Staff profile for Prof Michael Cousins

Position

Professor & Head of Dept of Anaesthesia & Pain Management, University of Sydney, Royal North Shore Hospital, St. Leonards NSW Australia Professor & Director Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, St. Leonards NSW Australia

Job description

Head of Department

Organisation

Head of Department, University of Sydney

Qualifications

MB BS MD DSc FRCA FANZCA FFPMANZCA FAChPM (RACP)

Education

Following specialist training in Anaesthesia, Professor Cousins was awarded a University of Sydney Post Graduate Fellowship to carry out research on Acute Pain Management with a pioneer in this field, Professor Philip Bromage, McGill University, Montreal, Canada. He was then appointed to the Faculty of Stanford University Medical Center in California, spending a total of 5 years in North America, where he completed the research for his MD degree.

Research interests

While at McGill and Stanford Universities he interacted with three of the pioneers of the field of Pain Medicine, Ronald Melzack and Patrick Wall, who in 1965 proposed the revolutionary “Gate Control Theory of Pain”, and John J. Bonica the Founding Father of the team approach to pain management. These key interactions, and others at Stanford University in the early 1970’s, stimulated his more than 32 years of research, teaching, clinical innovation and development of the field of Pain Medicine in Australia and Internationally.

In Australia, Professor Cousins was the Founding President of the Australian Pain Society (1979), Chairman of the Joint Advisory Committee on Pain Medicine of the specialist College of Anaesthesia (ANZCA), Medicine (RACP), Surgery (RACS), Psychiatry (RANZCP) and Rehabilitation Medicine (AFRM) which led to the formation of the Faculty of Pain Medicine (ANZCA) in 1999. He served as the Founding Dean of the Faculty (1999-2002), which is currently unique worldwide in bringing together five specialty bodies to oversee a single training program and examination leading to a specialist qualification in Pain Medicine.

Professor Cousins developed two large multidisciplinary centres in Pain Medicine, at Flinders Medical Centre, Adelaide (1975-1990) and at the University of Sydney, Royal North Shore Hospital (1990 – present). Both of these centres became internationally recognised for clinical care, teaching and research. The University of Sydney Pain Management & Research Centre was recognised by the National Health & Medical Research Council (NHMRC) of Australia in 1998 as one of only eight “Centres of Clinical Excellence in Hospital Based Research”, among all medical research disciplines across Australia. Professor Cousins also fostered the development of a University of Sydney Diploma and Masters course in Pain Management, which now enrols students from around the world in a web-based education program, which is unique worldwide.

He chaired an NHMRC Working Party (1995-1999) which developed Australia's first “evidence-based medicine” guideline on the Management of Acute Pain – a document now used throughout Australia and internationally; he also served as a Councillor for the NHMRC. Internationally Professor Cousins is the only Australian, and sole Anaesthetist after the Founder, JJ Bonica, to serve as President of the International Association for the Study of Pain (IASP) (1987-1990). He played a major role in stimulating IASP to form an official relationship with the WHO and to place more emphasis on the treatment of cancer pain and acute pain, in addition to pre-existing emphasis on chronic pain. In recognition of these contributions he was made an Honorary Member of the IASP, and also of the Pain Society of Great Britain and Ireland.

Running in parallel with his activities in the field of Pain Medicine, Professor Cousins has developed two major Centres of education and research in Anaesthesia via Foundation Chairs at Flinders University and University of Sydney. A strong focus in Intensive Care research was also developed at Flinders University. He also fostered the development of the Sydney Medical Simulation Centre, based at Royal North Shore Hospital. Four members of the Flinders Centre have become Professors and three Associate Professors. Six members of the Sydney Centre have reached professorial level, one of whom occupies the Chair of Anaesthesia, Critical Care and Pain Medicine at the University of Edinburgh.

In the Australian & New Zealand College of Anaesthetists, Professor Cousins served as President. He also served as Chairman of the Committee of Presidents of Medical Colleges (CPMC). Previously he has served as Chairman of the ANZCA Primary Examination Committee, Chairman of the Research Committee, and Councillor. He has also served as President of the Association of Clinical Professors of Australia.

His research has produced over 200 original papers, reviews and book chapters in the fields of mechanisms and treatment of acute, chronic and cancer pain; pharmacology and toxicology of anaesthetic and analgesic drugs; development of novel routes of delivery of analgesic drugs; epidemiology of chronic pain and impact of pain on the individual and society. He has published three editions of the text “Neural Blockade and Pain Management” which has become a key reference internationally. A review with colleague LE Mather in 1984 on the spinal route of analgesia has become the third most frequently cited reference in the entire field of pain medicine over the last 20 years, and the most cited reference in the Anesthesiology literature over the last 60 years. He has served on numerous international editorial boards including the leading journals “Pain”and “Anesthesia & Analgesia”. He was the Founding Section Editor for a new Pain Medicine section of the latter journal. 

Project

Grants/Awards

• Doctor of Science (DSc), University of Sydney
  
• Member of the Order of Australia
• Rotary Award for Vocational Excellence in Anaesthesia & Pain Medicine
• John Mitchell Crouch Research Award, Royal Australasian College of Surgeons
• Elected to Fellowship of Chapter of Palliative Medicine, Royal Australasian College of Physicians
• Inaugural Kester Brown Lecture, Australian Society of Anaesthetists
• Mushin Medal, Welsh National University
• Sir Arthur Sims Professorship, Royal College of Surgeons & Physicians of UK, Canada & South Africa
• Royal College of Anaesthetists (RCA) – Chloroform Sesquicentary Lecture, Edinburgh
• Royal College of Physicians & Surgeons of Canada, Royal College Lecture
• Inaugural JJ Bonica Distinguished Lecturer on Pain Therapy, American Society of Regional Anaesthesia (in memory of the "father” of the field of pain medicine)
• Carl Koller Gold Medal, European Society of Regional Anesthesia (commemorates the discovery of local anaesthesia)
• Gaston Labat Medal of the American Society of Regional Anesthesia (commemorates the acknowledged pioneer in the field of regional anesthesia for surgery)
• EA Rovenstine Memorial Lecture, American Society of Anesthesiologists (the prime eponymous lecture of the ASA)
• Ralph Waters Lecture, Illinois Society of Anesthesiologists (in honor of one of the pioneers of Anesthesiology)
• JJ Bonica Lecture, Eastern Pain Society, New York, USA
• Seldon Lecture of the International Anaesthesia Research Society (IARS)
• William Russ Pugh Award of the Australian Society of Anaesthetists for outstanding contribution to advancement of the science of anaesthesia and related disciplines

Government, health professional and community awareness of societal, humanitarian, financial and health resource implications of the “hidden epidemic” of chronic pain has been pursued nationally and internationally by Professor Cousins. He has assisted in the training of key individuals and in the setting up of resources/facilities for new pain medicine centres throughout Australia, in the Asia Pacifice region, Europe, Canada and in the USA. Over the last 28 years many overseas trainees have come to Australia to do training in Pain Medicine before taking up key roles in their own countries. He has been the driving force in Australia and internationally in drawing attention to evidence that severe persistent pain becomes a “disease entity” and has also championed the concept of “Pain relief as a basic human right”. In 2001 the Australian Neuroscience Society honoured him as their Eccles Lecturer (in memory of Nobel Laureat, Sir John Eccles), when he presented both of the foregoing themes with the evidence that underpins them.

Publications

RESEARCH PUBLICATIONS:

• Siddall PJ, Stanwell P, Woodhouse A, Somorjai RL, Dolenko B, Nikulin S, Himmelreich U, Cousins MJ, Mountford CE. Spectroscopy detects biochemical changes in the brain associated with chronic low back pain. Anesth Analg (submitted).
• Van Leeuwen MT, Blyth FM, March LM, Nicholas MK, Cousins MJ. Chronic pain and reduced work effectiveness: the hidden cost to Australian Employers. Europ.J.Pain 2006;10(2)161-6.
• Siddall PJ, Stanwell P, Woodhouse A, Somorjai RL, Dolenko B, Nikulin A, Bourne L, Himmelreich V, Leon C, Cousins MJ. Mountford, CE. Magnetic Resonance Spectroscopy detects biochemical changes in the brain associated with chronic low back pain: a preliminary report. Anesth Analg 2006;102:1164-1168.
• Finniss DG, Murphy PM, Brooker C, Nichola, MK, Cousins MJ. Complex regional pain syndrome in children and adolescents. Eur J Pain 2006; 10: 767-770.
• Murphy PM, Skouvaklis DE, Amadeo RJ, Haberman C, Brazier DH, Cousins MJ. Intrathecal catheter granuloma associated with isolated baclofen infusion. Anesth Analg 2006; 102:848-52.
• Blyth FM, March LM, Nicholas MN, Cousins MJ. Self management of chronic pain: a population based study. Pain 2005;11(3):285-292 (Editorial Pain 205;11(3):249-250.
• Siddall PJ, Cousins MJ, Otte A, Griesling T, Lachenby R. Pregabalin in central neuropathic pain: a placebo controlled trial in spinal cord injury. Neurology 2005;67(10):1792-1800.
• Cousins MJ, Miller RD. Intrathecal midazolam: an ethical editorial dilemma. Anesth Analg 2004;98(6):1507-8.
• Blyth FM, March LM, Brnabic AJM, Cousins MJ. Chronic pain and frequent use of health care. Pain 2004;111:51-58.
• Blyth FM, March LM, Nicholas MK,Cousins MJ. Chronic pain, work performance and litigation. Pain 2003;103:41-47.
• Blyth FM, March, LM, Cousins MJ. Chronic pain-related disability and use of analgesia and health services in a Sydney community MJA 2003;179(2):84-87.
• Mather LE, Cousins MJ. The site of action of epidural fentanyl: what can be learned by studying the difference between infusion and bolus administration? The importance of history, one hopes. Anesth Analg 2003;97(5):1211-3.
• Siddall PJ, McClelland JM, Rutkowski SP, Cousins MJ. A longitudinal study of the prevalence and characteristics of pain in the first five years following spinal cord injury. Pain, 2003;103:249-257.
• Barratt, S McG, Smith RC, Kee AJ, Mather LE, Cousins MJ. Multimodal Analgesia and Intravenous Nutrition Preserves Total Body Protein Following Major Upper Gastrointestinal Surgery. Reg. Anesth Pain Medicine 2002;27(1):15-22.
• Cousins, MJ. Postoperative multimodal analgesia and intravenous nutrition. Reg Anesth Pain Med 2002;27(5):536.
• Blyth FM, March LM, Shellard D, Cousins MJ. The experience of using random digit dialling methods in a population-based chronic pain study. Aust NZ J Public Health 2002;26:511-4.
• Blyth FM, March LM, Brnabic AJM, Jorm LR, Williamson M, Cousins MJ. Chronic pain in Australia: a prevalence study. Pain 2001;89:127-134.
• Malcolm A, Phillips SF, Kellow JE, Cousins MJ. Direct clinical evidence for spinal hyperalgesia in a patient with irritable bowel syndrome. Am J Gastroenterol 2001;96(8):2427-31.
• Cousins, MJ. Pain medicine and anesthesiologists: a new section of the journal. Anesth Analg 2001;93(3):526-7. Vickers RE, Cousins MJ. Neuropathic orofacial pain. Part 1 – Prevalence and pathophysiology. Aust Endodontic J. 2000;26:19-26.
• Vickers RE, Cousins MJ. Neuropathic orofacial pain. Part 2-Diagnostic procedures, treatment guidelines and case reports Aust Endodontic J. 2000;26:53-63.
• Veering, BT, Cousins, MJ. Cardiovascular and pulmonary effects of epidural anaesthesia. Anaesth Intensive Care 2000;28:620-635. Cousins, MJ. Relief of acute pain: a basic human right? Med J Aust 2000;172:3-4.
• Cousins, MJ. An additional dimension to the efficacy of epidural steroids. Anesthesiology 2000;93(2):565.
• Edwards SR, Mather LE, Lin Y, Power I, Cousins MJ. Glutamate and kynurenate in the rat central nervous system following treatments with tail ischaemia or diclofenac. J. Pharm.Pharmacol 2000;52:59-66.
• Mather LE, Cousins MJ, Huang YF, Pryor ME, Barratt SM. Lack of secondary hyperalgesia and central sensitization in an acute sheep model. Reg Anesth Pain Med 2000;25(2):174-180.
• Vickers ER, Cousins MJ, Nicholas M. Facial pain: a biopsychosocial problem. Medicine Today. Nov 2000; 1.11:42-48.
• Siddall PJ, Molloy AR, Walker S, Mather LE, Rutkowski SB, Cousins MJ. The efficacy of intrathecal morphine and clonidine in the treatment of pain after spinal cord injury. Anesth Analg 2000;91(6):1493-8.
• Lin Y, Mather LE, Power I, Cousins MJ. The effect of diclofenac on the expression of spinal cord c-fos-like immunoreactivity after ischemia-reperfusion-induced acute hyperalgesia in the rat tail. Anesth Analg 2000;90(5):1141-5.
• Mather LE, Edwards SR, Duke CC, Cousins MJ. Microdialysis study of the blood-brain equilibration of thiopental enantiomers. Br.J of Anaesth 2000;84(1):67-73.
• Mather LE, Fryirs BL, Duke CC, Cousins MJ. Lack of whole-body pharmacokinetic differences of halothane enantiomers in the rat. Anesthesiology 2000;92(1):190-6.

CHAPTERS and REVIEWS:

• Brennan F, Carr DB, Cousins MJ. Towards Pain Relief as a Human right: a survey of medical, ethical and legal background and strategies. Europ J Pain
• Siddall, P, Cousins, MJ. Postoperative Pain, Acute Neuropathic Pain. In Encyclopedia of Pain. ed Schmid, RF, Willis WD. p.16. Springer Berlin Heidelberg 2007. MacPherson R, Cousins MJ. Acute Pain. In Encyclopedia of Pain. ed Schmidt RF, Willis WD. p.1. Springer Berlin Heidelberg 2007.
• Murphy PM, Cousins MJ. Neural Blockade and Neuromodulation in Persistent Pain Management. In: Merskey H, Loeser JD, Dubner R (Eds). The Paths of Pain 1975-2005. IASP Press Seattle 2005.
• Siddall PJ, Cousins MJ. Siddall PJ, Cousins MJ. Central neuropathic pain from spinal cord injury. In: Schmidt RF, Willis WD. Encyclopedic Reference of Pain Springer-Verlag 2005.
• Hassenbusch SJ, Portenoy RK, Cousins MJ et al. Polyanalgesic Consensus Conference 2003: An update on the Management of Pain by Intraspinal Drug Delivery – Report of an Expert Panel. J. Pain & Symptom Manage 2004;27:540-563.
• Brennan F, Cousins MJ. Pain Relief as a Human Right. IASP Pain Clinical Updates. Sept 2004;12(5):1-4 .Cousins MJ, Siddall PJ. Persistent Pain as a Disease Entity. IARS 2004 Review Course Lectures Anesth Analg Suppl 2004, pp 21-24.
• Siddall PJ, Cousins MJ. Persistent Pain as a Disease Entity: Implications for Clinical Management. Anesthesia Analgesia 2004;99:510-20.
• Cousins MJ. History of the development of pain management with spinal opioid and non-opioid drugs. In Meldrum ML(ed) “Opioids and Pain relief: a historical perspective, Progress in Pain Research and Management”. IASP Press Seattle 2003;25:141-155.
• Hocking GM, Cousins MJ. Ketamine in chronic pain management: an evidence based review Anesthesia Analgesia 2003;97:1730-9.  
• Swarm, RA, Karanikolas M, Cousins MJ. Anaesthetic techniques for pain management In: Doyle, D., Hanks, G., MacDonald, N. Oxford Textbook of Palliative Medicine 3rd Edition. Oxford University Press, 2003:378-396.
• Cousins MJ, Siddall PJ. Pain associated with spinal cord injury: Mechanisms and treatment. IARS 2003 Review Course Lectures Anesth. Analg. 2003 Suppl pp23-28.
• Walker SM, Goudas LC , Cousins MJ, Carr DB. Combination spinal analgesic chemotherapy: a systematic review. Anesthesia Analgesia 2002;95:674-715.
• Walker SM, Cousins MJ. Medical versus multidimensional management of chronic pain. In: Burchiel K (ed) Surgical Management of Pain. Thieme New York 2002:181-196.
• Hassenbusch S, Burchiel K, Coffey R, Cousins MJ et al. Management of intrathecal catheter-tip inflammatory masses: a consensus statement. Pain Medicine 2002;3:313-323.
• Walker SM, Cousins MJ. Anesthesiological procedures. In: Brurera E, Portnoy R. Cancer Pain. Cambridge Univ. Press, New York, 2001:201-227.
• Siddall PJ, Cousins MJ. Physiology of Pain. In: Power, I, Kam, P, Knoblanche, G. Principles of Physiology for Anaesthetists. Chapman & Hall, 2001.
• Cousins MJ, Power I, Smith G. 1996 Labat Lecture: Pain-a persistent problem Reg Anesth Pain Med 2000;25:1,6-21. Veering BT, Cousins MJ. Cardiovascular and pulmonary effects of epidural anaesthesia. Anaesth Intens Care 2000;28:620-35.

CASE REPORTS:

• Cousins MJ, Brazier D, Cook R. Intracranial hypotension due to cervical CSF leak: treatment with epidural blood patch. Anesthesia Analgesia 2004;98:1794-97.
• Parisod E, Siddall PJ, Viney M, McClelland, Cousins MJ. Allodynia following acute intrathecal morphine administration in a patient with neuropathic pain following spinal cord injury: a case report and brief review Anesthesia Analgesia 2003;97:183-6.
• Parisod E, Murray RF, Cousins MJ. Conversion disorder after implant of a spinal cord stimulator in a patient with a complex regional pain syndrome. Anesth Analg 2003;96:201-6

LETTERS:

• Cousins MJ. Pain Relief: a universal right. Pain 2005.
• Cousins MJ. Central retinal thrombus. Anesthesiology 2003
• Goudas LC, Carr DB, Walker SM, Cousins MJ. Combination Spinal Analgesic Chemotherapy: An Additional Clinical Trial of Opioid plus Local Anaesthetic. Anesth Analg 2003;96:1837-46.
• Cousins MJ. Post operative multimodal analgesia and intravenous nutrition. Reg Anesth Pain Med 2002;27-5:536

EDITORIALS:

• Cousins MJ, Miller R. Intrathecal midazolam: an ethical editorial dilemma.. Anaesth Analg. 2004;98:1507-08.
• Cousins MJ, Brennan F, Carr DB. Pain relief: a universal human right. Pain 2004;112:1-4.
• Mather LE, Cousins MJ. The study of action of epidural fentanyl: what can be learned by studying the difference between infusion and bolus administration ? the importance of history, one hopes. Anaesth Analg. 2003;97:1211-13.
• Cousins MJ. Relief of acute pain: a basic human right? MJA 2000;172:3-4

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