Clinical Focus

• Anesthesia

Professional Education

Graduate & Fellowship Program Affiliations

• Anesthesia
• Epidemiology

Internet Links

• Stanford Pain Management Center

Industry Relationships

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Current Research Interests

Factors causing prolonged post-surgical pain and prolonged opioid use.

Some patients following routine surgery will experience chronic pain, and/or prolonged opioid use. This research done at Stanford Hospital and the Palo Alto VA Hospital will identify factors that delay pain resolution and opioid cessation in patients following surgery. Data collection is currently ongoing in the pilot stage, without funding. This clinical study offers abundant opportunities for undergraduate students, medical students, or residents to contribute meaningfully in collecting data from patients, and analyzing results. Local collaborators include:

Sean Mackey Pain Medicine
John Pollard Anesthesia
Keith Humphreys Addiction
Jodie Trafton Addiction/Pain Research
Peter Barelka Pain Medicine/ anesthesia
Stuart Goodman Orthopedic surgery
George Yang General Surgery
Fred Dirbas Breast Surgery

Dates: January 2007- Present

Brainstem Mechanisms of Analgesia in Patients with Post-Surgical Nerve Pain: an fMRI study.

Only a proportion of patients with neuropathic pain respond to conventional anti-neuropathic pain medications--most of which are sodium channel blockers. The mechanisms responsible for analgesia in response to a sodium channel blocker remain unknown. In this translational research at Stanford Hospital we are using functional MRI to define supraspinal changes in neuropathic pain patients specifically associated with analgesic responses to systemic lidocaine--a prototypical sodium channel blocker. Local Collaborators include:

Sean Mackey Pain Medicine

Funding: Foundation for Anesthesia Education and Research Mentored Research Training Grant.

Dates: January 2007-Present

Botulinum Toxin Sympathectomy for Chronic Sympathetically Maintained Pain. This is a prospective, double blind crossover trial of whether Botox improves duration of analgesia following lumbar sympathetic block. The study is centered at Stanford Hospital. Trial enrollment is nearing completion. Opportunities exist for students and residents to assist in data analysis. Collaborators include:

Sean Mackey Pain Medicine
David Clark Pain Medicine

Dates: January 2005-Present

Clinical Trials

• Study of Gabapentin to reduce duration of postoperative pain and opioid use Recruiting
• Study of T3 for the treatment of Fibromyalgia Recruiting
• Subcutaneous Botulinum Toxin for Cutaneous Allodynia Recruiting
• Effect of IV Lidocaine Infusions on Pain Recruiting
• A Pilot Clinical Trial of Sympathetic Blockade with Botulinum Toxin type A to Treat Complex Regional Pain Syndrome (CRPS): a Randomized, Double-Blind, Controlled, Crossover Trial. Completed

Publications

• Pain quality predicts lidocaine analgesia among patients with suspected neuropathic pain. Carroll IR, Younger JW, Mackey SC. Pain Med. 2010; 11 (4): 617-21
• Mexiletine therapy for chronic pain: survival analysis identifies factors predicting clinical success. Carroll IR, Kaplan KM, Mackey SC. J Pain Symptom Manage. 2008; 35 (3): 321-6
• Postoperative pain following foot and ankle surgery: a prospective study. Chou LB, Wagner D, Witten DM, Martinez-Diaz GJ, Brook NS, Toussaint M, Carroll IR. Foot Ankle Int. 2008; 29 (11): 1063-8
• Urinalysis vs urine protein-creatinine ratio to predict significant proteinuria in pregnancy. Dwyer BK, Gorman M, Carroll IR, Druzin M. J Perinatol. 2008; 28 (7): 461-7
• Intravenous lidocaine for neuropathic pain: diagnostic utility and therapeutic efficacy. Carroll I, Curr Pain Headache Rep. 2007; 11 (1): 20-4