Graeme Mcleod

Biography

Graeme McLeod qualified from the University of Edinburgh in 1983 and trained in General Practice, gaining MRCGP in 1987. He switched to Anesthesia training first at Monklands Hospital, Lanarkshire, rotating into Glasgow then came to Ninewells Hospital in 1991 after obtained FRCA. He was appointed NHS consultant in 1995 and on arrival of Professor JAW Wildsmith was appointed to Honorary Senior Lecturer. His thesis “The patterns and predictors of thoracic epidural analgesia” was awarded MD (Dundee) 2005. He gained PGCertMedEd (Dundee) 2006 and FFPMRCA in 2007.

Research Interest

Technical failure still occurs in 25% of epidural blocks and in 7% of regional techniques. Regional blocks are conducted using ultrasound, although epidural block remains a blind technique dependant on operator skill. Ultrasound scanning is estricted to identification of the mid-line and measurement of distance to the epidural space. For both epidural and regional block, resolution of tissue targets and needle tips is hampered by increasing depth. For example tissue resolution using 5MHz to 10MHz transducers varies between 600mm and 300mm due to attenuation of acoustic energy. Needle visibility is further impaired by increasing needle angle and out-of-plane needle alignment, even using echogenic or textured needles. The objective of my research is to develop new needle technologies that improve both image presentation and operator interpretation of ultrasound images particularly in the obese population where skin landmarks are difficult to feel and palpation much more prone to error. Visible vibrating needle project We have invented an ultrasound actuator that vibrates needles between 14g and 25g at 20,000 Hertz, patent No. GB 1304798.0, 2013. The licensing agreement for this technology was sold to Active Needle technologies, Buckinghamshire, UK by the University of Dundee in December 2015. Vibration shows needles in colour using doppler ultrasound, is less likely to deflect and, using the reverse peizo-electric effect, measures needle tip force, electrical impedance and resonant frequency in real-time. Ultrasound at Tip of Needle Project The logical key innovative step in future ultrasound technology is to narrow the distance between the ultrasound transducer and anatomical region of interest by building a needle incorporating ultrasound elements at its tip. The advantage of such a device would be two-fold: not only would energy be attenuated less because the distance between transducer and target was considerably reduced, but close proximity would necessitate the use of transducers with much higher frequencies with shorter focal points, and by inference much higher resolution and better discrimination between tissue not just outwith but also within nerves. I am a member of multi-disciplinary, multi-centre research group consisting of clinicians and engineres from the Universities of Dundee, Edinburgh, Glasgow, Heriot-Watt and Birmingham. My PhD student, Anu Chandra, is funded by a Br J Anaesth/RCoA grant