Richard Brull, MD, FRCPC

Despite advancements in safety and technology that have revolutionized the practice of anesthesia, pain and nausea remain the two leading obstacles to timely discharge from hospital after surgery. Conventional narcotic-based analgesic strategies create a vicious circle of pain and nausea that keep patients in hospital beds, creating further delays for operations and costing the health system thousands of dollars per hospital stay. Dr. Richard Brull’s research is focused on developing strategies that prolong the duration of regional anesthesia to push the boundaries of ambulatory surgery and facilitate same-day discharge from the hospital.

Total knee replacement surgery is one of the most commonly performed, yet painful surgeries worldwide. In Canada, only 69 per cent of patients receive knee replacement surgery within the recommended time frame and creating a backlog in our already strained healthcare system. Dr. Brull has played an instrumental role in developing, implementing and launching Canada’s first outpatient total knee and hip replacement program, building on the success of Women’s College Hospital’s outpatient total thyroid removal surgery program. By avoiding opioids and using sensory nerve blocks and short-acting spinal anesthesia to preserve muscle strength, patients undergoing total knee or hip replacement surgery at Women’s College Hospital are able to go home the same day.

Dr. Brull’s research has also been used to reduce severe acute postoperative pain following breast cancer surgery, which affects nearly 60 per cent of patients. As a result of postoperative pain, up to 50 per cent of women undergoing breast cancer surgery will develop chronic pain with long-term health impacts. To reduce pain following surgery, Dr. Brull evaluates the effectiveness of using novel nerve blocks. Based on evidence from Dr. Brull’s research, using nerve blocks during breast cancer surgery is now routine practice at Women’s College Hospital.