A5045423835- Anesthesia and Sedative Agents
- Anesthesia and Pain Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiac, Anesthesia and Surgical Outcomes
- Intraoperative Neuromonitoring and Anesthetic Effects
- Spine and Intervertebral Disc Pathology
- Neurosurgical Procedures and Complications
- Head and Neck Surgical Oncology
- Respiratory Support and Mechanisms
- Meningioma and schwannoma management
- Central Venous Catheters and Hemodialysis
- Food Allergy and Anaphylaxis Research
- Tracheal and airway disorders
- Pulmonary Hypertension Research and Treatments
- Neurological Complications and Syndromes
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Airway Management and Intubation Techniques
- Epilepsy research and treatment
- Spinal Fractures and Fixation Techniques
- Moyamoya disease diagnosis and treatment
- Coagulation, Bradykinin, Polyphosphates, and Angioedema
- Hemodynamic Monitoring and Therapy
- Intracranial Aneurysms: Treatment and Complications
- Patient Safety and Medication Errors
- Nausea and vomiting management
Stanford University
2016-2025
Stanford Medicine
2016-2023
University of Connecticut
2023
Stanford Health Care
2021
Barro Colorado Island
2016-2019
Alberta Bible College
2019
Palo Alto Institute
2018
Palo Alto University
2018
Pain and Rehabilitation Medicine
2017
University of Saskatchewan
2012-2014
Methods to ensure factual accuracy of text generated by large language models (LLM) in clinical medicine are lacking. VeriFact is an artificial intelligence system that combines retrieval-augmented generation and LLM-as-a-Judge verify whether LLM-generated factually supported a patient's medical history based on their electronic health record (EHR). To evaluate this system, we introduce VeriFact-BHC, new dataset decomposes Brief Hospital Course narratives from discharge summaries into set...
Background: This study aimed to compare analgesic practices for patients undergoing craniotomy in high-income countries (HICs) and low-income middle-income (LMICs), focusing on variations medication use techniques. Methods: An English-language Spanish-language electronic survey was sent over 300 anesthesiologists 35 from March 22 May 19, 2024, gather data analgesia patients. Anonymous responses through REDCap were analyzed as a whole by income category (HICs LMICs). Results: We received 328...
Background: Sugammadex is a modified cyclodextrin that being increasingly used in anesthetic practice worldwide for the reversal of aminosteroid neuromuscular blockers rocuronium and vecuronium. Its safety profile, however, incompletely understood. One such aspect incidence anaphylactic reactions occur after its administration. While several case reports exist literature, there paucity information on actual reactions. METHODS: A single-center retrospective chart review identified patients...
Evidence-based standardization of the perioperative management patients undergoing complex spine surgery can improve outcomes such as enhanced patient satisfaction, reduced intensive care and hospital length stay, costs. The Society for Neuroscience in Anesthesiology Critical Care (SNACC) tasked an expert group to review existing evidence generate recommendations surgery, defined on 2 or more thoracic and/or lumbar levels. Institutional clinical protocols be constructed based elements...
To the Editor We write to share important safety concerns about a local anesthetic being used primarily by surgeons with increasing frequency at our institution. Exparel® (Bupivacaine Liposome Injectable Suspension, Pacira Pharmaceuticals Inc., San Diego, CA) is novel formulation of bupivacaine available in United States since mid-2012. Bupivacaine encapsulated within multivesicular liposomes and released slowly, which claimed prolong its duration up 72 hours. Its primary use surgical wound...
Wheaton, Noah BA; Harrison, Natasha MPH; Doufas, Anthony MD, PhD; Chakraborty, Dipro MS; Chang, Alan Lee Aghaeepour, Nima Burbridge, Mark A. MD Author Information
Background Postoperative management in patients undergoing craniotomy is unique and challenging. We utilized a population of who underwent bilateral extracranial-to-intracranial (EC-IC bypass) revascularization procedures for moyamoya disease hypothesized that 1 gram (gm) intravenous (IV) acetaminophen given immediately after intubation again 45 minutes prior to the end may be more effective than saline minimizing opiate consumption decreasing pain scores. Methods In double-blind,...
We present a detailed report of an awake craniotomy for recurrent third ventricular colloid cyst in patient with severe pulmonary arterial hypertension the setting Eisenmenger syndrome, performed 6 weeks after we managed same more conservative procedure. This has high risk perioperative mortality and may be particularly susceptible to hemodynamic changes or fluid shifts. The risks general anesthesia induction emergence must balanced against inherent on per case basis.
Operating room waste is categorized as noncontaminated solid (SW) and regulated medical (RMW). RMW treated by autoclaving at an increased economic environmental cost. We evaluated these costs with a focus on the disposable carbon dioxide (CO 2 ) absorbers. At our institution, exhausted CO absorbers were discarded RMW. collaborated product representatives, anesthesia perioperative staff, management personnel to identify opportunities barriers for recycling reduction. Ultimately, we agreed...
A 32-year-old man with severe pulmonary arterial hypertension and Eisenmenger syndrome secondary to congenital ventricular septal defects presented for ventriculoperitoneal shunt insertion. Consultation between surgical anesthesia teams acknowledged the extreme risk of performing this case, but given ongoing symptoms related increased intracranial pressure from a large third ventricle colloid cyst, case was deemed urgent. After full discussion patient, including an explanation anesthetic...
We present the case of a 34-year-old man undergoing craniotomy for arteriovenous malformation resection under general anesthesia who suffered tonic–clonic seizure captured by intraoperative electroencephalograph. The was extinguished with propofol bolus. This patient had no previous history seizures, and precipitating cause identified. Intraoperative electroencephalographic seizures have been recorded previously in literature, but our observation is first to demonstrate this overt motor...
Department of Anesthesiology, Stanford Hospital, Stanford, CA The authors have no funding or conflicts interest to disclose.
Measuring and monitoring cerebral perfusion pressure (CPP) is important in the management of patients with certain neurological conditions. To accurately reflect blood at circle Willis, arterial line transducer should be leveled tragus. This study measured relative distance to tragus 100 intensive care unit (ICU) mixed ICU our institution, which 44 had a pressure-sensitive diagnosis. For patients, average was 10.9 cm for non-neurological 11.4 (p-value: 0.60). suggests that approximately same...
Head rotation causes compression and occlusion of the ipsilateral internal jugular (IJ) vein. This can result in raised intracranial pressure increased bleeding if patient is having or has recently had surgery. The amount head adults resulting IJ vein unknown however. We measured turn that produced 25 patients surgery under general anesthesia. On average, 80% veins occlude at a mean 55.6° on left 53.3° right.
For many, neurocritical care is a nebulous term. Patients with critical neurological pathology may be found in dedicated units or intermixed the general intensive unit. They managed by specialists, teams, neurologists, neurosurgeons, some combination. The objective of Neurointensive Care Unit: Clinical Practice and Organization first to educate intensivists caring for critically ill patients pathology. second more novel goal make these same management principles accessible wide variety...
We present the case of a 42-year-old man with moyamoya disease presenting for cerebral revascularization surgery who developed critical hyperkalemia following single intravenous (iv) dose 1000 mg acetazolamide 1 day preoperatively cerebrovascular reactivity study. His potassium increased from 5.1 to 6.7 mmol/L. Prompt treatment this abnormality allowed patient undergo next uneventfully. A paradoxical, increase in can result 1000-mg iv acetazolamide.
We present the case of a 58-year-old woman who underwent minimally invasive robotic-assisted L4-S1 instrumentation and fusion which was complicated by Kirschner wire (K-wire) fracture migration into abdominal cavity necessitating emergent exploratory laparotomy. Retrieval K-wire proceeded without incident, patient had an otherwise uneventful surgery recovery. This is first such description reported in literature. As spine procedures become more common, it essential for anesthesiologist to be...
Many factors contribute to errors that occur during emergency Cesarean birth under general anesthesia. The Joint Commission of Accreditation Health Care Organizations (JACO) reports 70% sentinel events in obstetric practice are attributable communication and teamwork. Our objective was develop a video training module address these deficiencies, measure its effectiveness. A webbased learning resource created using professionally made videos depicted effective non-effective...
Intraoperative seizures under general anesthesia are infrequent. However, seizure activity confirmed by contemporaneous EEG has been reported. We describe the case of a 39-year-old female undergoing right frontal brain tumor resection who experienced an intraoperative seizure. neuromonitoring was utilized and included four channels EEG, somatosensory evoked potentials (SSEP), transcranial motor (MEP). During this operation, characteristic manifestations occurred. did not demonstrate due to...