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Dr. Carvalho is the Chief of Obstetric Anesthesia and Professor in the Department of Anesthesiology, Stanford University Medical Center, and the President of the Society of Obstetric Anesthesia and Perinatology (SOAP). He has published extensively in the field of Obstetric Anesthesia with over 200 peer-reviewed articles, editorials, reviews, book chapters, and commentaries. He has received several NIH, pharmaceutical and institutional grants, and won numerous research awards including three Best Research Papers at SOAP scientific meetings. Dr. Carvalho has won the Teacher of the Year award at SOAP and at Stanford University’s Departments of Anesthesia. He has presented at over 150 regional, national, and international meetings and visiting professorships. His scholarly activities are focused on clinical and translational research in the field of cesarean and labor analgesia, perinatal pharmacology and immunology.
I have completed research in a number of important areas in obstetric anesthesia including: optimizing neuraxial techniques for labor and cesarean analgesia; predicting individual labor and cesarean pain and analgesic needs; evaluating pregnancy-induced and hormonal changes in pain perception; determining the role of cytokines and other biochemical mediators in incisional wounds; evaluating local anesthetic potency and anesthetic requirements during labor and cesarean delivery; determining epidural and spinal opioid applications and the role of long-acting neuraxial opioids in obstetric pain management; investigating peripartum hemostatic and coagulation changes; conducting cost-analyses of various obstetric anesthesia practices; optimizing the management of maternal cardiac arrest and other obstetrical emergencies; determining patient attitudes and ethnic preferences towards obstetric analgesia; determining the efficacy of peripheral wound drug administration; and pharmacokinetics/pharmacodynamics of drugs administered to pregnant women. My current area of research focus is in developing novel ways of improving post-cesarean and peripartum labor pain management, and developing detailed pharmacokinetics/pharmacodynamics models of key antenatal medications.
Calcium Chloride for Prevention of Uterine Atony During Cesarean
In this pilot study, investigators will administer calcium chloride or placebo to pregnant
women undergoing Cesarean delivery who have been identified as high risk for hemorrhage due
to poor uterine muscle contraction, or atony. They will assess whether a single dose of
calcium given immediately after the delivery of the fetus decreases the incidence of uterine
atony and bleeding for the mother. The pharmacokinetics of calcium chloride in pregnant women
will also be established. Data from this pilot study of 40 patients will be used to determine
sample size and appropriateness of a larger randomized clinical trial.
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Virtual Reality Compared to Nitrous Oxide for Labor Analgesia
The purpose of this study is to determine if non-invasive distracting devices (Virtual
Reality headsets) are non-inferior to conventional therapy (nitrous oxide) for addressing
maternal needs during labor who desire non-epidural pain relief.
Pharmacokinetic (PK) and Pharmacodynamic (PD) Modeling of Ampicillin and Gentamicin in Peripartum Patients
This study proposes to compare the metabolism of Ampicillin and Gentamicin by pregnant women
to that of non-pregnant women; the placental transfer over time; and the subsequent
metabolism of the transferred drug(s) in the neonate.
Stanford is currently not accepting patients for this trial.
For more information, please contact Brendan Carvalho, MBBCh, 650-861-8607.
PIEB vs CEI for Labor Analgesia: An MLAC Study
Utilizing a 'minimal local analgesic concentration (MLAC) study' design to first determine
the relative potency of Programmed Intermittent Epidural Bolus (PIEB) compared to Continuous
Epidural Infusion (CEI) and secondly to determine the mechanism to explain the potential PIEB