Anahi Perlas

Research Synopsis

Dr. Perlas’s research focuses on the development and validation of innovative perioperative applications of ultrasound to improve patient safety. She has done pioneer work on neuraxial and peripheral nerve sonoanatomy and has developed image-guided regional anesthesia techniques aimed at improving the safety and effectiveness of regional anesthesia. As the Director of the Clinical Regional Anesthesia Program at the Toronto Western Hospital, she has led a growing team of clinicians through a time of rapid expansion of clinical services of increasing complexity. She is currently an Associate Editor of the Journal Regional Anesthesiology and Pain Medicine, and a member of the Board of Directors of the American Society of Regional Anesthesia and Pain Medicine.

In addition, Dr. Perlas has developed a point-of-care ultrasound approach to assess gastric content and volume at the bedside.  She has studied the validity, reliability and diagnostic accuracy of this tool.   She is currently collaborating nationally and internationally to fully validate this tool in obese and non-obese adults, children and pregnant women. Her method and framework of gastric content evaluation is being rapidly adopted into anesthesia residency curricula locally and internationally. The ground work for this development has been supported by several peer-reviewed grants from the American Society of Anesthesiologists, the Anesthesia Patient Safety Foundation and the Canadian Society of Anesthesiologists. Dr. Perlas has published over 60 peer-reviewed original articles related to both research focus areas and lectures often at national and international events.

Recent Publications

1. Perlas A, Kirkham K, Billing R, Tse C, Brull R, Gandhi R, Chan V.  The impact of analgesic modality on early ambulation following total knee arthroplasty. Regional Anesthesia and Pain Medicine 2013 July; 38(4) 334-339 (PA)
2. Chin K J, Perlas A, Chan V.  The ultrasound-assisted paraspinous approach to lumbar neuraxial blockade – a simplified technique in patients with difficult anatomy. Acta Anaesthesiologica Scandinavica 2015 May; 59: 668-673 (CPA)
3. Perlas A, Chaparro L, Chin KJ.  Lumbar neuraxial ultrasound for spinal and epidural anesthesia.  A systematic review of the literature and meta-analysis. Regional Anesthesia and Pain Medicine 2015 April e-pub ahead of print; DOI: 10.1097/AAP: 0000000000000184 (PA)
4. Cruz-Eng H, Riazi S, Veillette C, Ami N, Niazi AU, Chin KJ, Chan V, Perlas A.  Early discharge and ambulatory continuous brachial plexus analgesia is a cost-effective alternative to standard inpatient care following complex arthroscopic elbow surgery.  A randomized, single-blinded study. Anesthesiology 2015; accepted for publication (SRA)
5. Perlas A, Mitsakakis N, Liu L, Cino M, Haldipur N, Davis L, Cubillos J, Chan V.  Validation of a mathematical model for ultrasound assessment of gastric volume by gastroscopic examination.   Anesthesia and Analgesia 2013 February; 116(2) 357-363 (PA)
6. Kruisselbrink R, Arzola C, Endersby R, Tse C, Chan V, Perlas A.  Intra and inter-rater reliability of ultrasound assessment of gastric volume. Anesthesiology 2014 July; 121 (1):46-51 (SRA)
7. Spencer AO, Walker AM, Yeung AK, Lardner DR, Yee K, Mulvey J, Perlas A.  Ultrasound assessment of gastric volume in the fasted pediatric patient undergoing upper gastrointestinal endoscopy: development of a predictive model using endoscopically-suctioned volumes. Pediatric Anesthesia 2015 January; 25: 301-308 (SRA)
8. Perlas A, Van de Putte P, Van Houwe P, Chan VWS.  An I-AIM framework for point-of-care gastric ultrasound. British Journal of Anesthesia 2015 May e-pub ahead of print DOI: 10.1093/bja/aev113 (PA)
9. Arzola C, Perlas A, Siddiqui N, Carvalho J.  Bedside gastric ultrasonography in term pregnant women before elective Cesarean delivery: A prospective cohort study. Anesthesia and Analgesia 2015; July e-pub ahead of print DOI: 10,1213/ ANE0000000000000818 (CPA)
10. Alakkad H, Kruisselbrink R, Chin K J, Niazi A, Abbas S, Chan V, Perlas A.  Point-of-care gastric ultrasound defines gastric content and changes the anesthetic management of elective surgical patients who have not followed fasting instructions. Canadian Journal of Anesthesia 2015; accepted for publication (SRA)

Appointments

Director, Clinical Regional Anesthesia Program at Toronto Western Hospital – University Health Network
Chair, Departmental Appointments Committee, Department of Anesthesia, University of Toronto
Member of the Board of Directors, American Society of Regional Anesthesia and Pain Medicine

Honours and Awards

Name: Best of the Meeting Abstract and Fellow Travel Award
Description:

April 2018 - World Congress on Regional Anesthesia and Pain Therapy, for the abstract: “The Effect of Anesthetic Technique on Mortality and Major Morbidity Following Hip Fracture Fixation.  A Retrospective, Propensity-Score Matched-Pair Cohort Study”.   New York, New York, USA (to fellow under my supervision)

Name: Finalist, Best of Meeting Abstract, International Anesthesia Research Society
Description:

April 2018 - for the abstract: “Diagnostic Accuracy of Point-of-Care Gastric Ultrasound: A Bayesian Analysis” (to resident under my supervision)

Name: Distinguished Service Award
Description:

Sept 2017 -European Society of Regional Anesthesia, Spanish Chapter, Madrid, Spain

Name: Excellence in Continuing Medical Education Award
Description:

June 2017 - Department of Anesthesia and Pain Management, Sinai Health System and University Health Network.

Name: Marion and Earl Orser Award
Description:

May 2016 - (awarded to clinical/research fellow Hillenn Cruz-Eng under my supervision) for best clinical peer-reviewed publication published as a first author (in 2015) by a University of Toronto resident or fellow in the areas of Anesthesia and Sleep Medicine.  Published in Anesthesiology 2015 December; 123(6): 1256-66 

Name: Best Pediatric Anesthesia Paper
Description:

2015 - Annual Meeting of the Canadian Anesthesiologists’ Society.  Title: “Antral Sonography in pediatric patients with large gastric volumes” Ottawa, ON

Name: David Fear Award
Description:

Nov 2014 - For outstanding contributions to continuing medical education and continuing professional development, University of Toronto, Department of Anesthesia

Name: Best paper
Description:

May 2013 - presented by a Fellow at the 34th Annual Shield’s Anesthesia Research Day,   Does gastric ultrasound change anesthetic management in non-fasted elective surgical patients?  

Name: David Bevan Award
Description:

May 2012 - For Best Poster presentation at the 33^rd Annual Shield’s Anesthesia Research Day, University of Toronto, Department of Anesthesia, Popliteal block at the site of sciatic nerve bifurcation through a common nerve sheath.  A randomized, double-blind study

Name: Postgraduate Teaching Award
Description:

Nov 2010 - Department of Anesthesia and Pain Management, Mount Sinai Hospital and University Health Network for excellence in teaching

Name: Best-of-Meeting Abstract
Description:

April 2009 - American Society of Regional Anesthesia Annual Meeting, Learning ultrasound-guided supraclavicular block: Success rates and patterns of nerve sparing, Phoenix, AZ

Name: Best of Meeting Abstract
Description:

March 2004 - American Society of Regional Anesthesia Annual Meeting, Ultrasound localization of the sciatic nerve.  A preliminary study, Orlando, FL

Name: The Hynek Rothbart Award
Description:

May 2002 - for best paper presented at the 24^th Annual Shield’s Research Day, Department of Anesthesia, University of Toronto, ultrasound localization of the brachial plexus, Toronto, ON

Courses

Course Number: 2004 – Present: Toronto Western Hospital Resident Teaching
Course Name: quarterly research rounds and quarterly regional anesthesia seminars
Course Number: 2010-2015: Curriculum Coordinator
Course Name: University of Toronto PGY2 Regional Anesthesia Curriculum Coordinator
Course Number: 2012: University of Toronto
Course Name: PGY2 Lecture Series: Local Anesthetic Pharmacology

Podcasts

A Discussion on Ultrasound for Neuraxial Anesthesia and Gastric Ultrasound hosted by Yale University