Physician Investigator (Cl) Anesthesia, Critical Care and Pain Medicine, Mass General Research Institute

Associate Professor of Anaesthesia Harvard Medical School

Associate Anesthetist Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital

BA Amherst College 1996

MD University of Pennsylvania 2000

anesthetic mechanisms and pharmacology; anesthetics general; anesthetics inhalation; anesthetics intravenous; arousal; basic systems neuroscience; consciousness; dopamine uptake inhibitors; dopaminergic neurons; sleep

I study the mechanisms of emergence and cognitive recovery from general anesthesia using a systems neuroscience approach. In current clinical practice, emergence from general anesthesia is treated as a passive process dictated by the pharmacokinetics of anesthetic drug clearance. My group discovered that dopamine agonists induce active emergence from general anesthesia, and we subsequently discovered that optogenetic stimulation of dopaminergic neurons in the ventral tegmental area (VTA) restores consciousness in anesthetized rodents. I currently direct a translational research program that studies the role of dopamine pathways in restoring consciousness and cognition after general anesthesia. We combine intracranial stimulation, neurophysiological recordings, and cognitive testing in rodents to elucidate the neural circuits that govern anesthetic emergence, and we are actively developing anesthetic reversal agents for clinical use. Our long-term goal is to make general anesthesia safer by developing new therapeutic options for common clinical problems such as delayed emergence, postoperative delirium, and perioperative neurocognitive disorder.