Nicholas Levy

Consultant in Anaesthesia and Acute Pain Medicine, Suffolk, UK.

Twitter @nicholasalevy 


Nicholas  graduated from the Royal Free Hospital in 1993 and undertook anaesthetic training in the Central London School of Anaesthesia. In 2003, he was appointed as a Consultant Anaesthetist at the West Suffolk Hospital, with an interest in acute pain medicine.

In 2017 he was the first UK anaesthetist to identify that surgery was a driver for persistent opioid use in the UK. He has subsequently highlighted various key drivers for persistent postoperative opioid use.

In early 2020 he worked with Professor Pam Macintyre to highlight the changes that need to be embraced by UK hospitals to prevent in patient harm and death from opioid induced ventilatory impairment.

More recently he was the lead author of an international group that has published guidelines on the prevention of severe opioid related harm, and is one the authors for the UK intercollegiate guidelines on prevention of opioid related harm

Key Pain papers

  1. Hermanowski J, Levy N, Mills P, Penfold N. Deprescribing: implications for the anaesthetist. Anaesthesia. 2017 ;72:565-9.
  2. Levy N, Mills P, Penfold N. The US prescribed opioid epidemic: lessons for perioperative medicine in the UK. Part 1.  RCoA Bulletin. 2018.107. 48-49
  3. Levy N, Mills P, Penfold N. The US prescribed opioid epidemic- lessons for perioperative medicine. Part 2. RCoA Bulletin. 2018.108. 46-47.
  4. Levy N, Sturgess J. Mills P. “Pain as the fifth vital sign” and dependence on the “numerical pain scale” is being abandoned in the US: Why?. BJA. 2018: 120: 435-438
  5. Levy N, Quinlan J, El‐Boghdadly K, Fawcett WJ, Agarwal V, Bastable RB, Cox FJ, de Boer HD, Dowdy SC, Hattingh K, Knaggs RD. An international multidisciplinary consensus statement on the prevention of opioid‐related harm in adult surgical patients. Anaesthesia. 2021 Apr;76(4):520-36.
  6. Bowen J, Levy N, Macintyre P. Opioid‐induced ventilatory impairment: current ‘track and trigger’ tools need to be updated. Anaesthesia. 2020 Apr 5.
  7. Levy N, Raghunathan K,. Lobo DN. De-implementation of extended-release opioids from peri-operative pathways.  Anaesthesia.
  8. Srivastava D, Hill S, Carty S et al. Surgery and opioids: evidence-based expert consensus guidelines on the perioperative use of opioids in the United Kingdom. BJA 2021. DOI:
  9. Quinlan J, Levy N, Lobo DN, Macintyre PE. Preoperative opioid use: a modifiable risk factor for poor postoperative outcomes. British Journal of Anaesthesia. 2021 ;127:327-31.
  10. Daliya, P., Adiamah, A., Roslan, F., Theophilidou, E., Knaggs, R.D., Levy, N., Lobo, D.N. and (2021), Opioid prescription at postoperative discharge: a retrospective observational cohort study. Anaesthesia.