Bio

Clinical Focus


  • Anesthesia
  • Obstetric Anesthesia
  • High Risk Pregnancy
  • Postpartum Hemorrhage
  • Post-Dural Puncture Headache
  • Congenital Heart Defects

Academic Appointments


Professional Education


  • Board Certification: American Board of Anesthesiology, Anesthesia (2019)
  • Internship: Stanford University Internal Medicine Residency (2013) CA
  • Fellowship: Stanford University Anesthesiology Fellowships (2018) CA
  • Residency: Stanford University Anesthesiology Residency (2016) CA
  • Medical Education: University of California at San Francisco School of Medicine (2012) CA

Publications

All Publications


  • Postpartum headaches after epidural or spinal anesthesia. Current opinion in obstetrics & gynecology Joudi, N., Ansari, J. 2021; 33 (2): 94?99

    Abstract

    PURPOSE OF REVIEW: Postpartum headache is a common occurrence with various obstetric, neurologic, and anesthetic etiologies. Post dural puncture headache (PDPH) after neuraxial anesthesia is a culprit that may be less familiar to obstetricians. In this review, authors will discuss the differential diagnosis and management of postpartum headache, review PDPH, and explore evidence suggesting that PDPH may have greater implications than previously considered.RECENT FINDINGS: Emerging evidence suggests that PDPH, previously believed to be benign and self-limited, is associated with significant acute and chronic sequelae. A recent large database study links PDPH to subdural hematoma and cerebral venous sinus thrombosis. The authors also identified associations between PDPH and bacterial meningitis, depression, and back pain. A growing body of literature also links PDPH or unintentional dural puncture with an epidural needle (UDP) with development of chronic headaches.SUMMARY: Patients who experience UDP or PDPH should be counseled to return for evaluation for new or worsening headache. In the immediate postpartum setting, clinicians assessing these patients should have a low threshold to obtain brain imaging. In addition, obstetricians should be alerted that patients who suffer UDP may be prone to develop chronic headache disorders and consider referral to pain specialists.

    View details for DOI 10.1097/GCO.0000000000000685

    View details for PubMedID 33620887

  • Superficial Cervical Plexus Block for Awake Large-Bore Central Line Placement in Parturients: A Case Series. A&A practice Sheikh, M., Carvalho, B., Boublik, J., Ansari, J. 2021; 15 (3): e01429

    Abstract

    Pregnant patients with high-risk conditions including abnormal placentation or severe cardiovascular disease may require large-bore central venous access at the time of delivery. Central lines are generally inserted while obstetric patients are awake, either because neuraxial anesthesia is planned or to minimize fetal exposure to anesthetic medications. Despite local infiltration, the procedure can cause significant patient discomfort. This case series describes use of a superficial cervical plexus block (SCPB) to facilitate line placement in 4 pregnant women with high-risk conditions. SCPB is technically straightforward with low reported complication rates and should be considered for pregnant patients requiring large-bore central lines.

    View details for DOI 10.1213/XAA.0000000000001429

    View details for PubMedID 33740791

  • 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 Rodrigues, A. 2021; 3 (1)
  • Confounders Not General Anesthesia Likely Explain Greater Postpartum Depression. Anesthesia and analgesia Ansari, J., Carvalho, B., Weiniger, C. F., Riley, E. T. 2020; 131 (6): e248?e250

    View details for DOI 10.1213/ANE.0000000000004850

    View details for PubMedID 33196470

  • Transesophageal Echocardiographic Observation of Caval Thrombus Followed by Intraoperative Placement of Inferior Vena Cava Filter for Presumed Pulmonary Embolism During Cesarean Hysterectomy for Placenta Percreta: A Case Report A & A PRACTICE Nanji, J. A., Ansari, J. R., Yurashevich, M., Ismawan, J. M., Lyell, D. J., Karam, A. K., Hovsepian, D. M., Riley, E. T. 2019; 12 (2): 37?40
  • Transesophageal Echocardiographic Observation of Caval Thrombus Followed by Intraoperative Placement of Inferior Vena Cava Filter for Presumed Pulmonary Embolism During Cesarean Hysterectomy for Placenta Percreta: A Case Report. A&A practice Nanji, J. A., Ansari, J. R., Yurashevich, M., Ismawan, J. M., Lyell, D. J., Karam, A. K., Hovsepian, D. M., Riley, E. T. 2018

    Abstract

    During a cesarean hysterectomy for placenta percreta, transesophageal echocardiography was used to monitor volume status and guide resuscitation. After delivery of the neonate but before massive surgical hemorrhage, a thrombus appeared in the inferior vena cava. Roughly 3 hours later, the patient had hemodynamic changes consistent with an intraoperative pulmonary embolism. Boluses of epinephrine stabilized the patient. An inferior vena cava filter was placed via an in situ internal jugular central venous cannula to prevent further embolic events. We believe transesophageal echocardiography is a useful monitor during surgery for placenta percreta.

    View details for PubMedID 30020106

  • Pharmacokinetics and Pharmacodynamics of Drugs Commonly Used in Pregnancy and Parturition. Anesthesia and analgesia Ansari, J., Carvalho, B., Shafer, S. L., Flood, P. 2016; 122 (3): 786-804

    Abstract

    The majority of pregnant women will be treated with a medication other than a vitamin supplement during their pregnancy. Almost half of these medications will be category C or D according to the former US Food and Drug Administration classification system, indicating a lack of human studies with animal studies suggesting adverse fetal effects (category C) or evidence of risk in humans (category D). Changes in maternal physiology alter drug bioavailability, distribution, clearance, and thus the drug half-life in often unpredictable ways. For many drugs, good pharmacokinetic and pharmacodynamic data in pregnancy and parturition are lacking. For other drugs, recent studies demonstrate major pharmacokinetic or pharmacodynamic changes that require dose adjustment in pregnancy, but current dosing guidelines do not reflect these data. In this review, we address the principles that underlie changes in pharmacology and physiology in pregnancy and provide information on drugs that anesthesiologists commonly encounter in treating pregnant patients.

    View details for DOI 10.1213/ANE.0000000000001143

    View details for PubMedID 26891392

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