Perioperative Medicine

Our work

We investigate approaches to risk assessment, causes of complications after major surgery, and ways to prevent them occurring. We collaborate with the Royal College and patient partners worldwide to develop these new ideas, working closely with the UCL Bloomsbury Institute of Intensive Care.

UCL Source

Lead: Prof. Ramani Moonesinghe

This group uses measurement to improve the quality of perioperative healthcare. The work undertaken by the group focuses on the following areas:

• Risk stratification. Understanding and improving methods to predict adverse outcomes (complications and mortality) after major non-cardiac surgery.
• Innovation in measurement. Development and validation of measures for assessing outcome from major surgery: encompassing complications and patient-reported outcome
• Improvement Science. Using measurement to improve quality of care; dissemination of learning for quality improvement

Our advice is based upon research data and audit studies looking at risk adjustment and outcome measures. Staff are mostly NHS clinicians. Academic input comes from DAHR and a partnership with the National Institute for Academic Anaesthesia’s Health Services Research Centre (NIAA-HSRC), based at the Royal College of Anaesthetists.

Translational Research Centre

Lead: Dr Dan Martin

Our team is involved with studies that will broaden our understanding of the cellular processes that may determine perioperative outcomes. Our interests lie in redox homeostasis and influence of oxygen on biological pathways.

We are funded via the National Institute for Academic Anaesthesia, British Journal of Anaesthesia, Royal Free Charity and UCLH-UCL NIHR BRC.

One of our key collaborations is with the dept at the University of Cambridge.

UCL-UCLH Perioperative Medicine Clinical Trials Group

Lead: Dr Sam Bampoe

We design and deliver local, national, and international collaborative clinical trials in surgery, anaesthesia, and perioperative medicine. Our UCL and UCLH team of clinicians and researchers lead the delivery of several locally designed NIHR portfolio studies, including X-MINS, X-LAB and SPACE.

We work closely with partners to deliver world-class perioperative research, focused on improving outcomes and experiences for surgical patients.

Clinical trials in development include studies of postoperative cognitive dysfunction in the elderly and perioperative anaemia and iron therapy in multiple surgical populations.

Our facilities

The Smiths-UCL Discovery Lab opened in 2013, marking a 20-year collaboration with multinational medical device company Smiths Medical. Here, clinical research and industry works together to develop promising medical innovations. We hold international patents on several innovative medical devices that have huge potential to benefit patient care.

While most projects focus on devices that are primarily for the critical care environment, there is substantial scope for use in other healthcare settings. Areas of particular interest include novel technology for airway management, temperature control, perioperative dehydration, and intravenous infusion.

The Centre for Perioperative Medicine

Funding / Partnerships

Our close relationship with Smiths Medical gives clinicians and UCL researchers the opportunity to discuss projects with industry, even during the early stages of development. This fosters a unique environment to expedite the progression of products from inception to bedside.

As well as providing engineering expertise, Smiths Medical funds a medical innovation fellow to work under the supervision of the Smiths Medical Professor of Anaesthesia and Critical Care, Professor Monty Mythen. Previous fellows have all gone on to consultant jobs at UCLH and elsewhere.

If you are interested in working with us, contact: m.mythen@ucl.ac.uk.

Global Health

We want to promote a better understanding of international healthcare issues through our growing Global Health Programme. We aim to connect with patients, communities, and healthcare professionals across the world, to improve our understanding of healthcare needs beyond our daily lives. We hope to contribute to health improvements through an active partnership with local experts and create opportunities for research, training, and education.

We have partnered with colleagues in Sri Lanka, the Network for Improving Critical Care Systems and Training (NICST), to produce The Care Quality Improvement Network. This multidisciplinary team collects, curates, and uses real-time local data to ask important health questions in low and middle-income countries, which provides an exciting opportunity for bi-directional learning. Local data drives projects in line with UCL Global Health strategy. Together with our overseas partners and experts in the field, it delivers a coherent programme and a unique opportunity for personal development.

To find out more, contact Dr Duncan Wagstaff: d.wagstaff@ucl.ac.uk.

Select publications

1. Mitchell, C., Cheuk, S.J., O'Donnell, C.M., Bampoe, S. & Walker, D. (2022). What is the impact of dexamethasone on postoperative pain in adults undergoing general anaesthesia for elective abdominal surgery: a systematic review and meta-analysis. Perioperative Medicine, 11 (1), 13.
2. Odor, P.M., Bampoe, S., Lucas, D.N., Moonesinghe, S.R., Andrade, J., et al. (2021). Incidence of accidental awareness during general anaesthesia in obstetrics: a multicentre, prospective cohort study. Anaesthesia. Vol 76 (6), 759-776
3. Odor, P.M., Bampoe, S., Moonesinghe, S.R., Andrade, J., Pandit, J.J., et al. (2020). General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study. Anaesthesia. Vol 76 (4), 460-471.
4. Odor, P.M., Bampoe, S., Gilhooly, D., Creagh-Brown, B. & Moonesinghe, S.R. (2020). Perioperative interventions for prevention of postoperative pulmonary complications: systematic review and meta-analysis. BMJ: British Medical Journal, 368:m540.
5. Odor, P.M., Bampoe, S., Lucas, D.N., Moonesinghe, S.R., Andrade, J. & Pandit, J.J. (2020). Protocol for direct reporting of awareness in maternity patients (DREAMY): a prospective, multicentre cohort study of accidental awareness during general anaesthesia. International Journal of Obstetric Anesthesia. Vol. 42, 47-56.
6. Bedford, J., Sahni, A., Bampoe, S., Moonesinghe, S.R., et al. (2018). Perioperative Quality Improvement Programme 2017/18 Annual Report. London: Royal College of Anaesthetists.
7. Bampoe, S., Cook, T., Fleisher, L., Grocott, M.P.W., et al. (2018). Clinical indicators for reporting the effectiveness of patient quality and safety-related interventions: a protocol of a systematic review and Delphi consensus process as part of the international Standardised Endpoints for Perioperative Medicine initiative (StEP). BMJ OPEN, 8 (11), ARTN e023427.
8. Bampoe, S., Odor, P. M., Dushianthan, A., Bennett-Guerrero, E., et al. (2017). Perioperative administration of buffered versus non-buffered crystalloid intravenous fluid to improve outcomes following adult surgical procedures (Review). Cochrane Database of Systematic Reviews 2017, Issue 9. Art. No: CD004089.
9. Bampoe, S., Odor, P. M., Moonesinghe, S.R., & Dickinson, M. (2017). A systematic review and overview of health economic evaluations of emergency laparotomy. Perioperative Medicine 6, 21.
10. Bampoe, S., Odor, P. & Walker, D. (2016). Harnessing the power of networks: the future of perioperative research. British Journal of Hospital Medicine, 77 (6), 320-321.

Teaching team wins awards

In 2019, our Perioperative Medicine team (Abigail Whiteman, Gautam Kumar, Sam Bampoe, Robert Stephens, David Walker and Anna Szajda) won Faculty Education and UCL Provost Education awards.