Lakshmikumar Venkat Raghavan

Research Synopsis

Since he started his career in 2005, Dr. Venkatraghavan’s primary research focus has been on anesthesia and functional neurosurgery (in particular, insertion of deep brain stimulators (DBS) and epilepsy surgery). At that time, functional neurosurgery was an emerging surgical procedure for patients with Parkinson’s disease and other movement disorders. There was no clear information on the anesthetic care of patients undergoing DBS surgery and the anesthetic agents were thought to interfere with the identification of target areas for stimulation. Dr. Venkatraghavan has published multiple articles on the perioperative anesthesia care of patients undergoing for DBS insertion. His work on epilepsy surgery has been focused on the use of intracarotid etomidate injection for WADA procedure for language and memory lateralization prior to epilepsy surgery. He has helped many centers across Canada, Europe and India with their transition to the use of etomidate for WADA procedure. 

Dr. Venkatraghavan’s secondary research focus is on anesthesia and functional neuroimaging. Along with his colleagues at the Toronto Western Hospital, Dr. Venkatraghavan has been working on the technique of measuring cerebrovascular reactivity (CVR) to carbon dioxide using BOLD -MRI and precise targeting of carbon dioxide. With funding from a UHN MSH AHSC AMO AFP Innovation Fund Award, they have shown that this technique can be used as a feasible, non-invasive, fast, reproducible “brain stress” test to identify patients with poor cerebrovascular reserve, i.e. at risk for stroke. His current work focuses on the role of functional imaging of brain as a tool to predict the clinical outcome in patients with neuropathic pain and to study the feasibility of precise targeting of Co2 in mechanically ventilated patients using a sequential breathing circuit. 

Recent Publications

1. Poublanc J, Crawley AP, Sobczyk O, Montandon G, Sam K, Mandell DM, Dufort P, Venkatraghavan L, Duffin J, Mikulis DJ, Fisher JA. Measuring cerebrovascular reactivity: the dynamic response to a step hypercapnic stimulus. J Cereb Blood Flow Metab. 2015 Jul 1. doi: 10.1038/jcbfm.2015.114. [Epub ahead of print]
2. Krishna V, Elias G, Sammartino F, Basha D, King NK, Fasano A, Munhoz R, Kalia SK, Hodaie M, Venkatraghavan L, Lozano AM, Hutchison WD. The effect of dexmedetomidine on the firing properties of STN neurons in Parkinson's disease. Eur J Neurosci. 2015 Aug;42(4):2070-7.
3. Venkatraghavan L, Rakhman E, Krishna V, Sammartino F, Manninen P, Hutchison W. The Effect of General Anesthesia on the Microelectrode Recordings From Pallidal Neurons in Patients With Dystonia. J Neurosurg Anesthesiol. 2015 Jun 4. [Epub ahead of print]
4. Mariappan R, Mehta J, Massicotte E, Nagappa M, Manninen P, Venkatraghavan L. Effect of superficial cervical plexus block on postoperative quality of recovery  after anterior cervical discectomy and fusion: a randomized controlled trial. Can J Anaesth. 2015 Aug;62(8):883-90.
5. Jadavji-Mithani R, Venkatraghavan L, Bernstein M. Music is Beneficial for Awake Craniotomy Patients: A Qualitative Study. Can J Neurol Sci. 2015 Jan;42(1):7-16..
6. Chui J, Manninen P, Sacho RH, Venkatraghavan L. Anesthetic management of patients undergoing intracranial bypass procedures. Anesth Analg. 2015 Jan;120(1):193-203.
7. Rahimi E, Mariappan R, Tharmaradinam S, Manninen P, Venkatraghavan L. Perioperative management and complications in patients with obstructive sleep apnea undergoing transsphenoidal surgery: Our institutional experience. J Anaesthesiol Clin Pharmacol. 2014 Jul;30(3):351-4.
8. Chong CT, Manninen P, Sivanaser V, Subramanyam R, Lu N, Venkatraghavan L. Direct comparison of the effect of desflurane and sevoflurane on intraoperative motor-evoked potentials monitoring. J Neurosurg Anesthesiol. 2014 Oct;26(4):306-12.
9. Chui J, Mariappan R, Mehta J, Manninen P, Venkatraghavan L. Comparison of propofol and volatile agents for maintenance of anesthesia during elective craniotomy procedures: systematic review and meta-analysis. Can J Anaesth. 2014 Apr;61(4):347-56.
10. Goettel N, Chui J, Venkatraghavan L, Tymianski M, Manninen PH. Day surgery craniotomy for unruptured cerebral aneurysms: a single center experience. J Neurosurg Anesthesiol. 2014 Jan;26(1):60-4. 

Appointments

Active Staff, Anesthesia, Women’s College Hospital
Director of Neuroanesthesia, Anesthesia, Toronto Western Hospital
Consultant Staff, Centre for Addiction and Mental Health
Active Staff, Anesthesia, Toronto Western Hospital, University Health Network

Honours and Awards

Name: Clinical Excellence Award
Description:

2015 - Department of Anesthesia, University of Toronto

Name: David Fear Award
Description:

2014 - for outstanding contributions to continuing medical education and continuing professional development in the Department of Anesthesia, University of Toronto

Name: Award for Excellence in Continuing Medical Educational Development
Description:

2012 - Department of Anesthesia and Pain Management, Mount Sinai Hospital – University Health Network

Courses

Course Number: Undergraduate
Course Name: Pre-clerkship Tutor (Year 1 Medical students) teaching the Problem Base Learning section on Brain and Behaviour, Wightman-Berris Academy, University of Toronto
Course Number: Residency
Course Name: Neuroanesthesia Core Seminars Organizer, Department of Anesthesia, University of Toronto
Course Number: Fellowship Director
Course Name: Neuroanesthesia, Department of Anesthesia and Pain Medicine, Toronto Western Hospital
Course Number: Senior revision tutorial for International Medical Graduates
Course Name: Department of Anesthesia, University of Toronto
Course Number: Basic and Advanced Fiberoptic Intubation course
Course Name: American Society of Anesthesiologist Annual Meetings.
Course Number: • International education mission with a neurosurgical team, teaching anesthesia for minimally invasive neurosurgery in developing countries
Course Name: