Scholars@Duke
Srinivas Pyati

Srinivas Pyati

Associate Professor of Anesthesiology
Anesthesiology, VA Anesthesiology Service
srinivas.pyati@duke.edu
DUMC Box 3094, Durham, NC 27710
D5005 VAMC, Durham, NC 27710
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Selected Publications

Transitional Pain Service: Optimizing Complex Surgical Patients.

Journal Article Curr Pain Headache Rep · March 2024 PURPOSE OF REVIEW: The care of patients with complex postsurgical pain can be challenging and burdensome for the healthcare system. Transitional pain service (TPS) is a relatively new concept and has not been widely adopted in the USA. This article explore ... Full text Link to item Cite

Ketamine for Chronic Pain and Mental Health: Regulations, Legalities, and the Growth of Infusion Clinics.

Journal Article Curr Pain Headache Rep · October 2023 PURPOSE OF REVIEW: In this article, we will review evidence for ketamine's role in chronic pain and mental health conditions, its current legal status and abuse potential, and the regulations related to its administration in stand-alone infusion clinics, a ... Full text Link to item Cite

Association Between Gabapentinoids and Postoperative Pulmonary Complications in Patients Undergoing Thoracic Surgery.

Journal Article J Cardiothorac Vasc Anesth · August 2022 OBJECTIVE: Perioperative gabapentinoids in general surgery have been associated with an increased risk of postoperative pulmonary complications (PPCs), while resulting in equivocal pain relief. This study's aim was to examine the utilization of gabapentino ... Full text Link to item Cite

Changes in analgesic strategies for lobectomy from 2009 to 2018.

Journal Article JTCVS Open · June 2021 OBJECTIVE: To evaluate trends in the use of epidural analgesia and nonopioid and opioid analgesics for patients undergoing lobectomy from 2009 to 2018. METHODS: We queried the Premier database for adult patients undergoing open, video-assisted, and robotic ... Full text Open Access Link to item Cite

Post-Thoracotomy Pain: Current Strategies for Prevention and Treatment.

Journal Article Drugs · November 2020 Treating acute pain after thoracotomy surgery and preventing the development of chronic post-thoracotomy pain syndrome (PTPS) remain significant challenges in this surgical population. While appropriately treated acute thoracotomy pain often resolves, a si ... Full text Link to item Cite

Effects of Acetaminophen, NSAIDs, Gabapentinoids, and Their Combinations on Postoperative Pulmonary Complications After Total Hip or Knee Arthroplasty.

Journal Article Pain Med · October 1, 2020 OBJECTIVE: Multimodal analgesia has gained popularity in total hip arthroplasty (THA) and total knee arthroplasty (TKA), but large multicenter studies evaluating specific analgesic combinations are lacking. DESIGN: A retrospective study using the Premier H ... Full text Open Access Link to item Cite

Effects of Tourniquets in the Development of Pain States: a Novel Clinical Pilot Study and Review of Utilization of Tissue Oximetry to Measure Neural Ischemia.

Journal Article Curr Pain Headache Rep · April 22, 2020 PURPOSE OF REVIEW: Approximately 20% of patients undergoing surgery develop persistent lower extremity pain following total knee arthroplasty. Animal studies have confirmed that prolonged tourniquet time increases the risk of endoneural ischemia and can me ... Full text Link to item Cite

Dose-Dependent Association of Gabapentinoids with Pulmonary Complications After Total Hip and Knee Arthroplasties.

Journal Article J Bone Joint Surg Am · February 5, 2020 BACKGROUND: Gabapentinoids are commonly prescribed in perioperative multimodal analgesia protocols. Despite widespread use, the optimal dose to reduce opioid consumption while minimizing risks is unknown. We assessed dose-dependent effects of gabapentinoid ... Full text Link to item Cite

Association 'Between Gabapentinoids on the Day of Colorectal Surgery and Adverse Postoperative Respiratory Outcomes.

Journal Article Ann Surg · December 2019 OBJECTIVE: The aim of this study was to determine the association between gabapentinoids on the day of surgery and adverse postoperative outcomes in patients undergoing colorectal surgery in the United States. BACKGROUND: Gabapentinoids, gabapentin and pre ... Full text Link to item Cite

Device review: Pulsante™ sphenopalatine ganglion microstimulator.

Journal Article Pain Manag · November 2019 Cluster headache (CH) is a primary headache disorder. The use of neuromodulation in treatment of CH is well documented. The sphenopalatine ganglion (SPG) has long been a target for management of CH. Intervention at the level of the SPG can interrupt the tr ... Full text Link to item Cite

New Persistent Opioid Use After Postoperative Intensive Care in US Veterans.

Journal Article JAMA Surg · August 1, 2019 This study uses medical records of more than 800 000 US veterans treated in the intensive care unit after surgery to determine the rate at which these patients developed new persistent opioid use. ... Full text Link to item Cite

Chronic Headache: a Review of Interventional Treatment Strategies in Headache Management.

Journal Article Curr Pain Headache Rep · July 29, 2019 PURPOSE OF THE REVIEW: To provide an overview of current interventional pain management techniques for primary headaches with a focus on peripheral nerve stimulation and nerve blocks. RECENT FINDINGS: Despite a plethora of treatment modalities, some forms ... Full text Link to item Cite

Acute Pain Is Associated With Chronic Opioid Use After Total Knee Arthroplasty.

Journal Article Reg Anesth Pain Med · October 2018 BACKGROUND AND OBJECTIVES: Pain scores are routinely reported in clinical practice, and we wanted to examine whether this routinely measured, patient-reported variable provides prognostic information, especially with regard to chronic opioid use, after tak ... Full text Link to item Cite

Controversies in office-based anesthesia: obstructive sleep apnea considerations.

Journal Article Minerva Anestesiol · September 2018 As the number of procedures being performed in the office-based anesthesia (OBA) setting are increasing, so are the number of patients presenting for surgery with obstructive sleep apnea (OSA). There continues to be controversy regarding whether these pati ... Full text Link to item Cite

Transitional Pain Service: Optimizing Complex Surgical Patients.

Journal Article Curr Pain Headache Rep · March 2024 PURPOSE OF REVIEW: The care of patients with complex postsurgical pain can be challenging and burdensome for the healthcare system. Transitional pain service (TPS) is a relatively new concept and has not been widely adopted in the USA. This article explore ... Full text Link to item Cite

Ketamine for Chronic Pain and Mental Health: Regulations, Legalities, and the Growth of Infusion Clinics.

Journal Article Curr Pain Headache Rep · October 2023 PURPOSE OF REVIEW: In this article, we will review evidence for ketamine's role in chronic pain and mental health conditions, its current legal status and abuse potential, and the regulations related to its administration in stand-alone infusion clinics, a ... Full text Link to item Cite

Association Between Gabapentinoids and Postoperative Pulmonary Complications in Patients Undergoing Thoracic Surgery.

Journal Article J Cardiothorac Vasc Anesth · August 2022 OBJECTIVE: Perioperative gabapentinoids in general surgery have been associated with an increased risk of postoperative pulmonary complications (PPCs), while resulting in equivocal pain relief. This study's aim was to examine the utilization of gabapentino ... Full text Link to item Cite

Changes in analgesic strategies for lobectomy from 2009 to 2018.

Journal Article JTCVS Open · June 2021 OBJECTIVE: To evaluate trends in the use of epidural analgesia and nonopioid and opioid analgesics for patients undergoing lobectomy from 2009 to 2018. METHODS: We queried the Premier database for adult patients undergoing open, video-assisted, and robotic ... Full text Open Access Link to item Cite

Post-Thoracotomy Pain: Current Strategies for Prevention and Treatment.

Journal Article Drugs · November 2020 Treating acute pain after thoracotomy surgery and preventing the development of chronic post-thoracotomy pain syndrome (PTPS) remain significant challenges in this surgical population. While appropriately treated acute thoracotomy pain often resolves, a si ... Full text Link to item Cite

Effects of Acetaminophen, NSAIDs, Gabapentinoids, and Their Combinations on Postoperative Pulmonary Complications After Total Hip or Knee Arthroplasty.

Journal Article Pain Med · October 1, 2020 OBJECTIVE: Multimodal analgesia has gained popularity in total hip arthroplasty (THA) and total knee arthroplasty (TKA), but large multicenter studies evaluating specific analgesic combinations are lacking. DESIGN: A retrospective study using the Premier H ... Full text Open Access Link to item Cite

Effects of Tourniquets in the Development of Pain States: a Novel Clinical Pilot Study and Review of Utilization of Tissue Oximetry to Measure Neural Ischemia.

Journal Article Curr Pain Headache Rep · April 22, 2020 PURPOSE OF REVIEW: Approximately 20% of patients undergoing surgery develop persistent lower extremity pain following total knee arthroplasty. Animal studies have confirmed that prolonged tourniquet time increases the risk of endoneural ischemia and can me ... Full text Link to item Cite

Dose-Dependent Association of Gabapentinoids with Pulmonary Complications After Total Hip and Knee Arthroplasties.

Journal Article J Bone Joint Surg Am · February 5, 2020 BACKGROUND: Gabapentinoids are commonly prescribed in perioperative multimodal analgesia protocols. Despite widespread use, the optimal dose to reduce opioid consumption while minimizing risks is unknown. We assessed dose-dependent effects of gabapentinoid ... Full text Link to item Cite

Association 'Between Gabapentinoids on the Day of Colorectal Surgery and Adverse Postoperative Respiratory Outcomes.

Journal Article Ann Surg · December 2019 OBJECTIVE: The aim of this study was to determine the association between gabapentinoids on the day of surgery and adverse postoperative outcomes in patients undergoing colorectal surgery in the United States. BACKGROUND: Gabapentinoids, gabapentin and pre ... Full text Link to item Cite

Device review: Pulsante™ sphenopalatine ganglion microstimulator.

Journal Article Pain Manag · November 2019 Cluster headache (CH) is a primary headache disorder. The use of neuromodulation in treatment of CH is well documented. The sphenopalatine ganglion (SPG) has long been a target for management of CH. Intervention at the level of the SPG can interrupt the tr ... Full text Link to item Cite

New Persistent Opioid Use After Postoperative Intensive Care in US Veterans.

Journal Article JAMA Surg · August 1, 2019 This study uses medical records of more than 800 000 US veterans treated in the intensive care unit after surgery to determine the rate at which these patients developed new persistent opioid use. ... Full text Link to item Cite

Chronic Headache: a Review of Interventional Treatment Strategies in Headache Management.

Journal Article Curr Pain Headache Rep · July 29, 2019 PURPOSE OF THE REVIEW: To provide an overview of current interventional pain management techniques for primary headaches with a focus on peripheral nerve stimulation and nerve blocks. RECENT FINDINGS: Despite a plethora of treatment modalities, some forms ... Full text Link to item Cite

Acute Pain Is Associated With Chronic Opioid Use After Total Knee Arthroplasty.

Journal Article Reg Anesth Pain Med · October 2018 BACKGROUND AND OBJECTIVES: Pain scores are routinely reported in clinical practice, and we wanted to examine whether this routinely measured, patient-reported variable provides prognostic information, especially with regard to chronic opioid use, after tak ... Full text Link to item Cite

Controversies in office-based anesthesia: obstructive sleep apnea considerations.

Journal Article Minerva Anestesiol · September 2018 As the number of procedures being performed in the office-based anesthesia (OBA) setting are increasing, so are the number of patients presenting for surgery with obstructive sleep apnea (OSA). There continues to be controversy regarding whether these pati ... Full text Link to item Cite

Implementation of Perioperative Music Using the Consolidated Framework for Implementation Research.

Journal Article Anesth Analg · September 2018 BACKGROUND: Complementary integrative health therapies have a perioperative role in the reduction of pain, analgesic use, and anxiety, and increasing patient satisfaction. However, long implementation lags have been quantified. The Consolidated Framework f ... Full text Link to item Cite

Utility of Radionuclide Bone Scintigraphy in Complex Regional Pain Syndrome.

Journal Article Curr Pain Headache Rep · February 1, 2018 PURPOSE OF REVIEW: To describe the current understanding of the role of three-phase bone scintigraphy (TPBS) in the diagnosis and management of complex regional pain syndrome (CRPS), discuss its advantages and limitations, and present three examples of TPB ... Full text Link to item Cite

Advances in regional anaesthesia: A review of current practice, newer techniques and outcomes.

Journal Article Indian J Anaesth · February 2018 Advances in ultrasound guided regional anaesthesia and introduction of newer long acting local anaesthetics have given clinicians an opportunity to apply novel approaches to block peripheral nerves with ease. Consequently, improvements in outcomes such as ... Full text Link to item Cite

Perioperative Ketamine Administration for Thoracotomy Pain.

Journal Article Pain Physician · March 2017 BACKGROUND: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotom ... Link to item Cite

Analgesia in the surgical intensive care unit.

Journal Article Postgrad Med J · January 2017 Critically ill patients are a heterogeneous group with diverse comorbidities and physiological derangements. The management of pain in the critically ill population is emerging as a standard of care in the intensive care unit (ICU). Pain control of critica ... Full text Link to item Cite

Residual limb pain is not a diagnosis: a proposed algorithm to classify postamputation pain.

Journal Article Clin J Pain · June 2013 BACKGROUND: Although postamputation pain (PAP) syndromes have been described since the 16th century, taxonomy of these conditions remains ill-defined. The term "Residual Limb Pain" fails to distinguish between distinct diagnostic entities such as neuroma, ... Full text Open Access Link to item Cite

Prevention of chronic pain after surgical nerve injury: amputation and thoracotomy.

Journal Article Surg Clin North Am · April 2012 Although techniques for acute pain management have improved in recent years, a dramatic reduction in the incidence and severity of chronic pain following surgery has not occurred. Amputation and thoracotomy, although technically different, share the common ... Full text Link to item Cite

Efficacy and safety of ketamine in patients with complex regional pain syndrome: a systematic review.

Journal Article CNS Drugs · March 1, 2012 Despite being a recognized clinical entity for over 140 years, complex regional pain syndrome (CRPS) remains a difficult-to-treat condition. While there have been multiple therapies explored in the treatment of CRPS, NMDA antagonists such as ketamine conti ... Full text Link to item Cite

Residual limb pain: more than a single entity?

Journal Article Anesthesiology · January 2012 Full text Link to item Cite

Perioperative pain management.

Journal Article CNS Drugs · 2007 The under-treatment of postoperative pain has been recognised to delay patient recovery and discharge from hospital. Despite recognition of the importance of effective pain control, up to 70% of patients still complain of moderate to severe pain postoperat ... Full text Link to item Cite

Headache in guillain-barre syndrome.

Journal Article J Neurosurg Anesthesiol · October 2004 Severe headache in Guillain-Barre syndrome is rare. We report the management of a young patient with Guillain-Barre syndrome who suffered severe headache, which was not relieved by conventional analgesics. There was evidence of raised intracranial pressure ... Full text Link to item Cite

Hepatic failure after rectal acetaminophen.

Journal Article Anesth Analg · February 2002 Link to item Cite