Bio

Clinical Focus


  • Anesthesia

Academic Appointments


Professional Education


  • Internship: Kaiser Permanente Santa Clara Internal Medicine Residency (2012) CA
  • Board Certification: American Board of Anesthesiology, Anesthesia (2016)
  • Residency: Stanford University Hospital and Clinics (2015) CA
  • Medical Education: University of California, San Francisco (2011) CA

Publications

All Publications


  • The Safety and Efficacy of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange for Laryngologic Surgery. The Laryngoscope Nekhendzy, V., Saxena, A., Mittal, B., Sun, E., Sung, K., Dewan, K., Damrose, E. J. 2020

    Abstract

    Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is an intraoperative ventilatory technique that allows avoidance of tracheal intubation (TI) or jet ventilation (JV) in selected laryngologic surgical cases. Unimpeded access to all parts of the glottis may improve surgical precision, decrease operative time, and potentially improve patient outcomes. The objective of this prospective, randomized, patient-blinded, 2-arm parallel pilot trial was to investigate the safety and efficacy of THRIVE use for adult patients undergoing nonlaser laryngologic surgery of short-to-intermediate duration.Twenty adult, American society of anesthesiology class 1-3 patients with body mass index (BMI)?

    View details for DOI 10.1002/lary.28562

    View details for PubMedID 32078170

  • Anesthetic considerations for functional endoscopic sinus surgery: a narrative review Journal of Head & Neck Anesthesia Saxena, A., Nekhendzy, V. 2020; 4 (2)
  • Prevention of postdural puncture headache after accidental dural puncture: a quantitative systematic review BRITISH JOURNAL OF ANAESTHESIA Apfel, C. C., Saxena, A., Cakmakkaya, O. S., Gaiser, R., George, E., Radke, O. 2010; 105 (3): 255-263

    Abstract

    No clear consensus exists on how to best prevent severe headache from occurring after accidental dural puncture. We conducted a quantitative systematic review to identify all available evidence for the prevention of postdural puncture headache (PDPH) and included 17 studies with 1264 patients investigating prophylactic epidural blood patch (PEBP), epidural morphine, intrathecal catheters, and epidural or intrathecal saline. The relative risk (RR) for headache after PEBP was 0.48 [95% confidence interval (CI): 0.23-0.99] in five non-randomized controlled trials (non-RCTs) and 0.32 (0.10-1.03) in four randomized controlled trials (RCTs). The RR for epidural morphine (based on a single RCT) was 0.25 (0.08-0.78). All other interventions were based on non-RCTs and failed statistical significance, including long-term intrathecal catheters with an RR of 0.21 (0.02-2.65). There are a number of promising options to prevent PDPH, yet heterogeneity between the studies and publication bias towards small non-RCTs with positive results limits the available evidence. Thus, a large multicentre RCT is needed to determine the best preventative practices.

    View details for DOI 10.1093/bja/aeq191

    View details for Web of Science ID 000282074300003

    View details for PubMedID 20682567

  • Analgesic requirements and postoperative recovery after scheduled compared to unplanned cesarean delivery: a retrospective chart review INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA Carvalho, B., Coleman, L., Saxena, A., Fuller, A. J., Riley, E. T. 2010; 19 (1): 10-15

    Abstract

    Studies examining the effects of various analgesics and anesthetics on postoperative pain following cesarean delivery conventionally use the scheduled cesarean population. This study compares postoperative analgesic requirements and recovery profiles in women undergoing scheduled cesarean compared to unplanned cesarean delivery following labor. We postulated that unplanned cesarean deliveries may increase postoperative analgesic requirements.We conducted a retrospective chart review of 200 cesarean deliveries at Lucile Packard Children's Hospital, California. We examined the records of 100 patients who underwent scheduled cesarean delivery under spinal anesthesia (hyperbaric bupivacaine 12 mg with intrathecal fentanyl 10 microg and morphine 200 microg) and 100 patients that following a trail of labor required unplanned cesarean under epidural anesthesia (10-25 mL 2% lidocaine top-up with epidural morphine 4 mg after clamping of the umbilical cord). We recorded pain scores, analgesic consumption, time to first analgesic request, side effects, and length of hospital stay.We found no differences in postoperative pain scores and analgesic consumption between scheduled and unplanned cesarean deliveries for up to five days postoperatively. There were no differences in treatment of side effects such as nausea, vomiting, or pruritus (P>0.05).The results indicate that women experience similar pain and analgesic requirements after scheduled compared to unplanned cesarean delivery. This suggests that the non-scheduled cesarean population may be a suitable pain model to study pain management strategies; and that alterations in pain management are not necessary for the unplanned cesarean delivery population.

    View details for DOI 10.1016/j.ijoa.2009.02.012

    View details for Web of Science ID 000273845400004

    View details for PubMedID 19954964

  • Vaginal twin delivery: a survey and review of location, anesthesia coverage and interventions 38th Annual Meeting of the Society-for-Obstetric-Anesthesia-and-Perinatology Carvalho, B., Saxena, A., Butwick, A., Macario, A. CHURCHILL LIVINGSTONE. 2008: 212?16

    Abstract

    Twin pregnancies are associated with increased perinatal morbidity and mortality. No consensus exists whether vaginal twin delivery should take place in the labor room or operating room, or whether anesthesiologists should be present. We surveyed members of the California Society of Anesthesiologists (CSA) to review management of vaginal twin delivery, and examined anesthetic intervention retrospectively at our institution.230 CSA members were asked to complete an online survey on location of vaginal twin delivery in their institution and whether they were required to be present throughout. We then retrospectively reviewed charts of vaginal twin deliveries at our institution over a 36-month period to analyze frequency and type of anesthetic intervention.The online survey response rate was 58%; 64% of responders reported that vaginal twin deliveries were performed in the operating room and 55% that an anesthesiologist was present. There was a strong association between anesthesiologist's presence and delivery in the operating room (OR 7; 95% CI 3-20). We reviewed 81 charts of women who underwent vaginal twin delivery. The median (range) time that the anesthesiologist was present for each delivery was 60 (20-380) min. Of women undergoing vaginal twin delivery, 27% required anesthetic intervention during the second stage of labor with 6% having emergency cesarean delivery.There is a lack of consensus regarding the appropriate location for vaginal twin delivery and the role of anesthesiologists. A significant percentage of women undergoing vaginal twin delivery in our institution received anesthetic intervention in the immediate delivery period.

    View details for DOI 10.1016/j.ijoa.2007.04.004

    View details for Web of Science ID 000257844200003

    View details for PubMedID 17881218

  • Wolff-Parkinson-White syndrome in athletes. Current sports medicine reports Saxena, A., Chang, C. J., Wang, S. 2006; 5 (5): 254-257

    View details for PubMedID 16934207

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