Dysphoria: Current Understanding & Recommendations to Prevent Post-Op Cognitive Decline

Check out the timestamps below to help you navigate through the many topics we discussed.

On This Episode:

Today we’re exploring a topic that goes deeper into the realms of medicine and neuroscience, and it’s something that affects us all: cognitive health post-surgery. Adam Flowe, Chief CRNA at Duke University Hospital, brings his 20 years of experience and a personal connection to the table, discussing the intricate relationship between anesthesia, surgical stress, and the brain. With the aging population and the rise in surgeries, the question of how these procedures affect our cognitive function is more pressing than ever.

What if the anesthesia we thought was causing postoperative cognitive decline was only part of the story? What if the surgical stress itself was triggering biochemical pathways that impact the brain? Adam challenges the common assumption that anesthesia is the sole culprit and opens up a discussion about the potential of certain medications, like ketamine, in promoting brain health.

But this isn’t just a conversation for medical professionals. It’s a topic that affects us all, whether we’re the ones undergoing surgery or we have loved ones who are. Understanding the implications of surgical procedures on cognitive health is essential for advocating for better care and outcomes.

 

Here’s some of what we discuss in this episode:

  • Post-op cognitive dysfunction is underreported and has greater incidence than expected.
  • CRNAs are critical to prevention and optimization as direct care has major impacts (more so than they probably realize).
  • Post-op cognitive decline might be caused by the surgery and not the anesthesia.
  • The science behind post-op cognitive decline is expanding rapidly. Inflammation is a key factor and the blood-brain barrier is also key.
  • Anesthesia has been awesome in improving safety through equipment and work on HARD OUTCOMES; the future of quality for us is in SOFT OUTCOMES.

 

About our guest: https://anesthesiology.duke.edu/personnel/adam-flowe-crna

Donate to Our Heart Your Hands here: https://www.ourheartsyourhands.org/donate 

Help us grow by leaving a review: https://podcasts.apple.com/us/podcast/beyond-the-mask-innovation-opportunities-for-crnas/id1440309246

 


“You ​can ​make ​somebody ​sleepy ​and ​confused ​and ​delirious if you give ​them ​enough ​sedatives ​and ​narcotics. ​But ​very ​quickly ​scratching ​into ​this ​topic, ​which ​is ​a ​really ​hot ​and ​rich ​topic ​right ​now,  ​you ​learn ​that ​there’s ​this ​thing ​related ​to ​the ​surgery ​and ​to ​the ​trauma ​of ​the ​body.  ​Whether ​it ​be ​some ​kind ​of ​unnatural ​trauma, trauma ​in ​the ​sense ​of ​surgery, incisions ​of ​the ​body, ​the ​breaking ​of ​bones, ​potentially ​the ​removal ​of ​organs ​that ​trigger ​these ​biochemical ​pathways ​in ​the ​blood ​that ​seem ​to ​have ​a ​major ​role ​in ​this.”

– Adam Flowe, CRNA


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Balancing a Career in Music with Being a CRNA

In this episode, Sharon and guest host Tracy Castleman, DNP, CRNA, APN-A, FAANA sit down David Giardinelli-O’Connor, PhD, DNAP, CRNA, who has successfully balanced a demanding career in anesthesia with his lifelong passion for music.

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