DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

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Goals for the Future The Ambulatory Surgery Center is in the third year of operation and we continue to have exciting goals for the future. Our statistics continue to reveal that we are achieving excellent patient satisfaction and that remains our first and foremost goal. We are already delivering regional anesthesia to nearly 60% of our patient population at the Ambulatory Surgery Center. It is our goal to continue to offer a wide variety of anesthesia options to our patients with special focus on Regional Anesthesia. Our status as a Center of Excellence in regional and ambulatory techniques has allowed us to offer training to fellow anesthesiologists throughout the country. We will continue to develop the Division of Ambulatory Anesthesia at Duke as a guiding force in education and training for Regional Anesthesia both nationally and internationally. We continue to integrate our outcomes data with patient satisfaction and are expanding it to look at the cost of care delivery. As we broaden and hone the outcomes database we are establishing a model in the field of outcomes for ambulatory surgical centers. Our improved technologic enhancement to our database systems will improve the deliverance of vital information regarding ambulatory surgery and patient satisfaction. The Division of Ambulatory Anesthesia is working to develop a protocol for home catheter infusion system for the management of post-operative pain. Drs. Susan Steele and Karen Nielsen have worked collaboratively with this protocol and have visited in patient’s home after surgery allowing first hand investigation of the efficacy of home catheter infusion. The results have been overwhelming. The patients who have participated in this protocol have been extremely satisfied with their pain con- 00 100% 80 80% 60 60% 40 40% 20 20% 0% 0 Very Satisfied trol and with the convenience of managing their pain at home. The Ambulatory Surgery Center is working with a team of surgeons, administrators and other key personnel to develop a Breast Care Center of Excellence at our facility. This would greatly enhance patient convenience Ambulatory Surgery Center CLINICAL ACTIVITIES TABLE 2 Patient Satisfaction with Anesthesia Techniques Ambulatory Surgery Center July 13, 1998–July 13, 2000 Somewhat Satisfied Neutral Somewhat Dissatisfied Very Dissatisfied 24 Hours 7 Days and satisfaction in allowing diagnostic procedures of the breast as well as surgical procedures to be accomplished in one location. This would be a great improvement to our present protocol for breast procedures. This is certainly one of the most promising initiatives on our horizon. We remain dedicated to providing the highest level of patient satisfaction of any ambulatory surgery in the nation. Our division is initiating an innovative pilot study on patients undergoing total knee arthroplasty. These procedures will be performed under continuous peripheral nerve blocks on an ambulatory basis. Patients will be discharge from our 23 hour recovery care unit to a rehabilitation unit. Continuous peripheral nerve blockade will be used during the first 72 hours allowing excellent postoperative analgesia, aggressive physical therapy, and early recovery. CLINICAL ACTIVITIES 43
CLINICAL ACTIVITIES CARDIOTHORACIC ANESTHESIA AND CRITICAL CARE MEDICINE Mark F. Newman, M.D. Chief, Division of Cardiothoracic Anesthesiology and Critical Care Medicine Director, Neurologic Outcome Research Group Professor and Vice-Chair of Anesthesiology Associate Professor in Medicine MEMBERS John V. Booth, M.B., Ch.B., FRCA Fiona M. Clements, M.D. Norbert P. deBruijn, M.D. Katherine P. Grichnik, M.D., M.S. Hilary P. Grocott, M.D., FRCP(C) Steven E. Hill, M.D. Andrew K. Hilton, M.B., B.S., FANZCA Joseph P. Mathew, M.D. J.G. Reves, M.D. Debra A. Schwinn, M.D. Mark Stafford Smith, M.D., C.M., FRCP, DABA Ian J. Welsby, M.B., B.S., B.Sc., FRCA FELLOWS Maher J. Albhrani, M.B., Ch.B. Daniel T. Bainbridge, M.D. George N. Djaiani, M.D., DA, DEAA, FRCA John G. Ellingham, M.D. 44 CLINICAL ACTIVITIES Maribel G. Gamoso, M.D. Alina M. Grigore, M.D. G. Burkhard Mackensen, M.D. Brian J. McCreath, M.B., Ch.B. Madhav Swaminathan, M.B.,B.S. Miahi V. Podgoreau, M.D. Ajeet Sharma, M.D. Timothy O. Stanley, M.D. Lian K. Ti, M.B., B.S. Bo Wu, M.D. CRNA Beatrice I. Baldwin, CRNA RESEARCH COORDINATORS: Aimee M. Butler, B.S. Wayne M. Cohen, RN, M.B.A. Kelli L. Cozart, RN Bonita L. Funk, RN Vincent E. Gaver, BA Malissa J. Harris, RN Jason F. Hawkins, B.S.N Jerry L. Kirchner, B.S. RESEARCH TECHNICIANS Chonna S. Campbell Amanda S. Cheek Mary H. Currier E. D. Derilus Tanya R. Kagarise Satarah K. Latiker Erich M. Lawff Kenya S. Lee Scott E. Lee Colin E. Macdonnell Terri C. Moore Beverly J. Perry Melanie K. Tirronen Erin E. Ward Jonathan E. Williams SUPPORT STAFF Cheryle E. Davis Marilyn L. Helms Teri-Lynne Kulik Brenda S. Mickley LaTanya M. Rhames Nineteen ninety-nine presented an outstanding opportunity to the cardiothoracic division, with additional continued increases in the cardiac and thoracic procedures during the year. This opportunity further strengthened the group's productivity and research opportunities. The introduction of minimally invasive techniques and “OP- CAB” further defined our course. In addition, we have expanded to provide critical care in the Acute Cardiac Unit as an additional resource in the perioperative care of patients. Clinical Activity The practice of cardiothoracic anesthesia has broadened markedly at Duke and across the nation. The trend continues toward less invasive mechanism to treat cardiothoracic disease including video-assisted thoracoscopic procedures, as well as midCAB (coronary artery bypass) and OPCAB (off bypass coronary artery bypass) beating heart revascularization procedures. The Cardiothoracic Division led an initiative for the development of an interventional suite in the operating room to allow combined cardiology, cardiac surgery and vascular surgery procedures to be performed in a cost-effective multidisciplinary manner. The Division is at the forefront of evaluating these minimally invasive technologies, and how they affect both short and long-term outcome. It remains inherently important due to the risk of reoperation that our patients receive the best therapy for long-term survival and quality of life. The Cardiothoracic Division is a world leader in the measurement and understanding of perioperative complications in many organ systems. We are now using this evidence to further improve the safety for our patients and protect their long-term quality of life. Research Duke Heart Center Division of Cardiothoracic Anesthesia is the top cardiac anesthesia research division in
Page 1 and 2: DEPARTMENT OF ANESTHESIOLOGY Duke U
Page 3 and 4: This issue is dedicated to the memo
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Page 7 and 8: FACULTY, RESIDENTS, FELLOWS, AND CR
Page 9 and 10: FACULTY Thomas E. Buchheit, M.D. Cl
Page 11 and 12: FACULTY Joel S. Goldberg, M.D. Assi
Page 13 and 14: FACULTY John C. Keifer, M.D. Associ
Page 15 and 16: FACULTY Joseph P. Mathew, M.D. Asso
Page 17 and 18: FACULTY Claude A. Piantadosi, M.D.
Page 19 and 20: FACULTY Mark Stafford-Smith, M.D.,
Page 21 and 22: FACULTY Christopher C. Young, M.D.,
Page 23 and 24: 20 FACULTY DUKE UNIVERSITY HEALTH S
Page 25 and 26: AFFILIATED FACULTY Scott T. Howell,
Page 27 and 28: Edmond C. Bloch, M.B., Ch.B. Associ
Page 29 and 30: INTERNS Atilio Barbeito, M.D. Abiga
Page 31 and 32: RESIDENTS John D. Mitchell, M.D. CA
Page 33 and 34: RESIDENTS CA-3 Tarsha V. Garvin, M.
Page 35 and 36: Paula D. Alford, B.A., CRNA Beatric
Page 37 and 38: CRNA Deborah J. Ferrero-Conover, CR
Page 39 and 40: CRNA Carolyn C. Knoop, CRNA, MSN Da
Page 41 and 42: CRNA Kena B. Sigman, CRNA, MSN Tede
Page 43 and 44: 40 DUKE ANESTHESIA FACULTY WHO BECA
Page 45: CLINICAL ACTIVITIES Infraclavicular
Page 49 and 50: CLINICAL ACTIVITIES Goals for 2000
Page 51 and 52: CLINICAL ACTIVITIES Narda D. Crough
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Page 55 and 56: CLINICAL ACTIVITIES GENERAL, VASCUL
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Page 61 and 62: CLINICAL ACTIVITIES Molecular Biolo
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Page 75 and 76: CLINICAL ACTIVITIES WOMEN’S ANEST
Page 77 and 78: BIOSTATISTICS AND CLINICAL OUTCOME
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Page 81 and 82: DEPARTMENTAL COMMITTEES David B. Sc
Page 83: 80 Thirteenth Annual ASA Duke Anest
Page 86 and 87: Several advances in the residency c
Page 88 and 89: The Annual Resident Graduation and
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Lectures, Conferences and Didactics
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2000 BUSINESS OFFICE ANNUAL REPORT
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Anesthesia Technician Staff Sitting
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Hyperbaric Center Left to right Eri
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Molecular Pharmacology Laboratory F
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Signal Transduction Laboratory Fron
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The determination of the MAC reduct
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Magnesium neuroprotection in cardia
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Active Institutional Animal Care an
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Mackensen, George B., M.D. Peri-Isc
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A Randomized, Double-Blind, Paralle
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Cardiac surgery in infants and chil
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An exciting development is the esta
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services to pharmaceutical companie
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Gerontological Research in Anesthes
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Masaya Kudo, M.D. Daniel Morris, Ph
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RESEARCH ASSISTANT Amy L. Kondyra V
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Gan TJ, Apfelbaum J, Chen C. Instit
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Pineda JA, Lynch JR, Laskowitz DT,
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East CJ, Clements F, Mathew J, Slau
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Mackensen GB, Stanley TO, Grocott H
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Taekman JM, Web alert. Current Anes
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Robertson KM. Donor management. Pro
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Rosemary W. Cumbie Special Assistan
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DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

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