Dr. Ottestad joined Stanford faculty in 2007 and became Director of the Acute Pain Service in 2009. As such, he manages acute, post-operative pain, acute-on-chronic inpatient pain consults, and cancer pain at Stanford Hospital. He is committed to the Stanford Pain Center’s multidisciplinary, comprehensive approach when treating pain clinic patients with chronic pain. In the outpatient pain clinic, Dr. Ottestad possesses expertise in advanced interventions such as intrathecal medications, spinal cord stimulation, peripheral nerve stimulation, cryotherapy and cryoanalgesia, radiofrequency neuromodulation and ablation and ultrasound-guided procedures in general for the treatment of chronic pain. Ultrasound imaging allows accurate imaging of soft tissues such as muscles, tendons, and nerves that are difficult to identify using only x-ray imaging or anatomic landmarks. This imaging is useful both diagnostically as well as therapeutically when specific, targeted treatment is needed in an area of pain.
Dr. Ottestad has written multiple book chapters and papers on pain management and has been an invited lecturer and instructor for over 60 national and international conferences in the last 8 years. He will become the President of World Academy of Pain Medicine Ultrasonography (WAPMU) in 2017. Dr. Ottestad is board certified in anesthesiology and pain management, and is an also an instructor and board examiner for the World Institute of Pain and the World Academy of Pain Medicine Ultrasonography, with secondary international qualifications FIPP (Fellow of Interventional Pain Practice) and CIPS (Certification in Pain Medicine Sonology).
- Pain Management
- Acute Pain Service
- Nerve Pain
- Interventional Ultrasound
- spinal cord stimulation
Clinical Associate Professor, Anesthesiology, Perioperative and Pain Medicine
President, World Academy of Pain Medicine Ultrasonography (2017 - 2018)
Vice President, World Academy of Pain Medicine Ultrasonography (2015 - 2017)
Chairman of education committee, World Academy of Pain Medicine Ultrasonography (2014 - Present)
Director, Acute Pain Service, Stanford University Hospital (2009 - Present)
Member, Quality, Efficiency, Patient Satisfaction Committee (2012 - Present)
Member, Interdisciplinary Practice Committee (2011 - Present)
Member, Resident Education Committee (2010 - Present)
Medical Education:Baylor College of Medicine Registrar (2002) TX
Board Certification: Pain Medicine, American Board of Anesthesiology (2010)
Board Certification: Anesthesia, American Board of Anesthesiology (2009)
Fellowship:Stanford Hospital and Clinics - Pain Mgmt (2008) CA
Residency:Stanford University - CAPS (2007) CA
Internship:The University of Texas Health Center @ Tyler (2003) TX
Board Certification, ABA, Pain Management (2010)
Current Research and Scholarly Interests
I have a strong interest in ultrasound for chronic pain management for diagnostics as well as therapeutics. I also have strong interest in acute pain in the hospital setting, including post-operative as well as cancer pain.
A case report of combined ultrasound and fluoroscopic-guided percutaneous radiofrequency lesioning of the obturator and femoral articular branches in the treatment of persistent hip pain in a pediatric patient.
Pain practice : the official journal of World Institute of Pain
Hip denervation comprising radiofrequency lesioning of the obturator and femoral articular branches is used in adults with refractory hip pain who are not surgical candidates. Persistent hip pain infrequently occurs in pediatric patients and there is limited data on the safety and efficacy of this procedure in a pediatric population. We provide a case report of a successful ultrasound and fluoroscopic-guided hip denervation procedure in an 11-year old female with persistent right hip pain after septic arthritis refractory to conservative and surgical management strategies. At an 18- week follow-up, hip denervation provided improvement in pain, mobility, and reduced opioid consumption by 20%. This article is protected by copyright. All rights reserved.
View details for DOI 10.1111/papr.12724
View details for PubMedID 29896934
Perioperative interventions to reduce chronic postsurgical pain.
Journal of reconstructive microsurgery
2013; 29 (4): 213-222
Approximately 10% of patients following a variety of surgeries develop chronic postsurgical pain. Reducing chronic postoperative pain is especially important to reconstructive surgeons because common operations such as breast and limb reconstruction have even higher risk for developing chronic postsurgical pain. Animal studies of posttraumatic nerve injury pain demonstrate that there is a critical time frame before and immediately after nerve injury in which specific interventions can reduce the incidence and intensity of chronic neuropathic pain behaviors-so called "preventative analgesia." In animal models, perineural local anesthetic, systemic intravenous local anesthetic, perineural clonidine, systemic gabapentin, systemic tricyclic antidepressants, and minocycline have each been shown to reduce pain behaviors days to weeks after treatment. The translation of this work to humans also suggests that brief perioperative interventions may protect patients from developing new chronic postsurgical pain. Recent clinical trial data show that there is an opportunity during the perioperative period to dramatically reduce the incidence and severity of chronic postsurgical pain. The surgeon, working with the anesthesiologist, has the ability to modify both early and chronic postoperative pain by implementing an evidence-based preventative analgesia plan.
View details for DOI 10.1055/s-0032-1329921
View details for PubMedID 23463498
- Perioperative Interventions to Reduce Chronic Postsurgical Pain JOURNAL OF RECONSTRUCTIVE MICROSURGERY 2013; 29 (4): 213-222
- Ultrasound-guided injections of the knee and hip joints Tech Reg Anesth Pain Manag 2009; 13 (3): 191-197
Evaluating the management of septic shock using patient simulation
CRITICAL CARE MEDICINE
2007; 35 (3): 769-775
Develop a scoring system that can assess the management of septic shock by individuals and teams.Retrospective review of videotapes of critical care house staff managing a standardized simulation of septic shock.Academic medical center; videotapes were made in a recreated intensive care unit environment using a high-fidelity patient simulator.Residents in medicine, surgery, and anesthesiology who had participated in the intensive care unit rotation.The septic patient was managed by the intensive care unit team in a graded manner with interns present for the first 10 mins and more senior-level help arriving after 10 mins. The intern was graded separately for the first 10 mins, and the team was graded for the entire 35-min performance.Both technical and nontechnical scoring systems were developed to rate the management of septic shock. Technical scores are based on guidelines and principles of managing septic shock. Team leadership, communication, contingency planning, and resource utilization were addressed by the nontechnical rating. Technical scores were calculated for both interns and teams; nontechnical scores applied only to the team. Of 16 technical checklist items, interns completed a mean of 7 with a range of 1.5-11. Team technical ratings had a mean of 9.3 with a range of 3.3-13. Nontechnical scores showed similar intergroup variability with a mean of 26 and a range of 10-35. Technical and nontechnical scores showed a modest correlation (r = .40, p = .05). Interrater reliabilities for intern and team technical scores were both r = .96 and for nontechnical scores r = .88.Objective measures of both knowledge-based and behavioral skills pertinent to the management of septic shock were made. Scores identified both adequate and poor levels of performance. Such assessments can be used to benchmark clinical skills of individuals and groups over time and may allow the identification of interventions that improve clinical effectiveness in sepsis management.
View details for DOI 10.1097/01.CCM.0000256849.75799.20
View details for Web of Science ID 000244470800011
View details for PubMedID 17235260
- Securing the airway of a 'super sized' patient: another use for the Aintree Catheter (R) EUROPEAN JOURNAL OF ANAESTHESIOLOGY 2006; 23 (12): 1064-1066
- Central venous access in obese patients: A potential complication ANESTHESIA AND ANALGESIA 2006; 102 (4): 1293-1294