Sarah Stone
Clinical Assistant Professor, Anesthesiology, Perioperative and Pain Medicine
Bio
Dr. Sarah A. Stone is a board certified anesthesiologist.
Dr. Stone is from Chicago, IL and graduated from the Chicago Medical School. She went on to complete internship, anesthesia residency and fellowship (neuroanesthesia) at Stanford. Dr. Stone is part of the Division of Neuroanesthesia and enjoys complex neurovascular surgery, designing and managing the neuroanesthesia website, and managing the curriculum for the neuro 1 rotation.
Clinical Focus
- Anesthesia
- Neuroanesthesia
Professional Education
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Fellowship, Stanford University Medical Center, Neuroanesthesia (2019)
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Residency: Stanford University Anesthesiology Residency (2018) CA
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Board Certification: American Board of Anesthesiology, Anesthesia (2019)
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Medical Education: Rosalind Franklin University The Chicago Medical School (2014) IL
All Publications
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Periprocedural Management and Multidisciplinary Care Pathways for Patients With Cardiac Implantable Electronic Devices: A Scientific Statement From the American Heart Association.
Circulation
2024; 150 (8): e183-e196
Abstract
The rapid technological advancements in cardiac implantable electronic devices such as pacemakers, implantable cardioverter defibrillators, and loop recorders, coupled with a rise in the number of patients with these devices, necessitate an updated clinical framework for periprocedural management. The introduction of leadless pacemakers, subcutaneous and extravascular defibrillators, and novel device communication protocols underscores the imperative for clinical updates. This scientific statement provides an inclusive framework for the periprocedural management of patients with these devices, encompassing the planning phase, procedure, and subsequent care coordinated with the primary device managing clinic. Expert contributions from anesthesiologists, cardiac electrophysiologists, and cardiac nurses are consolidated to appraise current evidence, offer patient and health system management strategies, and highlight key areas for future research. The statement, pertinent to a wide range of health care professionals, underscores the importance of quality care pathways for patient safety, optimal device function, and minimization of hemodynamic disturbances or arrhythmias during procedures. Our primary objective is to deliver quality care to the expanding patient cohort with cardiac implanted electronic devices, offering direction in the era of evolving technologies and laying a foundation for sustained education and practice enhancement.
View details for DOI 10.1161/CIR.0000000000001264
View details for PubMedID 38984417
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Rapid Blood Transfusion: The Importance of Hemodilution and Needleless Connectors.
Cureus
2021; 13 (3): e13999
Abstract
Large-bore cannulas are critical to administering IV fluids and blood products during resuscitation and treatment of hemorrhage. Although catheter flow rates for crystalloid solutions are well defined, rapid administration of blood products is poorly characterized. In this in vitro study, we examined the effects of hemodilution and needleless connectors on red blood cell (RBC) flow rates. To determine RBC flow rates through large-bore cannulae, a crystalloid solution (Normosol®, Hospira, Lake Forest, IL) or RBC units were warmed and delivered under pressure (360 mmHg) using a Level 1 H-1200 Fast Flow Fluid Warmer (Smiths Medical, St. Paul, MN). Flow rates for crystalloid, packed RBCs and diluted RBCs were determined using a stopwatch. Additionally, the effect of the MaxPlus® clear needleless connector (CareFusion, San Diego, CA) was measured in all three infusion groups. Flow rates for undiluted RBC units were 53% slower than crystalloid solution (220 mL/min vs. 463 mL/min; p=0.0003), however, when RBC units were diluted to a hematocrit of ~30% flow rate improved to 369 mL/min (p=0.005). The addition of the MaxPlus® needleless connector reduced flow of crystalloid solution by 47% (245 mL/min; p=0.0001), undiluted RBCs by 64% (78 mL/min; p=0.01), and diluted RBCs by 51% (180 mL/min; p=0.00003). Compared to undiluted RBC units, hemodilution increased RBC delivery rate through a MaxPlus® connector by 130% (p=0.004) and by 68% (p=0.02) when the catheter was directly connected to the Level 1 tubing (MaxPlus® excluded). In settings requiring rapid transfusion of RBC units, needleless connectors should not be used and hemodilution should be considered in order to decrease the time required to deliver an equivalent red cell mass.
View details for DOI 10.7759/cureus.13999
View details for PubMedID 33880314
View details for PubMedCentralID PMC8053387
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Rapid Blood Transfusion: The Importance of Hemodilution and Needleless Connectors
CUREUS
2021; 13 (3)
View details for DOI 10.7759/cureus.13999
View details for Web of Science ID 000631196700013
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Management of brain tumors presenting in pregnancy: a case series and systematic review
Management of brain tumors presenting in pregnancy: a case series and systematic review
2021; 3 (1)
View details for DOI 10.1016/j.ajogmf.2020.100256
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Management of brain tumors presenting in pregnancy: a case series and systematic review.
American journal of obstetrics & gynecology MFM
2021; 3 (1): 100256
Abstract
Patients who present with brain tumors during pregnancy require unique imaging and neurosurgical, obstetrical, and anesthetic considerations. Here, we review the literature and discuss the management of patients who present with brain tumors during pregnancy. Between 2009 and 2019, 9 patients were diagnosed at our institution with brain tumors during pregnancy. Clinical information was extracted from the electronic medical records. The median age at presentation was 29 years (range, 25-38 years). The most common symptoms at presentation included headache (n=5), visual changes (n=4), hemiparesis (n=3), and seizures (n=3). The median gestational age at presentation was 20.5 weeks (range, 11-37 weeks). Of note, 8 patients (89%) delivered healthy newborns, and 1 patient terminated her pregnancy. In addition, 5 patients (56%) required neurosurgical procedures during pregnancy (gestational ages, 14-37 weeks) because of disease progression (n=2) or neurologic instability (n=3). There was 1 episode of postneurosurgery morbidity (pulmonary embolism [PE]) and no surgical maternal mortality. The median length of follow-up was 15 months (range, 6-45 months). In cases demonstrating unstable or progressive neurosurgical status past the point of fetal viability, neurosurgical intervention should be considered. The physiological and pharmacodynamic changes of pregnancy substantially affect anesthetic management. Pregnancy termination should be discussed and offered to the patient when aggressive disease necessitates immediate treatment and the fetal gestational age remains previable, although neurologically stable patients may be able to continue the pregnancy to term. Ultimately, pregnant patients with brain tumors require an individualized approach to their care under the guidance of a multidisciplinary team.
View details for DOI 10.1016/j.ajogmf.2020.100256
View details for PubMedID 33451609
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Moyamoya disease in children and its anesthetic implications: A review.
Paediatric anaesthesia
2020; 30 (11): 1191-1198
Abstract
Moyamoya disease is a rare, progressive cerebral vasculopathy which most commonly presents in the first and fourth decades of life. The mainstay of treatment is surgical revascularization; without treatment, most patients experience ischemic or hemorrhagic strokes. This report reviews moyamoya disease, its associated conditions, surgical treatment techniques, and anesthetic management of patients with moyamoya disease.
View details for DOI 10.1111/pan.14001
View details for PubMedID 33463884
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Moyamoya disease in children and its anesthetic implications: A review
PEDIATRIC ANESTHESIA
2020
View details for DOI 10.1111/pan.14001
View details for Web of Science ID 000568620600001
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Acetaminophen Does Not Reduce Postoperative Opiate Consumption in Patients Undergoing Craniotomy for Cerebral Revascularization: A Randomized Control Trial.
Cureus
2019; 11 (1): e3863
Abstract
Background Postoperative management in patients undergoing craniotomy is unique and challenging. We utilized apopulation of patients who underwent bilateral extracranial-to-intracranial (EC-IC bypass) revascularization procedures for moyamoya disease and hypothesized that 1 gram (gm) of intravenous (IV) acetaminophen given immediately after intubation and again 45 minutes prior to the end of craniotomymay be more effective than saline in minimizing opiate consumption and decreasing pain scores. Methods In a double-blind, randomized, placebo-controlled crossover pilot study, 40 craniotomies in 20 patients were studied. A random number generator assigned patients to receive either 1 gram of IV acetaminophen or an equal volume of normal saline immediately after intubation and again 45 minutes prior to the end of their first operation. For the second surgery, patients received the study drug (IV acetaminophen or normal saline) that they did not receive during their first surgery. Results In the IV acetaminophen group, the average 24-hour postoperative fentanyl equivalent consumption was decreased but the difference was not statistically significant: 228 micrograms compared to 312 micrograms in the placebo group (Figure 1;p = 0.09). Pain scores did not significantly differ between the IV acetaminophen group and the placebo group in postoperative hours 0-12 (Figure 2; p = 0.44) or 24 (Figure 3;p = 0.77). Conclusion Our study demonstrates that in patients receiving bilateral craniotomies for moyamoya disease, IV acetaminophen when given immediately after intubation and again 45 minutes prior to closuredoes not significantly decrease 12- or 24-hour postoperative opiate consumption.
View details for PubMedID 30899614