NeuroNow - An Institute to Battle Neurosurgical Pain
An Institute to Battle Neurosurgical Pain
Date: June 12, 2014
Pain is one of the most common reasons patients seek the care of a neurosurgeon, and it’s nearly always a given after neurosurgery. But treating patients’ pain effectively is something that all hospitals have struggled with, say Michael Caterina and Allan Belzberg. For the past three years, Johns Hopkins has had a tool in its arsenal for helping patients overcome neurosurgical pain now and in the future.
Started with an initial $25 million gift from an anonymous donor, the Neurosurgery Pain Research Institute at Johns Hopkins – To Control, Prevent and Eliminate Pain, which Caterina and Belzberg co-direct, has three main branches: a pain resource team, scientists doing basic pain research and a group working on developing clinical trials for novel pain therapies.
The goal of the pain resource team is to bring immediate relief to current neurosurgery patients. Composed of a credentialed pain specialist nurse and a pain specialist pharmacist, the team makes rounds every day to listen to patients’ complaints and provide consultation to the patients and their physicians and nurses regarding tailored strategies for easing pain, whether by pharmaceutical or complementary methods. The nurse and pharmacist also provide education and consultations to each patient’s entire care team to make sure pain management needs are managed in the best possible way.
“The patient feels heard, and that alone is very important,” says Belzberg, a neurosurgeon who regularly works with the pain resource team.
In addition, he says, having a team devoted solely to managing patients’ pain needs helps ensure that medications are used appropriately. The team’s recommendations help prevent overdoses, adverse drug interactions and inadequate pain control due to drug resistance. Combining the skill sets of the various components of the institute will accelerate movement of therapeutic strategies from the laboratory to the bedside.
The institute’s other two branches were developed with an eye toward treating patients’ pain in the future, says Caterina, a sensory neurobiologist whose research focuses on the molecular basis of pain. He and other Johns Hopkins scientists are working to develop novel pain relief solutions. Recently, researchers supported by the institute’s funds found that pain-sensing nerve cells are not all the same, but rather come in different varieties that probably mediate different aspects of pain sensation.
“By bringing together a diverse array of tools to better measure and understand pain transmission by nerve cells in the laboratory,” Caterina says, “we might be able to better understand why different painful conditions respond better to one treatment versus another.”
In a step closer to getting research into the clinic, the institute supports a clinical trials team, including experienced clinical trial designers, biostatisticians and regulatory experts. This group is running trials not only to evaluate new pharmaceuticals but also therapies that attack pain in completely novel ways, such as magnetic stimulation across the brain’s surface.
In the end, the directors say, the institute’s mission is to help all patients with neurosurgical-related pain.
“If we can impact patient care not just at Hopkins but beyond,” says Caterina, “we will consider it a success.”
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