2022 DIG Research Project | “Pediatric Pain Optimization After Tonsillectomy: A Randomized Double Blind Methadone Pilot Study”
Background
Lisa Einhorn, MD, is a pediatric anesthesiologist and physician-scientist within Duke Anesthesiology with specialty board certifications in anesthesiology and pediatric anesthesiology from the American Board of Anesthesiology. Dr. Einhorn is a member of the Pediatric Anesthesiology Division where she practices anesthesiology in all areas of Duke Children’s Hospital. She is also a faculty member on the Inpatient Pain Service and practices pain management in hospitalized adult and pediatric patients with a variety of painful conditions. Dr. Einhorn is an active member of several national and international societies, including the American Society of Anesthesiologists, International Anesthesia Research Society, the Society for Pediatric Anesthesia, and the Society for Pediatric Pain Medicine. She is a Fellow of the American Academy of Pediatrics. Nationally, she has been invited to present at conferences on topics such as post-operative pain management in children, opioid prescribing and utilization after pediatric surgery, the development of chronic pain in children, and regional anesthesia techniques for pediatric patients. She is an invited member on the Anesthesia Patient Safety Foundation Advisory Committee on Opioid Related Harm. She has published numerous peer-reviewed publications.
Dr. Einhorn is originally from Baltimore, Maryland. As an undergraduate, she attended Emory University in Atlanta, Georgia where she majored in economics while completing her pre-requisite courses for medical school. During medical school at the University of Maryland, she published research analyzing the frequency and significance of hyperkalemia and hypoglycemia in patients with chronic kidney disease with support from the Agency for Healthcare Research and Quality (AHRQ). The outcome of these studies increased her interest in developing projects in the area of patient safety and quality. In medical school, she was elected into the Alpha Omega Alpha (AOA) Medical Honor Society and awarded the Dr. Martin Helrich Prize for Excellence in Anesthesiology. Dr. Einhorn completed her residency training in anesthesiology and fellowship training in pediatric anesthesiology at Duke University. As a resident, she was awarded the Department of Anesthesiology’s Bill White Research Award in 2014 and 2015 and was a member of the senior resident leadership as a teaching scholar. As a fellow, she continued her research pursuits and was awarded the Dick Smith Award for post-doctorate clinical research. Dr. Einhorn joined the faculty at Duke in 2016, where she continues to develop her career as an early investigator physician-scientist.
Research
Dr. Einhorn’s research interests involve investigating novel strategies to manage perioperative pediatric surgical pain. Pain in children remains a prevalent concern because it is often under-recognized and under-treated and has the potential to result in life-long comorbidities. There is strong evidence that untreated pediatric pain incurs a high risk for the subsequent development of persistent pain, disability and psychological disorders in adulthood. In fact, approximately 20 percent of adult chronic pain patients report a history of poorly managed pain in childhood or adolescence. Currently, there is limited guidance from pediatric governing bodies for both intraoperative and post-operative care which results in a haphazard approach to analgesia. At this time, Dr. Einhorn acts as the site PI in two multi-center NIH-funded research studies evaluating how genetics, epigenetics and behavioral factors all play a role in increased pain sensitivity and inadequate relief from opioids. Her long-term career goal is to be an independently funded clinician-scientist in acute pediatric pain medicine and pharmacology, conducting innovative research to improve acute post-operative pain and reduce the need for post-operative opioids in children following surgery.
DREAM Innovation Grants (DIG) support innovative high-risk and potentially high-reward investigations to accelerate anesthesia and pain management research and are made possible through Duke Anesthesiology’s Duke DREAM Campaign. Dr. Einhorn is excited to have received a 2022 DIG to pursue a randomized clinical pilot study examining the role of intraoperative methadone in pediatric tonsillectomy, a common surgery that often results in severe pain. The proposed pilot will investigate methadone’s effectiveness in reducing post-operative opioid utilization with the specific goal of determining the optimal dose to be used in subsequent larger trials. The work will be performed under the guidance of Dr. Evan Kharasch (Duke Anesthesiology) who is an internationally recognized expert and researcher in basic, translational and clinical pharmacology with a particular focus on opioids.
These awarded DIG funds are expected to generate preliminary data for future NIH grant applications that will allow Dr. Einhorn to establish herself as an independent investigator.