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Michael Lewis Kent

Associate Professor of Anesthesiology
Anesthesiology, Ambulatory

Selected Publications


Discharge Opioid Dose Indirectly Associated With Functional Outcomes 2 Weeks After Shoulder and Knee Arthroscopy in a US Military Sample.

Journal Article Mil Med · July 3, 2024 INTRODUCTION: Postsurgical opioid utilization may be directly and indirectly associated with a range of patient-related and surgery-related factors, above and beyond pain intensity. However, most studies examine postsurgical opioid utilization without acco ... Full text Link to item Cite

Patient-centered results from a multicenter study of continuous peripheral nerve blocks and postamputation phantom and residual limb pain: secondary outcomes from a randomized, clinical trial.

Journal Article Reg Anesth Pain Med · September 2023 INTRODUCTION: We previously reported that a 6-day continuous peripheral nerve block reduces established postamputation phantom pain. To provide patients and providers with the information to best inform treatment decisions, here we reanalyze the data and p ... Full text Link to item Cite

Acute postoperative pain impact trajectories and factors contributing to trajectory membership.

Journal Article Pain Med · July 5, 2023 BACKGROUND: Ongoing postoperative pain assessments are vital to optimizing pain management and attenuating the development of poor health outcomes after surgery. This study aimed to characterize acute multidimensional trajectories of pain impact on physica ... Full text Link to item Cite

Longitudinal Predictors of PROMIS Satisfaction With Social Roles and Activities After Shoulder and Knee Sports Orthopaedic Surgery in United States Military Servicemembers: An Observational Study.

Journal Article Orthop J Sports Med · July 2023 BACKGROUND: Satisfaction with social roles and activities is an important outcome for postsurgical rehabilitation and quality of life but not commonly assessed. PURPOSE: To evaluate longitudinal patterns of the Patient-Reported Outcomes Measurement Informa ... Full text Link to item Cite

Lagged effect of Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance on subacute postsurgical PROMIS Pain Behavior.

Journal Article J Orthop Res · April 2023 Sleep disturbance is a modifiable risk factor that, when reduced, may improve subacute postsurgical outcomes (e.g., pain-related impact). Evidence also indicates that pain and sleep may have a bidirectional longitudinal relationship before to (sub) acutely ... Full text Link to item Cite

Predictors of continued opioid use 6 months after total joint arthroplasty: a multi-site study.

Journal Article Arch Orthop Trauma Surg · December 2022 PURPOSE: Continued opioid use after total knee and hip arthroplasty (TKA/THA) is well-documented and associated with both surgical and patient-reported factors. Research examining the combined effects of a multitude of factors on continued, and even chroni ... Full text Link to item Cite

Association between traumatic brain injuries and ketamine infusion side effects following combat injury.

Journal Article BMJ Mil Health · October 2022 INTRODUCTION: Ketamine is a vital component for acute pain management in emergency trauma care for both civilian and military hospitals. This preliminary analysis examined whether combat-injured US service members sustaining traumatic brain injuries (TBI) ... Full text Link to item Cite

Multidimensional Perioperative Recovery Trajectories in a Mixed Surgical Cohort: A Longitudinal Cluster Analysis Utilizing National Institutes of Health Patient-Reported Outcome Measurement Information System Measures.

Journal Article Anesth Analg · February 1, 2022 BACKGROUND: Pain trajectories have been described in numerous surgical settings where preoperative characteristics have been used to predict trajectory membership. Suboptimal pain intensity trajectories have been linked to poor longitudinal outcomes. Howev ... Full text Link to item Cite

Racial and Ethnic Disparities among Thoracic Surgery Patients

Conference ANESTHESIA AND ANALGESIA · 2022 Cite

Patient Reported Outcomes

Chapter · January 1, 2022 Patients with persistent pain conditions in a hospitalized setting (with or without acute pain) represent a diverse and complex population with varying degrees of pain related biopsychosocial dysfunction. While pain related physiologic outcomes (e.g., opio ... Full text Cite

Discharge Opioid Dose Indirectly Associated With Functional Outcomes 2 Weeks After Shoulder and Knee Arthroscopy in a US Military Sample.

Journal Article Mil Med · July 3, 2024 INTRODUCTION: Postsurgical opioid utilization may be directly and indirectly associated with a range of patient-related and surgery-related factors, above and beyond pain intensity. However, most studies examine postsurgical opioid utilization without acco ... Full text Link to item Cite

Patient-centered results from a multicenter study of continuous peripheral nerve blocks and postamputation phantom and residual limb pain: secondary outcomes from a randomized, clinical trial.

Journal Article Reg Anesth Pain Med · September 2023 INTRODUCTION: We previously reported that a 6-day continuous peripheral nerve block reduces established postamputation phantom pain. To provide patients and providers with the information to best inform treatment decisions, here we reanalyze the data and p ... Full text Link to item Cite

Acute postoperative pain impact trajectories and factors contributing to trajectory membership.

Journal Article Pain Med · July 5, 2023 BACKGROUND: Ongoing postoperative pain assessments are vital to optimizing pain management and attenuating the development of poor health outcomes after surgery. This study aimed to characterize acute multidimensional trajectories of pain impact on physica ... Full text Link to item Cite

Longitudinal Predictors of PROMIS Satisfaction With Social Roles and Activities After Shoulder and Knee Sports Orthopaedic Surgery in United States Military Servicemembers: An Observational Study.

Journal Article Orthop J Sports Med · July 2023 BACKGROUND: Satisfaction with social roles and activities is an important outcome for postsurgical rehabilitation and quality of life but not commonly assessed. PURPOSE: To evaluate longitudinal patterns of the Patient-Reported Outcomes Measurement Informa ... Full text Link to item Cite

Lagged effect of Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance on subacute postsurgical PROMIS Pain Behavior.

Journal Article J Orthop Res · April 2023 Sleep disturbance is a modifiable risk factor that, when reduced, may improve subacute postsurgical outcomes (e.g., pain-related impact). Evidence also indicates that pain and sleep may have a bidirectional longitudinal relationship before to (sub) acutely ... Full text Link to item Cite

Predictors of continued opioid use 6 months after total joint arthroplasty: a multi-site study.

Journal Article Arch Orthop Trauma Surg · December 2022 PURPOSE: Continued opioid use after total knee and hip arthroplasty (TKA/THA) is well-documented and associated with both surgical and patient-reported factors. Research examining the combined effects of a multitude of factors on continued, and even chroni ... Full text Link to item Cite

Association between traumatic brain injuries and ketamine infusion side effects following combat injury.

Journal Article BMJ Mil Health · October 2022 INTRODUCTION: Ketamine is a vital component for acute pain management in emergency trauma care for both civilian and military hospitals. This preliminary analysis examined whether combat-injured US service members sustaining traumatic brain injuries (TBI) ... Full text Link to item Cite

Multidimensional Perioperative Recovery Trajectories in a Mixed Surgical Cohort: A Longitudinal Cluster Analysis Utilizing National Institutes of Health Patient-Reported Outcome Measurement Information System Measures.

Journal Article Anesth Analg · February 1, 2022 BACKGROUND: Pain trajectories have been described in numerous surgical settings where preoperative characteristics have been used to predict trajectory membership. Suboptimal pain intensity trajectories have been linked to poor longitudinal outcomes. Howev ... Full text Link to item Cite

Racial and Ethnic Disparities among Thoracic Surgery Patients

Conference ANESTHESIA AND ANALGESIA · 2022 Cite

Patient Reported Outcomes

Chapter · January 1, 2022 Patients with persistent pain conditions in a hospitalized setting (with or without acute pain) represent a diverse and complex population with varying degrees of pain related biopsychosocial dysfunction. While pain related physiologic outcomes (e.g., opio ... Full text Cite

NMDA Antagonists

Chapter · January 1, 2022 Ketamine is a useful NMDA receptor antagonist that provides a strong analgesic effect even at sub-anesthetic doses, and has an established role in both acute and chronic pain management. Intravenous ketamine infusions should be considered early for pain co ... Full text Cite

Immediate Effects of a Continuous Peripheral Nerve Block on Postamputation Phantom and Residual Limb Pain: Secondary Outcomes From a Multicenter Randomized Controlled Clinical Trial.

Journal Article Anesth Analg · October 1, 2021 BACKGROUND: We recently reported that a 6-day continuous peripheral nerve block reduced established postamputation phantom pain 3 weeks after treatment ended. However, the immediate effects of perineural infusion (secondary outcomes) have yet to be reporte ... Full text Link to item Cite

Postoperative Pain Mediates the Association Between Peripheral Nerve Blocks and Postoperative Sleep Following Lower Extremity Arthroplasty.

Journal Article Clin J Pain · July 1, 2021 OBJECTIVES: Despite substantial research showing the bidrectional relationship between sleep and pain, there remains a dearth of research examining the role of perioperative pain management interventions in mitigating postoperative sleep disturbances. This ... Full text Link to item Cite

Ambulatory continuous peripheral nerve blocks to treat postamputation phantom limb pain: a multicenter, randomized, quadruple-masked, placebo-controlled clinical trial.

Journal Article Pain · March 1, 2021 Phantom limb pain is thought to be sustained by reentrant neural pathways, which provoke dysfunctional reorganization in the somatosensory cortex. We hypothesized that disrupting reentrant pathways with a 6-day-long continuous peripheral nerve block reduce ... Full text Open Access Link to item Cite

A Longitudinal Comparison of Patient-Reported Outcomes Measurement Information System to Legacy Scales in Knee and Shoulder Arthroscopy Patients.

Journal Article Arthroscopy · January 2021 PURPOSE: The purpose of this prospective correlational study was to compare the psychometric properties of the Defense and Veterans Pain Rating Scale (DVPRS) and Patient-Reported Outcomes Measurement Information System (PROMIS) scales with those of traditi ... Full text Link to item Cite

Forty-two Million Ways to Describe Pain: Topic Modeling of 200,000 PubMed Pain-Related Abstracts Using Natural Language Processing and Deep Learning-Based Text Generation.

Journal Article Pain Med · November 1, 2020 OBJECTIVE: Recent efforts to update the definitions and taxonomic structure of concepts related to pain have revealed opportunities to better quantify topics of existing pain research subject areas. METHODS: Here, we apply basic natural language processing ... Full text Link to item Cite

Discrete and Dynamic Postoperative Pain Catastrophizing Trajectories Across 6 Months: A Prospective Observational Study.

Journal Article Arch Phys Med Rehabil · October 2020 OBJECTIVES: To investigate pain catastrophizing presentations up to 6 months postoperatively and subsequent changes in pain intensity and physical function. DESIGN: Prospective observational multisite study. SETTING: Two tertiary care facilities between 20 ... Full text Link to item Cite

Caregiver Patient Reported Outcomes Measurement Information System (PROMIS) profiles in patients undergoing total joint arthroplasty and spine surgery: a prospective observational cohort study.

Journal Article Reg Anesth Pain Med · November 5, 2019 BACKGROUND/OBJECTIVE: The role of caregiver psychosocial characteristics and their relation to postsurgical caregiving capability remains unclear. The objective of this study was to explore caregiver psychosocial variables following surgery of patients und ... Full text Link to item Cite

The Impact of Surgical Amputation and Valproic Acid on Pain and Functional Trajectory: Results from the Veterans Integrated Pain Evaluation Research (VIPER) Randomized, Double-Blinded Placebo-Controlled Trial.

Journal Article Pain Med · October 1, 2019 OBJECTIVE: To determine if the perioperative administration of valproic acid reduces the incidence of chronic pain three months after amputation or revision surgery. DESIGN: Multicenter, randomized, double-blind, placebo-controlled trial. SETTING: Academic ... Full text Open Access Link to item Cite

Identification of Functioning Domains in the Presurgical Period and Their Relationships with Opioid Use and Pain Catastrophizing.

Journal Article Pain Med · September 1, 2019 OBJECTIVES: The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) is a multidimensional screening system evaluating biopsychosocial factors affecting pain and functioning. Using a military sample, the current s ... Full text Link to item Cite

Fascia Iliaca Blockade With the Addition of Liposomal Bupivacaine Versus Plain Bupivacaine for Perioperative Pain Management During Hip Arthroscopy: A Double-Blinded Prospective Randomized Control Trial.

Journal Article Arthroscopy · September 2019 PURPOSE: To determine in a prospective, randomized fashion whether liposomal bupivacaine extends the effectiveness of decreased pain scores and reduces narcotic requirements following hip arthroscopy when used in addition to a fascia iliaca blockade with p ... Full text Link to item Cite

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Management of Patients on Preoperative Opioid Therapy.

Journal Article Anesth Analg · August 2019 Enhanced recovery pathways have quickly become part of the standard of care for patients undergoing elective surgery, especially in North America and Europe. One of the central tenets of this multidisciplinary approach is the use of multimodal analgesia wi ... Full text Link to item Cite

American Society for Enhanced Recovery and Perioperative Quality Initiative-4 Joint Consensus Statement on Persistent Postoperative Opioid Use: Definition, Incidence, Risk Factors, and Health Care System Initiatives.

Journal Article Anesth Analg · August 2019 Persistent postoperative opioid use is thought to contribute to the ongoing opioid epidemic in the United States. However, efforts to study and address the issue have been stymied by the lack of a standard definition, which has also hampered efforts to mea ... Full text Link to item Cite

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Opioid Minimization in Opioid-Naïve Patients.

Journal Article Anesth Analg · August 2019 Surgical care episodes place opioid-naïve patients at risk for transitioning to new persistent postoperative opioid use. With one of the central principles being the application of multimodal pain interventions to reduce the reliance on opioid-based medica ... Full text Link to item Cite

Safety in Acute Pain Medicine-Pharmacologic Considerations and the Impact of Systems-Based Gaps.

Journal Article Pain Med · November 1, 2018 OBJECTIVE: In the setting of an expanding prevalence of acute pain medicine services and the aggressive use of multimodal analgesia, an overview of systems-based safety gaps and safety concerns in the setting of aggressive multimodal analgesia is provided ... Full text Link to item Cite

Fascia iliaca blockade with the addition of liposomal bupivacaine vs. plain bupivacaine for perioperative pain management following hip arthroscopy.

Journal Article Knee Surg Sports Traumatol Arthrosc · August 2018 PURPOSE: A newer formulation of bupivacaine, encapsulated within carrier molecules, has garnered attention for its role in providing extended post-operative analgesia. The purpose was to evaluate the addition of liposomal bupivacaine to fascia iliaca block ... Full text Link to item Cite

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Patient-Reported Outcomes in an Enhanced Recovery Pathway.

Journal Article Anesth Analg · June 2018 Patient-reported outcomes (PROs) are measures of health status that come directly from the patient. PROs are an underutilized tool in the perioperative setting. Enhanced recovery pathways (ERPs) have primarily focused on traditional measures of health care ... Full text Open Access Link to item Cite

Benefits of the Restorative Exercise and Strength Training for Operational Resilience and Excellence Yoga Program for Chronic Low Back Pain in Service Members: A Pilot Randomized Controlled Trial.

Journal Article Arch Phys Med Rehabil · January 2018 OBJECTIVE: To examine the feasibility and preliminary effectiveness of an individualized yoga program. DESIGN: Pilot randomized controlled trial. SETTING: Military medical center. PARTICIPANTS: Patients (N=68) with chronic low back pain. INTERVENTIONS: Res ... Full text Link to item Cite

The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions.

Journal Article J Pain · May 2017 OBJECTIVE: With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. ... Full text Link to item Cite

The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions.

Journal Article Pain Med · May 1, 2017 OBJECTIVE: With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. ... Full text Link to item Cite

Perioperative Pain Management Strategies for Amputation: A Topical Review.

Journal Article Pain Med · March 1, 2017 OBJECTIVE: To review acute pain management strategies in patients undergoing amputation with consideration of preoperative patient factors, pharmacologic/interventional modalities, and multidisciplinary care models to alleviate suffering in the immediate p ... Full text Link to item Cite

Management of Acute Pain of the War Wounded during Short and Long-distance Transport and "casevac"

Conference Techniques in Orthopaedics · January 1, 2017 In recent conflicts, advances in acute pain management have been pushed to the forefront of battlefield medical care. With dramatic improvements in battlefield resuscitation, mortality rates have significantly decreased, as a result significant numbers of ... Full text Cite

Psychometric Testing of the Defense and Veterans Pain Rating Scale (DVPRS): A New Pain Scale for Military Population.

Journal Article Pain Med · August 2016 OBJECTIVE: The Defense and Veterans Pain Rating Scale (DVPRS 2.0) is a pain assessment tool that utilizes a numerical rating scale enhanced by functional word descriptors, color coding, and pictorial facial expressions matched to pain levels. Four suppleme ... Full text Link to item Cite

The acute pain team

Chapter · January 1, 2016 Aside from the moral imperative to avert needless suffering from pain, ineffective postoperative pain management may contribute to multiple adverse perioperative outcomes. The primary objective of the modern acute pain service (APS) is to diagnose and trea ... Full text Cite

Human Performance Optimization Metrics: Consensus Findings, Gaps, and Recommendations for Future Research.

Journal Article J Strength Cond Res · November 2015 Human performance optimization (HPO) is defined as "the process of applying knowledge, skills and emerging technologies to improve and preserve the capabilities of military members, and organizations to execute essential tasks." The lack of consensus for o ... Full text Link to item Cite

Acute Pain Medicine in the United States: A Status Report.

Journal Article Pain Med · September 2015 BACKGROUND: Consensus indicates that a comprehensive,multimodal, holistic approach is foundational to the practice of acute pain medicine (APM),but lack of uniform, evidence-based clinical pathways leads to undesirable variability throughout U. S. healthca ... Full text Link to item Cite

A comparison of ultrasound-guided and landmark-based approaches to saphenous nerve blockade: a prospective, controlled, blinded, crossover trial.

Journal Article Anesth Analg · July 2013 BACKGROUND: Blockade of the saphenous nerve is often used for surgeries below the knee. Depending on the approach, success rates vary widely ranging from 33% to 88%. In this prospective volunteer study, we compared 2 ultrasound-guided techniques, the modif ... Full text Link to item Cite

Assessment of postoperative analgesia after application of ultrasound-guided regional anesthesia for surgery in a swine femoral fracture model.

Journal Article J Am Assoc Lab Anim Sci · 2013 Management of pain in research swine used for studies involving painful procedures is a considerable challenge. Here we assessed whether a regional anesthesia method is effective for pain control of hindlimb injuries in pigs used for research in bone fract ... Link to item Cite

The evolution and practice of acute pain medicine.

Journal Article Pain Med · January 2013 BACKGROUND: In recent years, the field of acute pain medicine (APM) has witnessed a surge in its development, and pain has begun to be recognized not merely as a symptom, but as an actual disease process. This development warrants increased education of re ... Full text Link to item Cite

Battlefield regional anesthesia: Evolution and future concepts

Journal Article Techniques in Regional Anesthesia and Pain Management · October 1, 2012 Owing to advanced protective technologies, many servicemembers are returning home with injuries that proved fatal in previous conflicts. However, such severe injuries provide numerous challenges for acute pain physicians. Advanced regional anesthetic techn ... Full text Cite

Ultrasound-guided peripheral nerve stimulator placement in two soldiers with acute battlefield neuropathic pain.

Journal Article Anesth Analg · April 2012 Acute peripheral neuropathic pain after combat-related polytrauma is a common occurrence in the United States military that is often refractory to current drugs and regional anesthesia. Both spinal cord and peripheral nerve stimulation are successfully use ... Full text Link to item Cite