DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

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Gerontological Research in Anesthesia and Surgery Program (GRASP) MADAN M. KWATRA, Ph.D. Associate Professor in Anesthesiology Assistant Professor of Pharmacology and Cancer Biology J.G. REVES, M.D. Professor and Chairman of Anesthesiology AREA <strong>OF</strong> INTEREST: Geriatric Research and Education Focusing on the Special Needs of the Elderly Patient Undergoing Surgery FOCUS GRASP seeks to identify areas of basic and clinical research that will reduce the incidence of adverse post-surgical outcomes that frequently occur in the elderly. To this end, GRASP holds monthly meetings, organizes biennial conferences entitled “Surgery and the Elderly,” and develops research projects. MONTHLY GRASP MEETINGS These meetings, attended by basic science and clinical faculty, residents, fellows, and medical students from the departments of anesthesiology, surgery, and the center for aging research, discuss a variety of topics related to the elderly. Topics covered in GRASP meetings are listed in the Lectures, Conferences, and Didactic section of this report. BIENNIAL SURGERY AND THE ELDERLY CONFERENCES These conferences are held biennially and focus on specific issues affecting the elderly surgical patient. The first Duke conference on surgery and the elderly was held on September 17, 1997; anesthesiologists, basic scientists, geratricians, and surgeons from major medical centers across the country were in attendance. This conference highlighted the risks faced by an elderly patient undergoing surgery and how age affects the various organ systems. In addition, this meeting was instrumental in establishing contacts between the American Society of Anesthesiology (ASA) and the American Geriatric Society (AGS). These meetings were attended by basic scientists (AGS/the Hartford Foundation) whose goals are to introduce geriatrics into the curricula of various non-primary specialties. The second Duke conference on surgery and the elderly was held on September 30, 1999. The focus of this conference was on cognitive dysfunction in the elderly after non-brain surgery. The conference was divided into morning and afternoon sessions. The morning session was devoted to understanding the incidence of postoperative cognitive dysfunction after cardiac, hip fracture, and major noncardiac surgeries. The afternoon session focused on two issues: whether regional anesthesia produces less post-operative cognitive dysfunction and the cholinergic hypothesis of post-operative cognitive dysfunction. A total of 40-50 people were in attendance including anesthesiologists, basic scientists, geratricians, and surgeons from Duke and other universities. The third Duke conference on surgery and the elderly will be held on September 20, 2001. The theme of this conference will be “What we know and need to know about the elderly from existing databases.” RESEARCH PROJECTS A major aim of GRASP is to pursue research that will lead to better postoperative outcomes for the elderly. To this end, we are currently developing projects devoted to understanding post- LABORATORY PROGRAMS operative delirium in the elderly. Several projects are identified and include the following: 1) What is the role of pain in postoperative delirium? 2) Is regional anesthesia accompanied by a lower incidence of delirium? 3) Are certain combinations of anesthetics contributing to a higher incidence of post-operative delirium? 4) What is the molecular basis of post-operative delirium? Duke Chapel outdoor walkway LABORATORY PROGRAMS 127
RESEARCH ASSOCIATE Ivan T. Demchenko, D.Sc. Yung-Wei Hsu, M.D. 128 RESEARCH STAFF RESEARCH STAFF Mitsuo Aono, M.D. Peter J. Denoble, M.D., Ph.D. Jason D. Kilts, Ph.D. Gopa Biswas, Ph.D. Tracey V. Du Laney, Ph.D. Kyo Sang Kim, M.D.
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DEPARTMENT OF ANESTHESIOLOGY Duke U
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This issue is dedicated to the memo
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DUKE DEPARTMENT OF ANESTHESIOLOGY M
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FACULTY, RESIDENTS, FELLOWS, AND CR
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FACULTY Thomas E. Buchheit, M.D. Cl
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FACULTY Joel S. Goldberg, M.D. Assi
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FACULTY John C. Keifer, M.D. Associ
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FACULTY Joseph P. Mathew, M.D. Asso
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FACULTY Claude A. Piantadosi, M.D.
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FACULTY Mark Stafford-Smith, M.D.,
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FACULTY Christopher C. Young, M.D.,
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20 FACULTY DUKE UNIVERSITY HEALTH S
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AFFILIATED FACULTY Scott T. Howell,
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Edmond C. Bloch, M.B., Ch.B. Associ
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INTERNS Atilio Barbeito, M.D. Abiga
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RESIDENTS John D. Mitchell, M.D. CA
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RESIDENTS CA-3 Tarsha V. Garvin, M.
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Paula D. Alford, B.A., CRNA Beatric
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CRNA Deborah J. Ferrero-Conover, CR
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CRNA Carolyn C. Knoop, CRNA, MSN Da
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CRNA Kena B. Sigman, CRNA, MSN Tede
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40 DUKE ANESTHESIA FACULTY WHO BECA
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CLINICAL ACTIVITIES Infraclavicular
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CLINICAL ACTIVITIES CARDIOTHORACIC
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CLINICAL ACTIVITIES Goals for 2000
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CLINICAL ACTIVITIES Narda D. Crough
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CLINICAL ACTIVITIES returned home t
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CLINICAL ACTIVITIES GENERAL, VASCUL
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CLINICAL ACTIVITIES some of the ser
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CLINICAL ACTIVITIES years, has comb
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CLINICAL ACTIVITIES Molecular Biolo
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CLINICAL ACTIVITIES ORTHOPAEDICS, P
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CLINICAL ACTIVITIES OTOLARYNGOLOGY,
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CLINICAL ACTIVITIES PAIN MANAGEMENT
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CLINICAL ACTIVITIES therapy. This y
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CLINICAL ACTIVITIES Regional Anesth
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CLINICAL ACTIVITIES thesiology Pain
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CLINICAL ACTIVITIES WOMEN’S ANEST
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BIOSTATISTICS AND CLINICAL OUTCOME
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DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

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