Areas of Expertise

Dr. Griffiths, a highly skilled anaesthetist, specialising  in employing a range of advanced anaesthesia techniques to optimise patient care. Dr. Griffiths will tailor anaesthesia the available anaesthetic techniques  to meet the unique needs of each patient and surgical procedure, ensuring the highest level of safety and post-operative recovery.

Dr. Griffiths is adept at administering general anaesthesia, which induces a reversible state of unconsciousness, allowing patients to undergo surgery comfortably and safely. Additionally, he is trained to provide additional regional and local anaesthesia techniques, targeting specific areas of the body for pain control and minimizing the need for general anaesthesia.

Throughout procedures, Dr. Griffiths closely monitors patients' vital signs, adjusting medications as needed to maintain optimal levels of sedation, analgesia, and muscle relaxation. He works closely with his surgical consultant colleagues to ensure seamless coordination between anaesthesia and the required surgical or medical intervention.

Dr. Griffiths is a Pre-operative Exercise Testing and Evaluation accredited physician. The key component of this pre-operative assessment is Cardiopulmonary exercise testing (CPET). CPET is a specialised diagnostic tool that provides valuable insights into your cardiovascular and respiratory fitness. During CPET, you will undergo an exercise regimen while your heart rate, oxygen consumption, and other vital parameters are closely monitored. CPET is now recognised as the gold standard risk assessment tool for patients undergoing higher risk surgery.

The following is a link to the Perioperative Exercise Testing and Training Society of the United Kingdom.

https://www.poetts.co.uk/

Preoperative assessment is a crucial step in the surgical journey, ensuring that patients are well-prepared for their upcoming procedure. Dr. Griffiths was the pre-operative lead for the OUH NHS trust for 5 years (2012-2017) founding a high-risk anaesthetic clinic at the Churchill Hospital. This clinic has gone from strength under his successors, and has helped reduce peri and post-operative complications and ultimately improved surgical outcomes for patients having surgery within the OUH Trust. This work was highlighted in a local news article: 

https://www.oxfordmail.co.uk/news/11438698.pre-op-test-gets-heart-matter/

Drawing from this extensive pre-operative assessment experience gained in the NHS, Dr. Griffiths was appointed as the National Medical Lead for Nuffield Health (2018-2019). In this role he worked closely with the Nuffield Health Nursing Lead for Pre-operative assessment to modernise and standardise pre-assessment processes within the private sector, including the assessment of patients for higher risk surgery. 

Dr. Griffiths is a highly experienced consultant anaesthetist specialising in the provision of anaesthesia for major Plastic surgical procedures. He has a special interest in enhanced recovery after surgery (ERAS) pathways, and has been instrumental in the development and implementation of an ERAS pathway specifically for patients undergoing breast reconstruction surgery. The ERAS Pathway has been a 10 year evolving program designed to optimize the pre-operative, intra-operative, and post-operative care of women undergoing this complex surgery that started with a national survey of anaesthetic practice in 2014.

Overview of the ERAS Pathway

The primary goal of the ERAS Pathway is to streamline the surgical and anaesthetic processes for breast reconstruction, making the patient experience as efficient and evidence-based as possible. The pathway emphasises thorough preparation of patients before surgery, a focus on pain management through multimodal analgesia (primarily administered orally), and a swift recovery process.

Since its inception, nearly 100 patients have undergone surgery using the ERAS Pathway, with excellent outcomes. 

Key improvements include:

• Enhanced post-operative pain management using a multimodal analgesia approach.

• Reduced length of hospital stay, averaging 3-4 days.

• Improved patient experience throughout the surgical journey.

Key Achievements

The success of the ERAS Pathway is evident in its recent adoption at Mater Dei University Hospital in Malta. Under Dr. Griffiths and Mr. Peter Kalu's leadership, the pathway was used for the first two breast reconstruction surgeries in the country since the past-COVID hiatus. Both patients had successful outcomes, with hospital discharge occurring on post-operative day 5 and 6 respectively. This international implementation underscores the effectiveness of the pathway and Dr. Griffiths contribution to improving surgical care and his expertise in anaesthetics and commitment to patient-centred care and his continued to drive positive outcomes for patients both locally and internationally. 

Relevant Publications:

Sadideen, H., Fiddes, R., Birch, J., Griffiths J. The national variation in peri-operative anaesthetic technique for breast free flap reconstruction in the UK: is it time to define best practice?

Eur J Plast Surg 37, 653–660 (2014). https://doi.org/10.1007/s00238-014-1011-z

Relevant Presentations:

“Anaesthesia for abdominal Based Breast Reconstructions - The Oxford Experience: Past, Present & Future”

BAPRAS National Congress, Newcastle October 2023

Dr. Griffiths has been providing intravenous sedation services at the Oxford Fertility practice for over 10 years. Again, he recognises the importance of creating a calm and relaxed environment, helping patients navigate the emotional and physical aspects of their fertility journey.

https://tfp-fertility.com/en-gb/tfp-oxford-fertility

Dr. Griffiths provides  intravenous sedation services at the  Oxford Endoscopy Unit practice to help ensure the best patient experience for the procedures undertaken.

https://oxfordendoscopy.co.uk

Dr. Griffiths has a specific interest in hernia surgery under local anaesthesia and carefully titrated sedation. He is the lead anaesthetist for the Spectrum Hernia Clinic  that operates within the day surgery unit at the Manor Hospital, Oxford.  Within this clinic he helps provide inguinal, epigastric, umbilical and femoral hernia repair under local anaesthetic.

Despite not having any formal, dedicated  research time in his NHS contract Dr. Griffiths has managed to build a successful research profile. He has published 50 articles and has nearly 2000 citations in the fields of anaesthesia, preoperative assessment and critical care medicine. Given this research and academic portfolio Dr. Griffiths has been an invited speaker at and has presented  his work presented at a number of national and international conferences.

https://www.researchgate.net/profile/John-Griffiths

The following is a link to the most recent study Dr. Griffiths was a part of in collaboration with the University of Limerick - a study that intends to ignite and stimulate debate in the perioperative medicine, pre-optimisation and pre-habilitation narrative.

https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16158

Dr. Griffiths is a keen teacher with him actively providing teaching at a local and national level, to all domains of the anaesthetic and critical care community. 

He has always felt tremendous privilege to have had the opportunity to study at Oxford University and has maintained strong links with the undergraduate teaching programme.