Bio

Bio


Dr. Sam Rodriguez is a Pediatric Anesthesiologist at Stanford Children's Hospital in the Clinician Educator Line. His clinical research involves creating and studying the effects of new technologies on pediatric stress and pain. He is the founder and co-director of the Stanford CHARIOT Program which creates and studies innovative approaches to treating children. The CHARIOT Program has positively impacted thousands of children and has grown to include emerging technologies like virtual reality, augmented reality, and interactive video games. Dr. Rodriguez is also highly involved in medical humanities education at Stanford Medical School and teaches courses at the undergraduate and graduate levels on how studying art can make better physicians.

Clinical Focus


  • Anesthesiology
  • Pediatric Anesthesia

Academic Appointments


Professional Education


  • Medical Education:Perelman School of Medicine University of Pennsylvania (2008) PA
  • Board Certification: Anesthesiology, American Board of Anesthesiology (2013)
  • Residency:Massachusetts General HospitalMA
  • Fellowship:Boston Children's HospitalMA
  • Board Certification: Pediatric Anesthesia, American Board of Anesthesiology (2013)

Research & Scholarship

Clinical Trials


  • VR Usage in Non-Invasive Surgical Sub-Specialty Procedures Recruiting

    Preprocedural, preoperative, and prevascular access anxiety in pediatric patients has been previously shown to increase the likelihood of family stressors, agitation, sleep disturbances, and negative behavioral changes. The purpose of this study is to determine if a non-invasive distracting device (Virtual Reality (VR) headset, Augmented Reality (AR) headset, or bed mounted Video Projection unit (i.e. BERT, Bedside EnterRtainment Theater)) is more effective than the standard of care (i.e., no technology based distraction) for preventing anxiety before non-invasive surgical sub-specialty procedures among children during out-patient clinic visits. Examples of the most common procedures include, but are not limited to gastrostomy tube exchanges, suture removals, dressing changes, foley insertions, EEG set up, chest tube removals, cast removals, pin removals and other similar procedures. (The investigators refer to these procedures under an umbrella term of non-invasive surgical subspecialty procedures). The anticipated primary outcome will be reduction of child's anxiety during and after procedures.

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  • Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) Use in Pediatric Procedures Recruiting

    THRIVE (Transnasal Humidified Rapid-Insufflation Ventilatory Exchange) refers to the use of high-flow nasal cannula to augment the ability to oxygenate and ventilate a patient under general anesthesia. The use of high-flow nasal cannula oxygen supplementation during anesthesia for surgical procedures has been a recent development in the adult population, with limited data analyzing the pediatric population. This study will determine whether high flow nasal cannula oxygen supplementation during surgical or endoscopic procedures can safely prevent desaturation events in children under anesthesia.

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Publications

All Publications


  • Commentary on A Body of Work: Painting a Decade of Gross Dissection. Academic medicine : journal of the Association of American Medical Colleges Rodriguez, S., Srivastava, S. 2018; 93 (3): 429

    View details for DOI 10.1097/01.ACM.0000531163.02389.da

    View details for PubMedID 29485506

  • Bedside Entertainment and Relaxation Theater: size and novelty does matter when using video distraction for perioperative pediatric anxiety. Paediatric anaesthesia Rodriguez, S., Caruso, T., Tsui, B. 2017; 27 (6): 668–69

    View details for DOI 10.1111/pan.13133

    View details for PubMedID 28474813

  • Interactive video game built for mask induction in pediatric patients. Canadian journal of anaesthesia = Journal canadien d'anesthesie Rodriguez, S., Tsui, J. H., Jiang, S. Y., Caruso, T. J. 2017

    View details for DOI 10.1007/s12630-017-0922-0

    View details for PubMedID 28646461

  • Provider-controlled virtual reality experience may adjust for cognitive load during vascular access in pediatric patients. Canadian journal of anaesthesia = Journal canadien d'anesthesie Yuan, J. C., Rodriguez, S., Caruso, T. J., Tsui, J. H. 2017

    View details for DOI 10.1007/s12630-017-0962-5

    View details for PubMedID 28861855

  • The transfer of care. Anesthesia and analgesia Rodriguez, S. 2015; 120 (3): 687-?

    View details for DOI 10.1213/ANE.0000000000000592

    View details for PubMedID 25695585

  • A Body of Work: Painting a Decade of Gross Dissection. Academic medicine : journal of the Association of American Medical Colleges Rodriguez, S. 2018; 93 (3): 428

    View details for DOI 10.1097/ACM.0000000000002089

    View details for PubMedID 29485505

  • Continuous erector spinae plane block for an open pyeloplasty in an infant. Journal of clinical anesthesia Munshey, F., Rodriguez, S., Diaz, E., Tsui, B. 2018; 47: 47–49

    View details for DOI 10.1016/j.jclinane.2018.03.015

    View details for PubMedID 29573732

  • Contralateral osteotomy of the pedicle and posterolateral elements for en bloc resection: a technique for oncological resection of posterolateral spinal tumors JOURNAL OF NEUROSURGERY-SPINE Vasudeva, V. S., Ropper, A. E., Rodriguez, S., Wu, K. C., Chi, J. H. 2017; 26 (3): 275-281
  • Initial clinical outcomes of audiovisual-assisted therapeutic ambience in radiation therapy (AVATAR). Practical radiation oncology Hiniker, S. M., Bush, K., Fowler, T., White, E. C., Rodriguez, S., Maxim, P. G., Donaldson, S. S., Loo, B. W. 2017

    Abstract

    Radiation therapy is an important component of treatment for many childhood cancers. Depending upon the age and maturity of the child, pediatric radiation therapy often requires general anesthesia for immobilization, position reproducibility, and daily treatment delivery. We designed and clinically implemented a radiation therapy-compatible audiovisual system that allows children to watch streaming video during treatment, with the goal of reducing the need for daily anesthesia through immersion in video.We designed an audiovisual-assisted therapeutic ambience in radiation therapy (AVATAR) system using a digital media player with wireless streaming and pico projector, and a radiolucent display screen positioned within the child's field of view to him or her with sufficient entertainment and distraction for the duration of serial treatments without the need for daily anesthesia. We piloted this system in 25 pediatric patients between the ages of 3 and 12 years. We calculated the number of fractions of radiation for which this system was used successfully and anesthesia avoided and compared it with the anesthesia rates reported in the literature for children of this age.Twenty-three of 25 patients (92%) were able to complete the prescribed course of radiation therapy without anesthesia using the AVATAR system, with a total of 441 fractions of treatment administered when using AVATAR. The median age of patients successfully treated with this approach was 6 years. Seven of the 23 patients were initially treated with daily anesthesia and were successfully transitioned to use of the AVATAR system. Patients and families reported an improved treatment experience with the use of the AVATAR system compared with anesthesia.The AVATAR system enables a high proportion of children to undergo radiation therapy without anesthesia compared with reported anesthesia rates, justifying continued development and clinical investigation of this technique.

    View details for DOI 10.1016/j.prro.2017.01.007

    View details for PubMedID 28242188

  • Induction. Anesthesia and analgesia Wu, M., Rodriguez, S. T. 2017

    View details for DOI 10.1213/ANE.0000000000001772

    View details for PubMedID 28079583

  • Epidural Steroid Injections for Radiculopathy and/or Back Pain in Children and Adolescents: A Retrospective Cohort Study With a Prospective Follow-Up. Regional anesthesia and pain medicine Kurgansky, K. E., Rodriguez, S. T., Kralj, M. S., Mooney, J. J., Dinakar, P., d'Hemecourt, P. A., Hedequist, D. J., Proctor, M. R., Berde, C. B. 2016; 41 (1): 86-92

    Abstract

    Epidural steroid injections (ESIs) are commonly performed for adults with spinal pain and/or radiculopathy. Previous pediatric ESI case series were not identified by literature review. The primary aim of this study was to examine the safety and provisional outcomes of pediatric ESIs.With institutional review board approval, medical records were reviewed for patients aged 9 to 20 years receiving a first ESI at Boston Children's Hospital from 2003 through 2013. A subset of patients completed a Web-based follow-up questionnaire. Descriptive statistics included frequencies, medians, interquartile ranges, and Kaplan-Meier methods. Statistical comparisons were made using Wilcoxon rank sum, χ2, Fisher exact, and Cox proportional hazards regression analyses.A total of 224 patients aged 9 to 20 years underwent 428 ESIs. One hundred seventy-four (76.0%) patients had a lumbar disc herniation with radiculopathy; the others had a spectrum of other spinal disorders. There were no serious adverse events, hospitalizations, dural punctures, or nerve injuries. During follow-up, 69 (41.6%) of 166 previously nonoperated lumbar disc plus radiculopathy patients underwent discectomy at a median time of 128 days (interquartile range, 76-235 days) after first injection. Degrees of straight-leg raising at presentation was significantly associated with subsequent discectomy. On follow-up, patients who did and did not undergo discectomy had low pain scores and high function scores.Children and adolescents can receive ESIs under conscious sedation with good safety. Further prospective studies may better define the role for these injections in the comprehensive management of pediatric spinal pain disorders.

    View details for DOI 10.1097/AAP.0000000000000338

    View details for PubMedID 26655219

  • Artist's statement: the mighty fellow. Academic medicine Rodriguez, S. 2015; 90 (11): 1527-?

    View details for DOI 10.1097/ACM.0000000000000940

    View details for PubMedID 26506607

  • The development of pediatric anesthesiology and critical care medicine at the Cincinnati Children's Hospital: an interview with Dr. Theodore Striker PEDIATRIC ANESTHESIA Ahmed, Z., Samuels, P. J., Mai, C. L., Rodriguez, S., Iftikhar, A. R., Yaster, M. 2015; 25 (8): 764-769

    Abstract

    Dr. Theodore W. 'Ted' Striker (1936-), Professor of Anesthesiology and Pediatrics at the University of Cincinnati, has played a pioneering role in the development of pediatric anesthesiology in the United States. As a model educator, clinician, and administrator, he shaped the careers of hundreds of physicians-in-training and imbued them with his core values of honesty, integrity, and responsibility.

    View details for DOI 10.1111/pan.12677

    View details for Web of Science ID 000357730600002

    View details for PubMedID 25989362

  • Extensive spinal epidural abscess treated with "apical laminectomies" and irrigation of the epidural space: report of 2 cases JOURNAL OF NEUROSURGERY-SPINE Abd-El-Barr, M. M., Bi, W. L., Bahluyen, B., Rodriguez, S. T., Groff, M. W., Chi, J. H. 2015; 22 (3): 318-323

    Abstract

    Spinal epidural abscess (SEA) is a rare but often devastating infection of the epidural space around the spinal cord. When an SEA is widespread, extensive decompression with laminectomy is often impossible, as it may subject the patient to very long operative times, extensive blood loss, and mechanical instability. A technique called "skip laminectomy" has been described in the literature, in which laminectomies are performed at the rostral and caudal ends of an abscess that spans 3-5 levels and a Fogarty catheter is used to mechanically drain the abscess, much like in an embolectomy. In this report of 2 patients, the authors present a modification of this technique, which they call "apical laminectomies" to allow for irrigation and drainage of an extensive SEA spanning the entire length of the vertebral column (C1-2 to L5-S1). Two patients presented with cervico-thoraco-lumbar SEA. Laminectomies were performed at the natural apices of the spine, namely, at the midcervical, midthoracic, and midlumbar spine levels. Next, a pediatric feeding tube was inserted in the epidural space from the thoracic laminectomies up toward the cervical laminectomy site and down toward the lumbar laminectomy site, and saline antibiotics were used to irrigate the SEA. Both patients underwent this procedure with no adverse effects. Their SEAs resolved both clinically and radiologically. Neither patient suffered from mechanical instability at 1 year after treatment. For patients who present with extensive SEAs, apical laminectomies seem to allow for surgical cure of the infectious burden and do not subject the patient to extended operating room time, an increased risk of blood loss, and the risk of mechanical instability.

    View details for DOI 10.3171/2014.11.SPINE131166

    View details for Web of Science ID 000350266300015

    View details for PubMedID 25555055

  • A patient with surgically unrepaired single ventricle and uncontrolled amiodarone-induced thyrotoxicosis for emergent thyroidectomy. A & A case reports Downey, L., Rodriguez, S., Clendenin, D. 2014; 3 (5): 61-64

    Abstract

    We present the case of a 20-year-old woman with a history of hypoplastic left heart syndrome, D-transposition of the great arteries, and mitral/pulmonary valve atresia without surgical palliation, who was admitted with persistent atrial flutter/fibrillation and worsening cardiac function from amiodarone-induced thyrotoxicosis. Despite maximal medical therapy, she continued to have uncontrolled thyrotoxicosis and underwent successful emergent thyroidectomy under general anesthesia. With advances in the treatment of congenital heart disease, more patients are surviving to adulthood and require emergent noncardiac surgery. Therefore, anesthesiologists must understand the principles for managing patients with congenital heart disease and how the patient's physiology may affect the anesthetic plan.

    View details for DOI 10.1213/XAA.0000000000000080

    View details for PubMedID 25611355

  • Minimally invasive spine surgery for adult degenerative lumbar scoliosis NEUROSURGICAL FOCUS Dangelmajer, S., Zadnik, P. L., Rodriguez, S. T., Gokaslan, Z. L., Sciubba, D. M. 2014; 36 (5)

    Abstract

    Historically, adult degenerative lumbar scoliosis (DLS) has been treated with multilevel decompression and instrumented fusion to reduce neural compression and stabilize the spinal column. However, due to the profound morbidity associated with complex multilevel surgery, particularly in elderly patients and those with multiple medical comorbidities, minimally invasive surgical approaches have been proposed. The goal of this meta-analysis was to review the differences in patient selection for minimally invasive surgical versus open surgical procedures for adult DLS, and to compare the postoperative outcomes following minimally invasive surgery (MIS) and open surgery.In this meta-analysis the authors analyzed the complication rates and the clinical outcomes for patients with adult DLS undergoing complex decompressive procedures with fusion versus minimally invasive surgical approaches. Minimally invasive surgical approaches included decompressive laminectomy, microscopic decompression, lateral and extreme lateral interbody fusion (XLIF), and percutaneous pedicle screw placement for fusion. Mean patient age, complication rates, reoperation rates, Cobb angle, and measures of sagittal balance were investigated and compared between groups.Twelve studies were identified for comparison in the MIS group, with 8 studies describing the lateral interbody fusion or XLIF and 4 studies describing decompression without fusion. In the decompression MIS group, the mean preoperative Cobb angle was 16.7° and mean postoperative Cobb angle was 18°. In the XLIF group, mean pre- and postoperative Cobb angles were 22.3° and 9.2°, respectively. The difference in postoperative Cobb angle was statistically significant between groups on 1-way ANOVA (p = 0.014). Mean preoperative Cobb angle, mean patient age, and complication rate did not differ between the XLIF and decompression groups. Thirty-five studies were identified for inclusion in the open surgery group, with 18 studies describing patients with open fusion without osteotomy and 17 papers detailing outcomes after open fusion with osteotomy. Mean preoperative curve in the open fusion without osteotomy and with osteotomy groups was 41.3° and 32°, respectively. Mean reoperation rate was significantly higher in the osteotomy group (p = 0.008). On 1-way ANOVA comparing all groups, there was a statistically significant difference in mean age (p = 0.004) and mean preoperative curve (p = 0.002). There was no statistically significant difference in complication rates between groups (p = 0.28).The results of this study suggest that surgeons are offering patients open surgery or MIS depending on their age and the severity of their deformity. Greater sagittal and coronal correction was noted in the XLIF versus decompression only MIS groups. Larger Cobb angles, greater sagittal imbalance, and higher reoperation rates were found in studies reporting the use of open fusion with osteotomy. Although complication rates did not significantly differ between groups, these data are difficult to interpret given the heterogeneity in reporting complications between studies.

    View details for DOI 10.3171/2014.3.FOCUS144

    View details for Web of Science ID 000335969300008

    View details for PubMedID 24785489

  • Breaking the glass ceiling: an interview with Dr. Shirley Graves, a pioneering woman in medicine PEDIATRIC ANESTHESIA Ahmed, Z., Mai, C. L., Elder, B., Rodriguez, S., Yaster, M. 2014; 24 (4): 440-445

    Abstract

    Shirley Graves M.D., D.Sc. (honorary) (1936), Professor Emeritus of Anesthesiology and Pediatrics at the University of Florida, was one of the most influential women in medicine in the 1960 and 1970s, a time when the medical profession was overwhelmingly male-dominated. In today's society, it is hard to believe that only 50 years ago, women were scarce in the field of medicine. Yet Dr. Graves was a pioneer in the fields of pediatric anesthesia and pediatric critical care medicine. She identifies her development of the pediatric intensive care unit and her leadership in the Division of Pediatric Anesthesia at the University of Florida as her defining contributions. Through her journal articles, book chapters, national and international lectures, and leadership in the American Society of Anesthesiology and the Florida Society of Anesthesiology, she inspired a generation of men and women physicians to conquer the unthinkable and break through the glass ceiling.

    View details for DOI 10.1111/pan.12363

    View details for Web of Science ID 000332773500012

    View details for PubMedID 24571660

  • The development of a specialty: an interview with Dr. Mark C. Rogers, a pioneering pediatric intensivist. Paediatric anaesthesia Mai, C. L., Firth, P. G., Ahmed, Z., Rodriguez, S., Yaster, M. 2014

    Abstract

    Dr. Mark C. Rogers (1942-), Professor of Anesthesiology, Critical Care Medicine, and Pediatrics at the Johns Hopkins University, was recruited by the Department of Pediatrics at Johns Hopkins Hospital in 1977 to become the first director of its pediatric intensive care unit. After the dean of the medical school appointed him to chair the Department of Anesthesia in 1979, Rogers changed the course and culture of the department. He renamed it the Department of Anesthesiology and Critical Care Medicine, and developed a long-term strategy of excellence in clinical care, research, and education. However, throughout this period, he never lost his connection to pediatric intensive care. He has made numerous contributions to pediatric critical care medicine through research and his authoritative textbook, Rogers' Textbook of Pediatric Intensive Care. He established a training programme that has produced a plethora of leaders, helped develop the pediatric critical care board examination, and initiated the first World Congress of Pediatric Intensive Care. Based on a series of interviews with Dr. Rogers, this article reviews his influential career and the impact he made on developing pediatric critical care as a specialty.

    View details for DOI 10.1111/pan.12497

    View details for PubMedID 25065470

  • Assessment of the length of myotomy in peroral endoscopic pyloromyotomy (G-POEM) using a submucosal tunnel technique (video). Surgical endoscopy Jung, Y., Lee, J., Gromski, M. A., Kato, M., Rodriguez, S., Chuttani, R., Matthes, K. 2014

    Abstract

    Peroral endoscopic pyloromyotomy is a novel technique that has recently been described in the literature. There is little data to guide the length of myotomy created. The aim of study was to evaluate the proper incision length of the muscular layer during peroral endoscopic pyloromyotomy using a submucosal tunnel technique.The study was designed as a prospective ex vivo study. Fresh ex vivo porcine stomachs from animals weighing 80-100 kg and porcine stomachs from animals weighing 15-25 kg were used for pyloromyotomy. Four different myotomy lengths (1, 2, 3, and 4) were compared in the large animal series and three different myotomy lengths (1, 2, and 3) were compared in the small series. A total of 23 cases of the submucosal tunnel technique were performed by two endoscopists using 12 large stomachs and 11 small stomachs.The mean overall procedure time (±SD) of pyloromyotomy was 65.7 (±14.3) min. In the large stomach series, the mean pyloric diameter (±SD) and change from baseline (as percentage) following a 1, 2, 3, and 4 pyloromyotomy were 13.3 ± 9.5 mm (7.1 %), 20.7 ± 11.7 mm (10.6 %), 31.1 ± 15.0 mm (15.2 %), and 33.0 ± 15.0 mm (16.0 %), respectively. In the small stomach series, the changes of mean pyloric diameter following a 1, 2, and 3 cm pyloromyotomy were 12.2 ± 5.6 mm (7.5 %), 23.1 ± 7.6 mm (13.1 %), and 28.0 ± 10.4 mm (15.5 %), respectively.A 3 cm pyloromyotomy for a large animal series and 2 cm for the small animal series appeared to be most appropriate for enlargement of the pylorus.

    View details for DOI 10.1007/s00464-014-3948-1

    View details for PubMedID 25424365