Dr. David MacLeod is member of the Regional Division and the director of the Human Pharmacology and Physiology Laboratory (HPPL) at Duke Anesthesiology, which has attracted dozens of governmental, industry and university grants in order to conduct clinical trials and other scientific studies. He is also the director of regional research for the division. MacLeod and the HPPL research unit utilizes healthy volunteers to investigate a broad range of topics relevant to anesthesiology and critical care, including:

  • Phase 1 dose ascending studies in healthy volunteers to determine the safety, pharmacokinetic and pharmacodynamic effects of novel local anesthetics
  • Evaluating the relationship between BIS and plasma drug concentrations using target controlled infusions of Propofol and remifentanil
  • Comparison of skeletal muscle parameters from handheld ultrasound to CT imaging

The Regional Division is a highly-productive research division with interests in clinical, translational, education, and basic science research, including:

  • The development and implementation of Enhanced Recovery After Surgery (ERAS) pathways for joint replacement
  • The development of novel peripheral blocks for patients undergoing joint replacement
  • Safety of nerve block procedure and prevention of injury during peripheral nerve blockade
  • The role and impact of novel fascial plane blocks in reducing opioid use and pain experience for abdominal, pelvic and cardiac surgery
  • The role of fascial plane blocks in accelerating recovery after Cesarean delivery
  • The utility of 3D-guided needle tracking in nerve block performance
  • Defining the anatomical spread of injectate during peripheral and fascial plane block models using cadaveric models
  • Pharmacodynamics of local anesthetics and local anesthetic adjuvants
  • The use of Point of Care Ultrasound (POCUS) to enhance perioperative decision-making

Representative Publications

  1. Kumar L, Kumar AH, Grant SA, Gadsden J. Updates in Enhanced Recovery Pathways for Total Knee Arthroplasty. Anesthesiol Clin. 2018 Sep;36(3):375-386. doi: 10.1016/j.anclin.2018.04.007. Epub 2018 Jul 11. PMID: 30092935.
  2. Bain AR, Ainslie PN, Barak OF, Hoiland RL, Drvis I, Mijacika T, Bailey DM, Santoro A, DeMasi DK, Dujic Z, MacLeod DB. Hypercapnia is essential to reduce the cerebral oxidative metabolism during extreme apnea in humans. J Cereb Blood Flow Metab. 2017 Sep;37(9):3231-3242. doi: 10.1177/0271678X16686093. Epub 2017 Jan 10. PMID: 28071964; PMCID: PMC5584699.
  3. Gadsden JC, Sata S, Bullock WM, Kumar AH, Grant SA, Dooley JR. The relative analgesic value of a femoral nerve block versus adductor canal block following total knee arthroplasty: a randomized, controlled, double-blinded study. Korean J Anesthesiol. 2020 Oct;73(5):417-424. doi: 10.4097/kja.20269. Epub 2020 Aug 26. PMID: 32842722; PMCID: PMC7533174.
  4. Dooley J, Bullock WM, Kumar AH, MacLeod DB, Gadsden J. Systematic sonographic and evoked motor identification of the nerve to vastus medialis during adductor canal block. Reg Anesth Pain Med. 2020 Nov;45(11):937-938. doi: 10.1136/rapm-2019-101232. Epub 2020 May 19. PMID: 32434793.
  5. Klement MR, Bullock WM, Nickel BT, Lampley AJ, Seyler TM, Green CL, Wellman SS, Bolognesi MP, Grant SA. Continuous adductor canal blockade facilitates increased home discharge and decreased opioid consumption after total knee arthroplasty. Knee. 2019 Jun;26(3):679-686. doi: 10.1016/j.knee.2019.01.020. Epub 2019 Mar 20. PMID: 30904327.
  6. Gadsden J. Enhanced Recovery for Orthopedic Surgery. Int Anesthesiol Clin. 2017 Fall;55(4):116-134. doi: 10.1097/AIA.0000000000000161. PMID: 28901986.
  7. Gadsden J. Current devices used for the monitoring of injection pressure during peripheral nerve blocks. Expert Rev Med Devices. 2018 Aug;15(8):571-578. doi: 10.1080/17434440.2018.1507731. Epub 2018 Aug 7. PMID: 30079786.
  8. Gadsden J, Orebaugh S. Targeted intracluster supraclavicular brachial plexus block: too close for comfort. Br J Anaesth. 2019 Jun;122(6):713-715. doi: 10.1016/j.bja.2019.02.020. Epub 2019 Mar 28. PMID: 30929761.

View the Department’s Grant Awards