Cite as: Nanda M, Chamessian A, Chen YK. Research grants: 2026 update. ASRA Pain Medicine News 2026;51. https://doi.org/10.52211/asra080126.004.

ASRA Pain Medicine offers several research grants annually. The recipients of the Carl Koller Memorial Research Grant, the Chronic Pain Medicine Research Grant, and the Early-Stage Investigator Award share an update on their progress in 2026.

2025 Carl Koller Memorial Research Grant

Monika Nanda, MBBS, MPH, FASA

Interscalene vs Phrenic-Sparing Blocks in Obesity: Effect of Pre-Operative Maximum Inspiratory Pressure in a Randomized Trial

Introduction: Interscalene block remains one of the most effective regional anesthetic techniques for shoulder surgery, but its major limitation is predictable phrenic nerve involvement, which can lead to hemidiaphragmatic paresis (HDP). While many patients tolerate this physiologic effect, patients with obesity may be more vulnerable to dyspnea, hypoxia, or delayed recovery. Yet, obesity alone is an imprecise marker of risk. Our pilot work suggested that lower baseline maximum inspiratory pressure (MIP), a bedside measure of baseline inspiratory strength, may be associated with worse respiratory symptoms after interscalene block in patients with obesity.

Study Methodology: This ASRA Pain Medicine-funded randomized trial, registered as ClinicalTrials.gov NCT07216820, is enrolling patients with BMI >35 undergoing shoulder surgery at the University of North Carolina (UNC) Hospitals. Before surgery, participants undergo baseline MIP testing to assess inspiratory strength. Participants are stratified by baseline MIP using a threshold of <90 versus ≥90 cm H₂O and then randomized to receive either a standard interscalene block or a phrenic-sparing block strategy combining an infraclavicular block with a distal suprascapular nerve block. The study evaluates postoperative respiratory outcomes, including breathlessness and oxygen requirement, as well as analgesic outcomes.

Anticipated Completion and Potential Impact: Enrollment began in January 2026, with a planned sample size of 68 participants, and anticipated completion by June 2027. This trial addresses a practical clinical question for regional anesthesiologists: Can we predict the tolerability of HDP from interscalene block in patients with obesity using a simple bedside monitor? If baseline MIP helps identify patients at higher risk, it could support a more personalized approach to shoulder anesthesia, matching block choice to baseline inspiratory strength rather than relying on BMI alone.

2025 Chronic Pain Medicine Research Grant

Alexander Chamessian, MD, PhD

Chronic pain affects over 20% of Americans, costing $600 billion annually; yet, non-addictive analgesics remain scarce. Voltage-gated sodium channels NaV1.7 and NaV1.8 are validated pain targets, but inhibitors have largely failed clinically. Our project applies targeted protein degradation—using proteolysis-targeting chimeras (PROTACs) to eliminate rather than block NaVs—to achieve potent, specific, durable analgesia. To do this, we proposed generating degron-tagged (dTA) NaV1.7 and NaV1.8 knock-in mice, characterizing pain behaviors after PROTAC treatment across routes of administration and nerve injury, and confirming effects via DRG electrophysiology.

With the support of the ASRA Pain Medicine Chronic Pain Grant, in year 1 we successfully generated and characterized these mice, and in vitro we showed potent silencing of sensory neuron firing with dTAG PROTACs. Now, in the remainder of the award period, we will carry out comprehensive in vivo evaluation of PROTAC-mediated degradation of NaV1.8 and NaV1.7 in the knock-in mice. Altogether, this work would establish degrader therapeutics as a transformative, long-lasting new path for treating chronic pain.

2025 Early-Stage Investigator Award

Yun-Yun K. Chen, MD

Over 80% of surgical patients report moderate or severe levels of pain during recovery. In the United States, more than a million adults undergo open abdominal surgery each year, for which untreated severe pain can result in respiratory complications (eg shallow breathing, atelectasis, retention of secretions), inability to ambulate or participate in physical therapy, and venous thromboembolism. Postoperative pain is commonly treated with opioids, which can lead to complications, such as sedation, respiratory depression, delirium, constipation, and prolonged ileus. Regional anesthesia (eg epidural, peripheral nerve blocks) has been shown to reduce postoperative pain, incidence of ileus, and vomiting after abdominal surgery. Therefore, regional anesthesia may play a crucial role in multimodal perioperative pain management for patients undergoing major abdominal surgery, especially those with higher risk of greater severity and duration of postsurgical pain. However, many patients who undergo open abdominal surgeries do not receive regional anesthesia due to the lack of agreement about the benefit and concerns regarding time pressure and lack of appropriate resources.

My project aims to develop a machine learning model to predict severe postoperative pain and high opioid consumption postoperatively in patients undergoing open abdominal surgery and identify the gaps in regional anesthetic delivery, comparing individual-level factors that predict actual receipt of regional anesthesia to those associated with severe acute postoperative pain and high opioid consumption. During the project, we realized that individual-level factors may present in unstructured data (eg history of chronic pain, opioid use disorder, medication-assisted therapy such as methadone). Therefore, we are also leveraging natural language processing and large language models to incorporate predictor variables associated with severe postoperative pain and high opioid consumption to make the best machine learning models for this study.