Anesthesiology, Perioperative and Pain Medicine

Research Fellowship Opportunities

Area of Interest


Pharmacokinetics and Pharmacodynamics

Fellows may undertake clinical research on the pharmacodynamics of drugs used in anesthesia. All fellows receive didactic training in pharmacokinetics, pharmaco- dynamics, statistics and computer programming. Training in analytical chemistry is also offered. Fellows may participate in activities of the Division of Clinical Pharmacology, including rounds, research seminars and consultation service. Research emphasizes the use of the electroencephalogram to quantitate anesthesia depth, the development of pharmacodynamic models for drugs used in anesthesia, the physiological processes that govern drug distribution in man and the interaction between hemodynamics and pharmacokinetics in intravenous agents. Investigations in both humans and animals are available.

Principal Faculty: Hendrikus Lemmens M.D., PhD and David Drover M.D.


Neurophysiology of Anesthesia

Recognizing the explosive growth of neuroscience and its potential impact in anesthesia, the department has established a strong concentration of research effort in this area. Dr Bruce MacIver uses patch-clamp electrophysiological recording in isolated brain slices to investigate anesthetic actions on synaptic transmission and nerve cell excitability.  Dr Boris Heifets uses optogenetic techniques combined with electrophysiologic recordings, in defined brain circuits, to further our understanding of deep brain stimulation therapies.  Drs Trudell and Bertaccini provide molecular modelling, novel chemicals and advice for collaborative physiological experiments to design better, safer anesthetics.  Dr Rona Giffard's group collaborates on externally funded research into both ischemia and radiation effects on synaptic physiology.  Drs Jaffe and Brock-Utne collaborate on translational studies in animals and humans to improve the safety and effectiveness of anesthesia therapies.

Principal Faculty:M Bruce MacIver MSc PhD.


Cerebral Ischemia

Dr. Rona Giffard’s laboratory studies stroke.  Stroke is a devastating problem that is the leading cause of long term neurological disability and the third leading cause of death worldwide. We try to identify ways to reduce ischemic brain injury, and to better understand the interactions between different brain cell types during injury and recovery. Astrocytes and their response to injury is an important focus in the lab. We have found that astrocyte impairment contributes to neuronal injury in global ischemia.  Targeting protective strategies to astrocytes leads to markedly increased neuronal survival. 

Another area of focus in the lab is the increase in neurogenesis following stroke, and the deleterious effects of inflammation on neurogenesis in this setting.  We are studying ways to improve mitochondrial function to increase newborn neuron survival, and modulate inflammation. 

MicroRNAs are small noncoding RNAs that reduce translation and thus inhibit gene expression.  Recent work shows that microRNAs are regulated in response to stroke, and may play an important role in neuroprotection. We are studying microRNAs that regulate important survival proteins including members of the Bcl-2 family and heat shock proteins. Because each microRNA can target multiple messengerRNAs, this is a way to target several physiologically related genes at once.

Inflammation following stroke while having important necessary roles, can also contribute to worsening injury.  We have investigated the importance of IL4 in stroke, and found that it protects male mice from stroke injury.  Results in females however, differed.  Biological sex differences are seen in differences in the age of stroke and outcome to stroke in patients.  We are also investigating sex differences in response to stroke, with a focus on differences in inflammation.

Studies are performed in animal models and primary cultures from brain.

Principal Faculty: Rona Giffard M.D., PhD.


Systems Neuroscience of Pain and Analgesia

Historically, pain has been considered in relation to its etiologic or disease factors, such as the relationship between surgery and postoperative pain, herpes zoster and postherpetic neuralgia, and arthritis and painful joints. This has had the effect of addressing pain as a symptom of disease, and although much progress has been made in understanding the molecular and cellular mechanisms of disease, the resulting pain has not necessarily been alleviated. What is required, and has been missing from the evaluation, is an understanding of the underlying mechanisms responsible for the pain itself.

Dr. Mackey’s Stanford Systems Neuroscience and Pain Lab (SNAPL) is focused on elucidating and characterizing underlying mechanisms of pain and analgesia. In particular, he has focused his efforts on characterizing the mechanisms of pain from the level of the network to behavior (see figure). Important mechanisms of nociception exist at the level of the gene through the neuron; however, pain is ultimately a subjective experience that does not commonly correspond to the level of tissue injury or nociception that a person experiences. Additionally, while much has been learned from animal models of pain, it is ultimately the human patient that needs to be studied to best understand and treat this terrible condition.
SNAPL uses a combination of sophisticated neurobehavioral, psychophysical and neuroimaging (fMRI, VBM, DTI, effective connectivity) techniques to investigate acute and chronic pain mechanisms and analgesia in the spinal cord and brain in humans. Dr. Mackey has several ongoing NIH, foundation and industry funded projects related to real-time fMRI and learned brain control, cognitive and affective dimensions of pain, pharmacologic fMRI, spinal cord mapping, epidemiology of chronic pain, sodium channel blockers in neuropathic pain and neurotoxins in neuropathic pain. Multiple research fellowship opportunities are available for qualified candidates. These include immediate openings in MRI research and cognitive neuroscience, as well as an ongoing multi-departmental collaboration in Pain and/or Substance Use Disorders.  To learn more, please see http://snapl.stanford.edu/postdoc/.

Research fellowships are available for qualified candidates. For more information contact:
Andrew Morrow

Principal Faculty: Sean Mackey M.D., PhD.


Patient Safety and Human Performance

The Patient Safety Center of Inquiry at the VA Palo Alto Health Care System has 7 major areas of study and fellows participate in all aspects of laboratory activity and are expected to develop their own area of expertise under faculty guidance. The major areas of study include:

  1. Simulation-based training in decision making, crisis management, and teamwork;
  2. Theory of organizational safety applied to health care;
  3. Effects of sleep deprivation and fatigue on patient safety;
  4. Cultures of safety in health care;
  5. Safety-related event reporting and analysis;
  6. Safety of human subjects in research; and human factors issues in medical equipment design and use.

In addition to its internal collaborators within the VA Palo Alto HCS and Veterans Health Administration (VHA), external collaborators include: The Center for Health Policy at Stanford University, the California Collaboration for Improving Patient Safety, and investigators from The Haas School of Business at UC Berkeley and from the Naval Postgraduate School in Monterey, CA.

Principal Faculty: David Gaba MD, Steven Howard MD, Kyle Harrison, MD


Pain Research - Maladaptations to Opioids and CRPS

The Clark laboratory pursues research questions in two areas related to pain management. The first focus of interest is on the mechanisms responsible for maladaptations to opioids. We specifically study opioid dependence, tolerance and opioid-induced hyperalgesia. These problems limit the effectiveness of our most useful class of pain relieving medications, and support adverse outcomes such as enhanced levels of pain and addiction. Our projects extend from the study of very basic molecular mechanisms to complex behavioral studies in laboratory animals. We use genetic mapping to identify new pathways and contributors to the various opioid maladaptations. In addition, our work involves epigenetic mechanisms in specific neural tissues in the periphery and in the brain. This work is joined translationally to various human projects ongoing within the department.

The second area of interest is in Complex Regional Pain Syndrome (CRPS). This syndrome is addressed comprehensively using laboratory and, in some cases, human models. Our specific interests relate to how activation of the innate and adaptive systems of immunity contributes to CRPS. We have ongoing projects designed to determine how cytokines, growth factors and autoantibodies support the various components of CRPS. In addition, we are investigating the transition of the syndrome from its acute phases to its more chronic form in which neuroplastic changes within the CNS support alterations in mood, anxiety and memory as well as ongoing pain.

Principal Faculty: David Clark, MD, PhD


Physical Chemistry of Anesthetic Agents

This laboratory studies molecular theories of anesthesia and alcohol. We build molecular models of ligand-gated ion channels and then perform molecular dynamics calculations of anesthetic binding. Training is offered in analytical techniques including mass spectrometry, high pressure liquid chromatography, gas chromatography and radioactive labeling.

Metabolic studies employ cell culture, preparation of cell membrane fractions and reconstituted cytochrome P-450. Research projects can be tailored to suit individual interests and the background of the fellow.

Possible projects include treatment of rat liver hepatocytes in culture with suspected liver necrosis-inducing metabolites, raising antibodies to hepatocyte surface antigens and studying neutrophil-hepatocyte interactions.

Principal Faculty: James R.Trudell PhD.


Clinical Pharmacology of Analgesic Drugs/Interventions

Our laboratory's current transformative research efforts focus on studying immune health in the context of surgery and anesthesia. Our interest stems from previous work elucidating the modulation of inflammatory responses by anesthetic and analgesic drugs. The aim of studying immunity in patients undergoing surgery is to identify immune phenotypes predictive of aversive postoperative outcomes including protracted recovery and infection. Our major working hypotheses are that 1) specific immune phenotypes will predict the risk for developing postoperative complications, 2) immune phenotyping will lead to the discovery of mechanisms aggravating or alleviating such risk, and 3) gained knowledge will allow devising immune-modulatory strategies mitigating such risk. Mass cytometry (CyTOF), proteomics, and functional ex-vivo immune assays are the major molecular tools for the systems-based numerical and functional exploration of the circulating immune system.

Principal Faculty: Martin Angst M.D.


Cellular and Molecular Mechanisms of Pain and its Control by Opioids

Our laboratory's current transformative research efforts focus on studying immune health in the context of surgery and anesthesia. Our interest stems from previous work elucidating the modulation of inflammatory responses by anesthetic and analgesic drugs. The aim of studying immunity in patients undergoing surgery is to identify immune phenotypes predictive of aversive postoperative outcomes including protracted recovery and infection. Our major working hypotheses are that 1) specific immune phenotypes will predict the risk for developing postoperative complications, 2) immune phenotyping will lead to the discovery of mechanisms aggravating or alleviating such risk, and 3) gained knowledge will allow devising immune-modulatory strategies mitigating such risk. Mass cytometry (CyTOF), proteomics, and functional ex-vivo immune assays are the major molecular tools for the systems-based numerical and functional exploration of the circulating immune system.

Principal Faculty: Greg Scherrer, PhD


Anesthesia Research Funding for Fellows

Please visit the anesthesia research fellowship funding webpage (http://med.stanford.edu/anesthesia/research/fellowship.html) or the resident research fuding webpage (http://med.stanford.edu/anesthesia/education/residentresearch.html) for further information about potential funding.

Stanford Medicine Resources:

Footer Links: