A5036161954- Anesthesia and Pain Management
- Pain Management and Opioid Use
- Opioid Use Disorder Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Musculoskeletal pain and rehabilitation
- Cannabis and Cannabinoid Research
- Pain Mechanisms and Treatments
- Pediatric Pain Management Techniques
- Pain Management and Placebo Effect
- Prenatal Substance Exposure Effects
- Anesthesia and Sedative Agents
- Nausea and vomiting management
- Digital Mental Health Interventions
- Substance Abuse Treatment and Outcomes
- Shoulder Injury and Treatment
- Connective tissue disorders research
- Spine and Intervertebral Disc Pathology
- Cardiac Health and Mental Health
- Myofascial pain diagnosis and treatment
- Cancer survivorship and care
- Hip and Femur Fractures
- Frailty in Older Adults
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Mobile Health and mHealth Applications
- Hemodynamic Monitoring and Therapy
University of Toronto
2016-2025
University Health Network
2016-2025
Toronto General Hospital
2016-2025
The Scarborough Hospital
2023-2025
Krembil Research Institute
2022-2025
Sunnybrook Health Science Centre
2007-2024
Toronto Western Hospital
2016-2024
Health Sciences Centre
1980-2024
York University
2012-2024
Health Net
2020-2024
Neuropathic pain (NeP), redefined as caused by a lesion or disease of the somatosensory system, is disabling condition that affects approximately two million Canadians.To review randomized controlled trials (RCTs) and systematic reviews related to pharmacological management NeP develop revised evidence-based consensus statement on its management.RCTs, existing guidelines were evaluated at meeting in May 2012 updated until September 2013. Medications recommended if their analgesic efficacy...
Chronic postsurgical pain (CPSP), an often unanticipated result of necessary and even life-saving procedures, develops in 5-10% patients one-year after major surgery. Substantial advances have been made identifying at elevated risk developing CPSP based on perioperative pain, opioid use, negative affect, including depression, anxiety, catastrophizing, posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS) Toronto General Hospital (TGH) is the first to...
Globally, medical cannabis legalization has increased in recent years and is commonly used to treat chronic pain. However, there are few randomized control trials studying indicating expert guidance on how dose administer safely effectively needed.Using a multistage modified Delphi process, twenty global experts across nine countries developed consensus-based recommendations patients with pain.There was consensus that may be considered for experiencing neuropathic, inflammatory, nociplastic,...
The past two decades have seen an increase in cannabis use due to both regulatory changes and interest potential therapeutic effects of the substance, yet many aspects substance their health implications remain controversial or unclear.In November 2020, American Society Regional Anesthesia Pain Medicine charged Cannabis Working Group develop guidelines for perioperative cannabis. Perioperative Use Cannabinoids Guidelines Committee was with drafting responses nine key questions using a...
In an era of considerable advances in anaesthesiology and pain medicine, chronic after major surgery continues to be problematic. This article briefly reviews the known psychological risk protective factors associated with development postsurgical (CPSP). We begin a definition CPSP then explain what we mean by risk/protective factor. Next, summarize for CPSP. Psychological interventions that target may impact are reviewed, including acceptance commitment therapy (ACT)-based approach...
BackgroundThe Duke Activity Status Index (DASI) questionnaire might help incorporate self-reported functional capacity into preoperative risk assessment. Nonetheless, prognostically important thresholds in DASI scores remain unclear. We conducted a nested cohort analysis of the Measurement Exercise Tolerance before Surgery (METS) study to characterise association with postoperative death or complications.MethodsThe included 1546 participants (≥40 yr age) at an elevated cardiac who had...
Medical cannabis has been legally available for patients in a number of countries. Licensed producers produce variety strains with different concentrations phytocannabinoids. Phytocannabinoids medical are decarboxylated when subjected to heating consumption by the or extracted preparing derivative products. There is little understanding true chemical composition extracts, changes occurring during and their relevance pharmacological effects. We investigated extract from popular commercial...
To identify the 3-month incidence of chronic postsurgical pain and long-term opioid use in patients at Toronto General Hospital.200 consecutive presenting for elective major surgery completed standardized questionnaires by telephone 3 months after surgery.51 reported a preoperative condition, with 12 taking opioids preoperatively. 35% having surgical site 13.5% continued to relief. Postoperative was associated interference walking work, lower mood.Chronic ongoing are concerns that warrant...
Abstract Background Although cannabis is known to have cardiovascular and psychoactive effects, the implications of its use before surgery are currently unknown. The objective present study was determine whether patients with an active disorder elevated risk postoperative complications. Methods authors conducted a retrospective population-based cohort undergoing elective in United States using Nationwide Inpatient Sample from 2006 2015. A sample 4,186,622 inpatients 18 65 yr age presenting...
Chronic pain imposes a large burden on individuals and society. A patient-centric digital chronic management app called Manage My Pain (MMP) can be used to enhance communication between providers patients promote self-management.The purpose of this study was evaluate the real-world engagement in urban rural settings Ontario, Canada with MMP alongside their standard care assess impact its usage clinical outcomes related mental health.A total 246 participants at 2 clinics were recruited into...
Abstract Past research has indicated that individuals with Ehlers-Danlos Syndromes (EDS) and Generalized Hypermobililty Spectrum Disorder (G-HSD) report psychological psychiatric symptoms, particularly anxiety disorders depressive at much greater rates than the general population. However, these studies have been primarily conducted in small samples European centres. We a retrospective chart review from 1035 consecutive patients (88% female) assessed for EDS/G-HSD GoodHope EDS Clinic Toronto...
Gabapentin (GPN) is effective in reducing post-operative pain and opioid consumption, but its effects with regional anesthesia for total hip arthroplasty (THA) are not known. We designed this study to determine whether (1) gabapentin administration reduces use after THA using a multimodal analgesic regimen including spinal anesthesia; (2) pre-operative of more than administration.After REB approval informed consent, 126 patients were enrolled double-blinded, randomized-controlled study....
Moderate to severe pain after total knee arthroplasty often interferes with postoperative rehabilitation and delays discharge from hospital. The present study examined the effects of a four-day gabapentin (GBP) regimen versus placebo on opioid consumption, scores flexion, as well adverse effects, arthroplasty.After obtaining research ethics board approval informed consent, 40 patients were enrolled in randomized, single-blind, placebo-controlled, open-label study. Patients assigned one five...
: Chronic postsurgical pain (CPSP) and associated long-term opioid use are major public health concerns.
The goal of this study was to follow a cohort patients undergoing total knee arthroplasty over time to: (1) identify and describe the various pain trajectories beginning preoperatively for up 12 months after surgery, (2) baseline predictors trajectory group membership, (3) groups associated with poor psychosocial outcomes surgery. One hundred seventy-three participants (female = 85 [49%]; mean age [years] 62.9, SD 6.8) completed psychological questionnaires functional performance tests 4...