members have the unique opportunity to study the impact of specific anesthetic management techniques on patient outcomes. MPOG has already begun research into acute kidney injury, pulmonary complications, myocardial infarction, and stroke.

Another research area in which UM anesthesiology has unique strengths relates to the prevention of adverse perioperative outcomes and the promotion of patient safety by changing practice patterns. Dr. James Bagian, a more recent faculty recruit, is an anesthesiologist, engineer and former astronaut. Dr. Bagian has been a pioneer in the use of simulation and training to improve patient safety in the operating room, conducting this initial work across the entire VA system. 

Several faculty members have world-class expertise in metabolic activity and drug metabolism. Dr. Steve Britton is a departmental pre-clinical researcher who developed a highly innovative animal model of poor aerobic conditioning and metabolic syndrome. Based on the strong statistical association between aerobic capacity and all-cause morbidity and mortality, Britton hypothesized that artificial selection of rats for low and high aerobic exercise capacity would yield models that also contrast for disease risks. This model is being used in studies with collaborators from 25 institutions representing 10 countries. Information from these models should immediately suggest pathways for translational studies aimed at identifying more effective modes of diagnosis, prevention, and treatment of complex diseases.

Physician-scientists interested in studying cytochrome P450 drug metabolism would have access to preclinical scientists in the Department, such as Dr. Lucy Waskell, an internationally renowned researcher in this field. For over 30 years, the NIH and the VA have supported Dr. Waskell's research on drug metabolism through cytochrome P450. Dr. Waskell's laboratory is investigating how cytochrome P450 and its helper proteins, cytochrome b5 and cytochrome P450 reductase, metabolize a wide variety of compounds. Her laboratory currently uses protein engineering, X-ray crystallography, and biochemical techniques to assist in unraveling the mechanistic secrets of these essential enzymes. 

The Pediatric Anesthesiology research section at the University of Michigan is widely acknowledged as one of the leading centers of its kind in the country. This group, led by Dr. Alan Tait and Dr. Shobha Malviya (Director of Pediatric Anesthesia Research), has been particularly successful in promoting the safety of children undergoing anesthesia and surgery through rigorous outcomes-based research. Primary areas of focus include the effect of anesthesia on outcomes in children with a variety of risk factors, including obesity, sleep-disordered breathing, and viral infections. In addition, this research has been particularly instrumental in furthering our understanding of pain, pain assessment and pain management in cognitively impaired and cognitively intact children. As such, this group’s work is closely aligned with the clinical and translational focus of other groups in our department. Dr. Tait, a NIH-funded investigator, has made important contributions to children with respiratory infections and obesity, and is a world expert on the topic of informed consent. Dr. Shobha Malviya and Dr. Terri Voepel-Lewis are both noted experts in the assessment, management, and understanding of the outcomes related to pediatric pain in the perioperative period. Dr. Olubukola “Bukky” Nafiu has received national press coverage on his work in obesity and the pediatric population.

The Division of Obstetric Anesthesiology has been active in clinical research since the mid-1990s. Research led by Linda S. Polley, M.D. determined the Minimum Local Anesthetic Concentration (MLAC) of multiple analgesics and adjuncts used for labor analgesia. The model provided the first quantitative and systematic application of dose-response pharmacodynamics to neuraxial anesthesia and was instrumental in the development of current high volume, low concentration, local anesthetic dosing regimens. More recently, research studies and publications have focused on the prevention of maternal mortality and morbidity. Former faculty member Jill M. Mhyre, M.D. published a landmark study in Anesthesiology in 2007 identifying the postoperative period as the highest risk for serious respiratory depression and death. Her study of maternal cardiac arrest (also completed at the University of Michigan) was published as the lead article in Anesthesiology in April 2014 with an accompanying editorial. The first epidemiological study of maternal sepsis and risk factors was led by Melissa E.B. Bauer, D.O., and was recognized as on the Best Abstracts at the 2012 annual meeting of the American Society of Anesthesiologists. Studies underway include a multicenter retrospective case control study to validate risk factors for maternal sepsis and establish Systemic Inflammatory Response Syndrome (SIRS) criteria adjusted for the physiological changes of pregnancy to aid in early diagnosis. Further research will focus on novel techniques to identify maternal sepsis and infection as well as interventions to decrease maternal mortality and morbidity.

Dr. George A. Mashour leads a NIH- and foundation-funded multidisciplinary translational research program focused on consciousness and the mechanisms by which general anesthetics suppress consciousness. Mashour’s research team is comprised of anesthesiologists, neurobiologists, biomedical engineers, and physicists specializing in complex systems and network science. Together, they have investigated the underlying mechanisms of general anesthesia in the brain, assessed current neurophysiologic technology for brain monitoring in surgical patients, and innovated novel techniques for analyzing brain networks during the induction and emergence of general anesthesia. In terms of clinical research related to consciousness, Mashour and other national collaborators have conducted large scale studies on intraoperative awareness with explicit recall. Recent publications from the consciousness and cognition research group have spanned theory (Proceedings of the National Academy of Sciences), basic studies in animals (Proceedings of the National Academy of Sciences and Anesthesiology), translational studies in healthy volunteers and surgical patients (PLoS One and Anesthesiology), and large multicenter randomized controlled trials (New England Journal of Medicine and Anesthesiology).

This division is led by Dr. Milo Engoren and focuses on outcomes using both traditional large databases and novel complex system analyses to find factors associated with good and bad outcomes. Large database studies have included associations between blood transfusions and morbidity and mortality, glycemic control as it relates to complications; and acute kidney injury and recovery. With NIH funding we have implemented a system to capture and store ECG and pressure waveforms for later analysis. We are currently using innovative mathematical techniques to extract information from these waveforms as an aid to predict complications. Future aims are to prospectively test interventions to modify the factors identified in these retrospective studies to be associated with adverse outcomes.