The incidence of donor-site morbidity after transverse cervical artery vascularized lymph node transfers: the need for a lymphatic surgery national registry.

The overall theme of my research is the application of clinical pharmacology tools to the individualization of the care of high-risk surgical patients, especially those undergoing neurosurgical procedures.  Current research focuses on creating pharmacokinetic-pharmacodynamic models to allow simulation of dose-concentration-effect relationships that will result in reduced toxicity while maximizing efficacy of intravenous opioids and hypnotics. The perioperative period is a time when patients are exposed to a multitude of drugs from a different classes, some of which may attenuate while others may augment the deleterious cascade of events that starts in the operating room and result in worse neuro-oncologic, neurovascular, or pain outcomes, even after the perioperative medication has been discontinued.  Analytical techniques for perioperative “big data” have not been combined with the clinical pharmacology toolbox to create dose-response models that can help optimize perioperative care. Through collaboration with pharmacometricians and informaticians, care paths can be developed in an iterative fashion to expose the innards of the perioperative black box.