Department / Division
Anesthesiology / Anesthesiology-Neuro Division
Durham, NC 27710
General, regional, and monitored anesthesia care to adult patients; anesthesia care for neurosurgical patients
I am interested in the fundamental neural mechanisms for reversible loss of consciousness. This area, therefore, includes naturally occurring sleep, drug-induced somnolence, and anesthesia. My interest stems from previous work that explored the interaction of narcotics and anesthetic agents with the medical pontine reticular formation (mPRF), a brainstem center responsible for control of rapid eye movement (REM) sleep. The medial pontine reticular formation was identified as a critical site in narcotic induced REM suppression as a result of this work. Additional studies revealed the role of the pontine reticular formation in generating cortical discharges associated with inhaled anesthetics. I wish to take these studies to the heman level to explore the similarities and differences between the sleep and anestheitc state. These studies will use electrophysiologic measurement (i.e. electroencephalography) and I hope to include functional brain imaging studies as well. Other points of focus include the effect of sleep and anesthesia on cardiovascular and pulmonary function. However, my prine area of interest is the understanding of neural mechanisms that mediate the change of these states. Further fundemental knowledge in this area may improve our understanding of anesthetic function. Potential application of this knowledge include improved anesthetic regimens resulting in more predictable onset and resolution of the anesthetic state, a reduction in anesthetic side effects and a clearer understanding of the natural sleep cycle.
This faculty member has no reported relationships with industry.
Keifer, JC; Dentchev, D; Little, K; Warner, DS; Friedman, AH; Borel, CO. A retrospective analysis of a remifentanil/propofol general anesthetic for craniotomy before awake functional brain mapping. Anesthesia and Analgesia. 2005;101:502-508. (2005) Abstract
Cortinez, LI; Hsu, YW; Sum-Ping, ST; Young, C; Keifer, JC; Macleod, D; Robertson, KM; Wright, DR; Moretti, EW; Somma, J. Dexmedetomidine pharmacodynamics: Part II: Crossover comparison of the analgesic effect of dexmedetomidine and remifentanil in healthy volunteers. Anesthesiology. 2004;101:1077-1083. (2004) Abstract
Hsu, YW; Cortinez, LI; Robertson, KM; Keifer, JC; Sum-Ping, ST; Moretti, EW; Young, CC; Wright, DR; Macleod, DB; Somma, J. Dexmedetomidine pharmacodynamics: part I: crossover comparison of the respiratory effects of dexmedetomidine and remifentanil in healthy volunteers. Anesthesiology. 2004;101:1066-1076. (2004) Abstract
Keifer, JC; Baghdoyan, HA; Lydic, R. Pontine cholinergic mechanisms modulate the cortical electroencephalographic spindles of halothane anesthesia. Anesthesiology. 1996;84:945-954. (1996) Abstract
Lydic, R; Keifer, JC; Baghdoyan, HA; Becker, L. Microdialysis of the pontine reticular formation reveals inhibition of acetylcholine release by morphine. Anesthesiology. 1993;79:1003-1012. (1993) Abstract