Department / Division
Anesthesiology / Anesthesiology-Regional Division
Durham, NC 27710
Perioperative ethics and care of the dying patient, palliative care, general anesthesiology, regional anesthesia
My research interests are in regional anesthesia using ultrasound technology and developing best practices. I am also interested in perioperative ethics and drug development for palliation of distressing symptoms at the end of life.
Summary of Research:
Dying patients are increasingly offered surgical, in addition to, medical treatment. Many of these patients have DNR orders. Respect of DNR orders is assumed in the hospitalized patient except when patients present for surgical procedures. Standards of care for management of the surgical patient with DNR orders do not exist on a national level, leading to haphazard care of patients, including automatic suspension of DNR orders. My research uses both qualitative and quantitative methods to assess what the dying patients’ expectation is for management of DNR orders in the perioperative period, specifically with regard to their decision making process and what constitutes desirable resuscitation. I am also researching the likelihood, duration and outcomes of intraoperative cardiac arrests and post-operative and prolonged ventilation. This information will enable us to more accurately communicate the risks and benefits of anesthesia and post-operative ventilation to our patients at the end of life. In doing so, we may increase our patient’s satisfaction, sense of autonomy and dignity should they require surgical intervention.
Finally, I am interested in the prospective study of medications that might alleviate symptoms of distress at the end of life, including delirium, agitation and pain using, while maintaining communication capacity allowing the dying patient to interact as peacefully with their loved ones as possible. Dexmedetomidine, a drug commonly used in the operating room and the intensive care unit.
This faculty member has no reported relationships with industry.