Richard M. Smiley, M.D., Ph.D. Professor of Clinical Anesthesiology (in Obstetrics and Gynecology) Chief of Obstetric Anesthesia
Dr. Smiley's recent areas of research interest have been in the general area of pharmacogenetics. He has shown that a common genetic polymorphism (arginine 16) of the beta-2 adrenergic receptor has a significant protective effect on the incidence or outcome of preterm labor. Other recently published work has demonstrated that genetic variation of this receptor affects the hemodynamic response to spinal anesthesia and vasopressor use during cesarean section. In research on another receptor system, a common genetic variant of the mu-opioid receptor has been shown to significantly affect the analgesic response to spinal fentanyl in labor. Another investigation of altered drug and hormonal responses involves studying the response of the vascular system to vasoconstrictors and dilators during pregnancy compared to the non-pregnant state. This is being studied in humans using a mini-dose venous infusion technique and linear variable differential transformer ("LVDT") sensor. Dr. Smiley helped initiate and is participating in a multi-center study of the development of chronic or persistent pain after cesarean or vaginal delivery (the PAD study). Other clinical research projects and interest include studies of various drugs and strategies of use of spinal and epidural analgesia for the relief of labor, postoperative and postpartum pain.
Dr. Smiley's recent areas of research interest have been in the general area of pharmacogenetics. He has shown that a common genetic polymorphism (arginine 16) of the beta-2 adrenergic receptor has a significant protective effect on the incidence or outcome of preterm labor. Other recently published work has demonstrated that genetic variation of this receptor affects the hemodynamic response to spinal anesthesia and vasopressor use during cesarean section. In research on another receptor system, a common genetic variant of the mu-opioid receptor has been shown to significantly affect the analgesic response to spinal fentanyl in labor. Another investigation of altered drug and hormonal responses involves studying the response of the vascular system to vasoconstrictors and dilators during pregnancy compared to the non-pregnant state. This is being studied in humans using a mini-dose venous infusion technique and linear variable differential transformer ("LVDT") sensor. Dr. Smiley helped initiate and is participating in a multi-center study of the development of chronic or persistent pain after cesarean or vaginal delivery (the PAD study). Other clinical research projects and interest include studies of various drugs and strategies of use of spinal and epidural analgesia for the relief of labor, postoperative and postpartum pain.