Physicians

Department / Division
Anesthesiology / Anesthesiology-Pain Division

Address
DUMC 3094
Durham, NC 27710

Appointment Telephone
919-684-7246

Office Telephone
919-668-2386

Fax Telephone
919-681-7094

Training

• MD, University of North Carolina at Chapel Hill School of Medicine, 1978

Residency

• Anesthesiology, UNC Hospitals, 1979-1981

Fellowship

• Pain Management, UNC Hospitals, 1981-1982

Clinical Interests
General anesthesiology, chronic pain, ambulatory anesthesia for cosmetic surgery

Research Interests
Analgesic tolerance or habituation has long been the limiting factor in the use of narcotics as an adjuvant in treatment of chronic pain situations.  Several investigators have studied the causes for tolerance development in the animal.  Only Contreras, et al presented clinically useful information in their study using the mouse model when they proposed that calcium channel blockers may be useful in antagonizing morphine tolerance.   Although analgesic tolerance (loss of pain relieving ability) has been well established in using the animal model, few studies have been done using human subjects.  In our institution, it has been suggested that analgesic tolerance to the narcotic fentanyl can occur in humans after four hours or less of continuous infusion.    The purposes of this prospective crossover study on human volunteers are to document the occurrence of acute tolerance to narcotics in four hours or less during a continuous infusion and to investigate whether Contreras' findings of reversing narcotic tolerance with calcium channel blockers are reproducible in the human.  These results could significantly affect management of chronic and acute pain where the use of narcotics is unavoidable.  Narcotic response will be tested by experimentally induced pain using the submaximal tourniquet test.

Industry Relationships and Collaborations (What's this?)

This physician has no reported relationships with industry.

Representative Publications
5. Scott DL. Ambulatory Anesthesia for Cosmetic Surgery in Ambulatory Anesthesia and Perioperative Analgesia. McGraw-Hill. 2004. (2004)

D'Ercole F, Scott D, Bell E, Klein S, Greengrass R.  Paravertebral blockade for modified radical mastectomy in a pregnant patient. Anesth Analg. 1999;88:1351-3. (1999)

Scott DL. Pain syndromes associated with cancer and nonmalignant diseases. Current Opinion in Anaesthesiology. 1992;5:693-697. (1992)

Urban BJ, France RD, Steinberger EK, Scott DL, Maltbie AA. Long-term use of narcotic/antidepressant medication in the management of phantom limb pain. Pain. 1986;24:191-196. (1986)

Scott DL, Teeple E, Ghia JN. Hemiparesis and aphasia following left stellate ganglion block. Anesthesia and Analgesia. 1983;62:1038-1040. (1983)