Clinical Instructor, Anesthesiology, Perioperative and Pain Medicine
Honors & Awards
Resident of the Year, Stanford Department of Anesthesiology (2015-2016)
Senior Resident Teaching Scholar, Stanford Department of Anesthesiology (2015-2016)
Teaching and Mentoring Academy Innovation Grants, Stanford School of Medicine (2016)
Stanford Society of Physician Scholars Research Grant, Stanford School of Medicine (2015)
Resident Quality Improvement Recognition Program: Second Place Award, Anesthesia Patient Safety Foundation (2015)
Peer Support and Resiliency in Medicine (PRIME) Scholarship, Stanford Department of Anesthesiology (2014)
Humanism and Excellence in Teaching Award, Arnold P. Gold Foundation (2014)
Fellowship, Stanford University Hospital, Medical Education and Simulation
Fellowship, Stanford University Hospital, Research
- A PIECE OF MY MIND. Meeting the Organ Donor. JAMA 2016; 315 (11): 1111-1112
The impact of breastfeeding on postpartum pain after vaginal and cesarean delivery.
Journal of clinical anesthesia
2015; 27 (1): 33-38
Oxytocin may play a role in pain modulation. The analgesic effects of breastfeeding with its associated endogenous oxytocin release have not been well investigated. To determine the impact of breastfeeding on incisional, perineal, and cramping pain after cesarean and vaginal delivery.Institutional review board-approved prospective observational study.Labor and delivery and maternity wards.Healthy (American Society of Anesthesiology physical statuses 1 and 2) multiparous women who had cesarean (n = 40) and vaginal (n = 43) deliveries of singleton term infants and who were breastfeeding were enrolled.Women completed diaries to record incisional, perineal, or cramping pain scores 5 minutes before, during, and 5 minutes after breastfeeding.Demographic, obstetric, and neonatal variables, as well as analgesic use, were recorded.There was no difference in incisional pain before, during, and after breastfeeding in women post-cesarean delivery. Cramping pain was significantly increased during, as compared with before or after breastfeeding in both the vaginal (P < .001) and cesarean (P < .001) delivery cohorts.There was no analgesic effect on incisional pain during breastfeeding, indicating that endogenous oxytocin associated with breastfeeding may not play a significant role in postpartum cesarean wound pain modulation. Breastfeeding increased cramping pain after vaginal and cesarean delivery. The increase in cramping pain is most likely due to the breastfeeding-associated oxytocin surge increasing uterine tone.
View details for DOI 10.1016/j.jclinane.2014.06.010
View details for PubMedID 25468582
- Value of expert systems, quick reference guides and other cognitive aids CURRENT OPINION IN ANESTHESIOLOGY 2014; 27 (6): 643-648
Prospective longitudinal cohort questionnaire assessment of labouring women's preference both pre- and post-delivery for either reduced pain intensity for a longer duration or greater pain intensity for a shorter duration.
British journal of anaesthesia
2014; 113 (3): 468-473
Assessments of labour pain focus on pain intensity, not on duration. We aimed to assess the importance labouring women apply to pain intensity and duration before labour and post-delivery.Forty healthy women scheduled for labour induction were enrolled in this institutional review board-approved, prospective cohort study. Participants completed a pain preference questionnaire before active labour and within 24-h of delivery. The questionnaire consisted of seven stem questions that evaluated preference for pain intensity or duration. The pain preference ratio was determined by dividing the percentage of women who preferred reduced pain intensity for longer duration by that of those who preferred greater pain intensity for shorter duration (estimate of the odds). The overall hypothetical pain burden was determined by multiplying intensity by time. All questions presented the same overall hypothetical pain burden.Pain preference questionnaire scores demonstrated preference for low intensity pain for a longer duration rather than higher intensity for a shorter duration, both pre-labour (P<0.001) and post-delivery (P<0.001): the null median imputed as 3 of 6 (i.e. no preference for pain intensity over pain duration). This preference for pain duration over intensity was greater post-delivery compared with before labour (P=0.03). There was a significant correlation (r=0.83; P=0.04) between the pain preference ratio vs overall hypothetical pain burden before labour but not after delivery (r=0.28; P=0.59).In this preliminary labour assessment, women preferred lower pain intensity at the cost of longer pain duration. This suggests that pain intensity is the primary driver of hypothetical pain burden-a preference reinforced post-delivery.
View details for DOI 10.1093/bja/aeu149
View details for PubMedID 24907280