Faraj Abdallah

Research Synopsis

Dr. Abdallah’s first research interest is aimed at evolving anesthetic techniques to optimize the short- and long-term outcomes following breast cancer surgery. The focus of his research is the use of regional anesthesia technique, namely paravertebral blocks, in improving acute post-surgical pain and preventing the transition from acute to chronic pain in women undergoing mastectomy. To date, he has described a novel technique to perform PVB that provides anesthesia and pain relief to the breast. He has also developed a teaching phantom model to train anesthesiologists on paravertebral blocks. Subsequently, Dr. Abdallah led two RCTs: the first demonstrated that paravertebral block improves acute post-surgical pain and enhances the quality of recovery after mastectomy; while the second validated a chronic pain identification tool in the post-mastectomy population and demonstrated that paravertebral blocks protect against chronic pain at 6 months after mastectomy.

Dr. Abdallah’s second research interest is aimed at prolonging the duration of analgesia of single-shot nerve blocks in patients undergoing ambulatory surgery. His team has recently demonstrated that the recession of single-shot nerve blocks is associated with a rebound pain phenomenon whereby patients who receive blocks may experience worse pain than those who do not. Consequently, we have explored the efficacy of several adjuvants including dexamethasone and dexmedetomidine in extending the duration of postoperative analgesia and preventing rebound pain. Since applying these adjuvants directly on the nerves (perineurally) is associated with safety concerns (neurotoxicity), we have examined and successfully demonstrated that the systemic routes of administration of these adjuvants are effective in prolonging the duration of analgesia.

Recent Publications

1. Abdallah FW, Chan VW, Gandhi R, Koshkin A, Abbas S, Brull R. The analgesic effects of proximal, distal, or no sciatic nerve block on posterior knee pain after total knee arthroplasty: a double-blind placebo-controlled randomized trial. Anesthesiology. 2014;121:1302-10.
2. Abdallah FW, Morgan PJ, Cil T, McNaught A, Escallon JM, Semple JL, Wu W, Chan VW. Ultrasound-guided multilevel paravertebral blocks and total intravenous anesthesia improve the quality of recovery after ambulatory breast tumor resection. Anesthesiology. 2014;120:703-13.
3. Abdallah FW, Morgan PJ, Cil T, Escallon JM, Semple JL, Chan VW. Comparing the DN4 tool with the IASP grading system for chronic neuropathic pain screening after breast tumor resection with and without paravertebral blocks: a prospective 6-month validation study. Pain. 2015;156:740-9
4. Abdallah FW, Johnson J, Chan V, Murgatroyd H, Ghafari M, Ami N, Jin R, Brull R. Intravenous dexamethasone and perineural dexamethasone similarly prolong the duration of analgesia after supraclavicular brachial plexus block: a randomized, triple-arm, double-blind, placebo-controlled trial. Reg Anesth Pain Med. 2015;40:125-32.
5. Abdallah FW, Halpern SH, Aoyama K, Brull R. Will the Real Benefits of Single-Shot Interscalene Block Please Stand Up? A Systematic Review and Meta-Analysis. Anesth Analg. 2015;120:1114-29.

Appointments

Associate Scientist, Li Ka Shing Knowledge Institute

Honours and Awards

Name: Pain Scientist award, University of Toronto Center for the Study of Pain
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Name: Alan Laws Fellowship, University of Toronto Department of Anesthesia
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Name: R. J. Byrick Award, University of Toronto Department of Anesthesia
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Courses

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Course Name: American Society of Regional Anesthesia (ASRA)
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Course Name: International Symposium of Ultrasound for Regional Anesthesia and Pain Medicine (ISURA)
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Course Name: New York School of Regional Anesthesia (NYSORA)
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Course Name: University of Toronto Regional Anesthesia and Pain Medicine (RAPM) Annual Conference and Workshop