Clinical Faculty

John C. Keifer, MD

Associate Professor of Anesthesiology

Department:
Anesthesiology

Division:
Anesthesiology

Mailing Address:
DUMC 3094 Durham, NC 27710

Office Telephone:
919-681-3947

Fax:
919-681-4698

Training:
MD, University of North Carolina at Chapel Hill School of Medicine, 1979

Residency:
Pathology, Penn State Hershey Medical Center, 1983

Clinical Interests:
General, regional, and monitored anesthesia care to adult patients, anesthesia care for neurosurgical patients

Research Interests:
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.

Publications:
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. Anesth Analg. 2005 Aug;101(2):502-8, table of contents.

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 Nov;101(5):1066-76.

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 Nov;101(5):1077-83.

Keifer JC, Baghdoyan HA, Lydic R. Pontine cholinergic mechanisms modulate the cortical electroencephalographic spindles of halothane anesthesia. Anesthesiology. 1996 Apr;84(4):945-54.

Lydic R, Keifer JC, Baghdoyan HA, Becker L. Microdialysis of the pontine reticular formation reveals inhibition of acetylcholine release by morphine. Anesthesiology. 1993 Nov;79(5):1003-12.