Alex Butwick

Anesthesiologist

Assistant Professor of Anesthesiology, Perioperative and Pain Medicine at the Stanford University Medical Center
After developing a research interest in obstetric anesthesia during anesthesia residency in the United Kingdom, I completed a clinical research fellowship in obstetric anesthesia at Stanford University School of Medicine in 2005. This training provided a key platform in launching my research career as a clinician investigator in obstetric anesthesia. After completing my fellowship at Stanford, I developed a strong clinical research interest in developing preventive strategies for postpartum hemorrhage. With collaborators within the Divisions of Obstetric Anesthesia and Maternal-Fetal Medicine, I have been principal investigator on a number of clinical studies which have investigated strategies for optimizing anesthetic outcomes for women undergoing cesarean delivery. I have also developed research interests investigating point-of-care devices for assessing the maternal hematologic and hemostatic profiles during the peripartum period.

In 2011, I completed a M.S. in Clinical Epidemiology at Stanford University which has allowed me to advance my career as an outcomes-based researcher in obstetrics. By integrating my background in clinical epidemiology and clinical obstetric anesthesia research, my overarching goal is to develop clinical prediction rules which will assist providers in identifying patients at risk of obstetric morbidity related to postpartum hemorrhage.

I have previously won the Gertie Marx award (best paper by a junior investigator) at the Annual Meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP) and the award for best paper at the Obstetric Anesthetists' Association (OAA) Annual Meeting. I have given the prestigious Gerard W. Ostheimer “What’s New in Obstetrics?” lecture at the 2012 SOAP Conference, and have presented at other national and international obstetric anesthesia meetings. I serve on the associate editorial board of the International Journal of Obstetric Anesthesia, and I am an ad-hoc reviewer for over 8 anesthesia and obstetric journals. I am currently a recipient of federal funding (K23) from the National Institute of Health.

Anesthesia Preoperative Evaluation Clinic

  • 300 Pasteur Drive
  • Stanford, CA 94305
  • Phone: 650-723-6412
Learn More About the Clinic Getting Here Make An Appointment

Professional Education

Fellowship: Stanford University School of Medicine (2006) CA

Residency: South Thames West - St George's Chool of Anaesthesia (2004) UK

Residency: The Royal Sussex County Hospital (1999) United Kingdom

Internship: Hemel Hempstead Hospital (1997) UK

Medical Education: St George's Hospital Medical School (1997) England

M.S., Department of Health Research and Policy, Stanford University, Epidemiology (2011)

FRCA, Fellow of the Royal College of Anaesthetists, UK, Anesthesiology (2003)

Residency: Eastbourne District General Hospital (2001) United Kingdom

Internship: Worthing District General Hospital (1999) UK

Internship: The Royal Surrey County Hospital (1998) United Kingdom

Honors & Awards

Mentored Patient-Oriented Research Career Development Award (K23), NICHD, NIH (2013)

Gerard W. Ostheimer Lecture: 'What's New in Obstetrics -2011?', Annual Meeting of the Society of Obstetric Anesthesia and Perinatology (2012)

Outstanding Interdepartmental Faculty Professor, Department of Obstetrics and Gynecology, Stanford University School of Medicine (2011)

Gertie Marx Award (1st prize), Society of Obstetric Anesthesia and Perinatology (SOAP) (2006)

Clinical Trials

Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you have access to the latest, advanced clinical trials.

Open trials refer to studies currently accepting participants. Closed trials are not currently enrolling, but may open in the future.

Anticoagulant prescribing practices and anesthetic interventions among anticoagulated pregnant patients: a retrospective study.
Butwick, A., Hass, C., Wong, J., Lyell, D., & El-Sayed, Y. (2014). Anticoagulant prescribing practices and anesthetic interventions among anticoagulated pregnant patients: a retrospective study. International journal of obstetric anesthesia, 23(3), 238-245.

Perioperative and transfusion outcomes in women undergoing cesarean hysterectomy for abnormal placentation
Brookfield, K. F., Goodnough, L. T., Lyell, D. J., & Butwick, A. J. (2014). Perioperative and transfusion outcomes in women undergoing cesarean hysterectomy for abnormal placentation. TRANSFUSION, 54(6), 1530-1536.

Preferred spoken language mediates differences in neuraxial labor analgesia utilization among racial and ethnic groups
Caballero, J. A., Butwick, A. J., Carvalho, B., & Riley, E. T. (2014). Preferred spoken language mediates differences in neuraxial labor analgesia utilization among racial and ethnic groups. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 23(2), 161-167.

Risk factors for obstetric morbidity in patients with uterine atony undergoing Caesarean delivery†
Butwick, A. J., Carvalho, B., & El-Sayed, Y. Y. (2014). Risk factors for obstetric morbidity in patients with uterine atony undergoing Caesarean delivery†. British journal of anaesthesia.

Medical advances in the treatment of postpartum hemorrhage.
Ducloy-Bouthors, A. S., Susen, S., Wong, C. A., Butwick, A., Vallet, B., & Lockhart, E. (2014). Medical advances in the treatment of postpartum hemorrhage. Anesthesia and analgesia, 119(5), 1140-7.

Patterns of Second-Line Uterotonic Use in a Large Sample of Hospitalizations for Childbirth in the United States: 2007-2011.
Bateman, B. T., Tsen, L. C., Liu, J., Butwick, A. J., & Huybrechts, K. F. (2014). Patterns of Second-Line Uterotonic Use in a Large Sample of Hospitalizations for Childbirth in the United States: 2007-2011. Anesthesia and analgesia.

Preventing spinal hypotension during Caesarean delivery: what is the latest?
Butwick, A. J., Columb, M. O., & Carvalho, B. (2014). Preventing spinal hypotension during Caesarean delivery: what is the latest?. British journal of anaesthesia.

Platelet Counts and Coagulation Tests Prior to Neuraxial Anesthesia in Patients With Preeclampsia A Retrospective Analysis
Sultan, P., & Butwick, A. (2013). Platelet Counts and Coagulation Tests Prior to Neuraxial Anesthesia in Patients With Preeclampsia A Retrospective Analysis. CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS, 19(5), 529-534.

Anesthetic management of a parturient with VACTERL association undergoing Cesarean delivery.
Hilton, G., Mihm, F., & Butwick, A. (2013). Anesthetic management of a parturient with VACTERL association undergoing Cesarean delivery. Canadian journal of anaesthesia = Journal canadien d'anesthésie, 60(6), 570-576.

Methodological queries about point-of-care haemoglobin data
Butwick, A. (2013). Methodological queries about point-of-care haemoglobin data. ANAESTHESIA, 68(5), 540-541.

Postpartum hemorrhage and low fibrinogen levels: the past, present and future.
Butwick, A. J. (2013). Postpartum hemorrhage and low fibrinogen levels: the past, present and future. International journal of obstetric anesthesia, 22(2), 87-91.

What's New in Obstetric Anesthesia in 2011? Reducing Maternal Adverse Outcomes and Improving Obstetric Anesthesia Quality of Care
Butwick, A. (2012). What's New in Obstetric Anesthesia in 2011? Reducing Maternal Adverse Outcomes and Improving Obstetric Anesthesia Quality of Care. ANESTHESIA AND ANALGESIA, 115(5), 1137-1145.

2012 Gerard W. Ostheimer Lecture - What's new in obstetric anesthesia?
Butwick, A. J. (2012). 2012 Gerard W. Ostheimer Lecture - What's new in obstetric anesthesia?. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 21(4), 348-356.

Postpartum hemorrhage treated with a massive transfusion protocol at a tertiary obstetric center: a retrospective study
Gutierrez, M. C., GOODNOUGH, L. T., Druzin, M., & Butwick, A. J. (2012). Postpartum hemorrhage treated with a massive transfusion protocol at a tertiary obstetric center: a retrospective study. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 21(3), 230-235.

Continuous spinal anesthesia for Cesarean hysterectomy and massive hemorrhage in a parturient with placenta increta
Sultan, P., Hilton, G., Butwick, A., & Carvalho, B. (2012). Continuous spinal anesthesia for Cesarean hysterectomy and massive hemorrhage in a parturient with placenta increta. CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 59(5), 473-477.

Managing Patients with Abnormal Placentation: What Are the Best Anesthetic and Transfusion Strategies?
Butwick, A. J. (2012). Managing Patients with Abnormal Placentation: What Are the Best Anesthetic and Transfusion Strategies?. ANESTHESIOLOGY, 116(5), 1156-1157.

Non-invasive haemoglobin measurement in patients undergoing elective Caesarean section
Butwick, A., Hilton, G., & Carvalho, B. (2012). Non-invasive haemoglobin measurement in patients undergoing elective Caesarean section. BRITISH JOURNAL OF ANAESTHESIA, 108(2), 271-277.

How we treat: transfusion medicine support of obstetric services
Goodnough, L. T., Daniels, K., Wong, A. E., Viele, M., Fontaine, M. F., & Butwick, A. J. (2011). How we treat: transfusion medicine support of obstetric services. TRANSFUSION, 51(12), 2540-2548.

Epidural Catheter Removal in Patients on Warfarin Thromboprophylaxis A More Cautious Interpretation of Results Required?
Carvalho, B., Mariano, E. R., & Butwick, A. J. (2011). Epidural Catheter Removal in Patients on Warfarin Thromboprophylaxis A More Cautious Interpretation of Results Required?. REGIONAL ANESTHESIA AND PAIN MEDICINE, 36(6), 632-632.

An In Vitro Investigation of the Coagulation Effects of Exogenous Oxytocin Using Thromboelastography in Healthy Parturients
Butwick, A., & Harter, S. (2011). An In Vitro Investigation of the Coagulation Effects of Exogenous Oxytocin Using Thromboelastography in Healthy Parturients. ANESTHESIA AND ANALGESIA, 113(2), 323-326.

The Proseal laryngeal mask airway and elective caesarean section
Dyer, R. A., James, M. F., Butwick, A. J., & Carvalho, B. (2011). The Proseal laryngeal mask airway and elective caesarean section. ANAESTHESIA AND INTENSIVE CARE, 39(4), 760-761.

Non-invasive measurement of hemoglobin during cesarean hysterectomy: a case series
Butwick, A. J., Hilton, G., Riley, E. T., & Carvalho, B. (2011). Non-invasive measurement of hemoglobin during cesarean hysterectomy: a case series. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 20(3), 240-245.

Oxytocin for labour and caesarean delivery: implications for the anaesthesiologist
Dyer, R. A., Butwick, A. J., & Carvalho, B. (2011). Oxytocin for labour and caesarean delivery: implications for the anaesthesiologist. CURRENT OPINION IN ANESTHESIOLOGY, 24(3), 255-261.

The effectiveness of preemptive sphenopalatine ganglion block on postoperative pain and functional outcomes after functional endoscopic sinus surgery
Cho, D.-Y., Drover, D. R., Nekhendzy, V., Butwick, A. J., Collins, J., & Hwang, P. H. (2011). The effectiveness of preemptive sphenopalatine ganglion block on postoperative pain and functional outcomes after functional endoscopic sinus surgery. INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY, 1(3), 212-218.

The Association Between Thromboelastographic Parameters and Total Estimated Blood Loss in Patients Undergoing Elective Cesarean Delivery
Butwick, A., Ting, V., Ralls, L. A., Harter, S., & Riley, E. (2011). The Association Between Thromboelastographic Parameters and Total Estimated Blood Loss in Patients Undergoing Elective Cesarean Delivery. ANESTHESIA AND ANALGESIA, 112(5), 1041-1047.

The postoperative anaesthetic review.
Sultan, P., Jigajinni, S., McGlennan, A., & Butwick, A. (2011). The postoperative anaesthetic review. Journal of perioperative practice, 21(4), 135-139.

Anticoagulant and antithrombotic drugs in pregnancy: what are the anesthetic implications for labor and cesarean delivery?
Butwick, A. J., & Carvalho, B. (2011). Anticoagulant and antithrombotic drugs in pregnancy: what are the anesthetic implications for labor and cesarean delivery?. JOURNAL OF PERINATOLOGY, 31(2), 73-84.

Retrospective analysis of anesthetic interventions for obese patients undergoing elective cesarean delivery
Butwick, A., Carvalho, B., Danial, C., & Riley, E. (2010). Retrospective analysis of anesthetic interventions for obese patients undergoing elective cesarean delivery. JOURNAL OF CLINICAL ANESTHESIA, 22(7), 519-526.

ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial
Butwick, A., & Dyer, R. (2010). ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial. BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 117(9), 1165-1165.

Neuraxial anesthesia in obstetric patients receiving anticoagulant and antithrombotic drugs
Butwick, A. J., & Carvalho, B. (2010). Neuraxial anesthesia in obstetric patients receiving anticoagulant and antithrombotic drugs. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 19(2), 193-201.

Minimum effective bolus dose of oxytocin during elective Caesarean delivery
Butwick, A. J., Coleman, L., Cohen, S. E., Riley, E. T., & Carvalho, B. (2010). Minimum effective bolus dose of oxytocin during elective Caesarean delivery. BRITISH JOURNAL OF ANAESTHESIA, 104(3), 338-343.

Retrospective analysis of transfusion outcomes in pregnant patients at a tertiary obstetric center
Butwick, A. J., Aleshi, P., Fontaine, M., Riley, E. T., & GOODNOUGH, L. T. (2009). Retrospective analysis of transfusion outcomes in pregnant patients at a tertiary obstetric center. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 18(4), 302-308.

Obstetric hemorrhage during an exit procedure for severe fetal airway obstruction
Butwick, A., Aleshi, P., & Yamout, I. (2009). Obstetric hemorrhage during an exit procedure for severe fetal airway obstruction. CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 56(6), 437-442.

A survey of perioperative and postoperative anesthetic practices for cesarean delivery.
Aiono-Le Tagaloa, L., Butwick, A. J., & Carvalho, B. (2009). A survey of perioperative and postoperative anesthetic practices for cesarean delivery. Anesthesiology research and practice, 2009, 510642-?.

Vaginal twin delivery: a survey and review of location, anesthesia coverage and interventions
Carvalho, B., Saxena, A., Butwick, A., & Macario, A. (2008). Vaginal twin delivery: a survey and review of location, anesthesia coverage and interventions. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 17(3), 212-216.

Intraoperative forced air-warming during cesarean delivery under spinal anesthesia does not prevent maternal hypothermia
Butwick, A. J., Lipman, S. S., & Carvalho, B. (2007). Intraoperative forced air-warming during cesarean delivery under spinal anesthesia does not prevent maternal hypothermia. ANESTHESIA AND ANALGESIA, 105(5), 1413-1419.

Can we improve maternal outcome for high-risk obstetric patients?
Carvalho, B. (2007). Can we improve maternal outcome for high-risk obstetric patients?. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 16(4), 311-313.

Successful spinal blockade in a parturient with myotonia congenita
Butwick, A. J. (2007). Successful spinal blockade in a parturient with myotonia congenita. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 16(3), 292-293.

Neuraxial anesthesia for cesarean delivery in a parturient with type 1 von Willebrand disease and scoliosis
Butwick, A. J., & Carvalho, B. (2007). Neuraxial anesthesia for cesarean delivery in a parturient with type 1 von Willebrand disease and scoliosis. JOURNAL OF CLINICAL ANESTHESIA, 19(3), 230-233.

The effect of colloid and crystalloid preloading on thromboelastography prior to Cesarean delivery
Butwick, A., & Carvalho, B. (2007). The effect of colloid and crystalloid preloading on thromboelastography prior to Cesarean delivery. CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 54(3), 190-195.

Remifentanil patient-controlled analgesia in labor
Butwick, A., & Carvalho, B. (2006). Remifentanil patient-controlled analgesia in labor. ANESTHESIA AND ANALGESIA, 102(1), 333-333.

Recombinant factor VIIa for life-threatening post-partum haemorrhage
Butwick, A. J., & Riley, E. T. (2005). Recombinant factor VIIa for life-threatening post-partum haemorrhage. BRITISH JOURNAL OF ANAESTHESIA, 95(4), 558-558.

Maternal and neonatal side-effects of remifentanil patient-controlled analgesia in labour
Volikas, I., Butwick, A., Wilkinson, C., Pleming, A., & Nicholson, G. (2005). Maternal and neonatal side-effects of remifentanil patient-controlled analgesia in labour. BRITISH JOURNAL OF ANAESTHESIA, 95(4), 504-509.

Management of pregnancy in a patient with beta thalassaemia major
Butwick, A., Findley, I., & Wonke, B. (2005). Management of pregnancy in a patient with beta thalassaemia major. INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 14(4), 351-354.

Ventilator-assisted nasotracheal intubation
Butwick, A., & Garewal, D. (2004). Ventilator-assisted nasotracheal intubation. ANAESTHESIA, 59(2), 197-197.

A pilot study of the effect of the Queen's Square external bladder stimulator on urinary retention after knee replacement surgery
Butwick, A., Carter, P., & Dolin, S. J. (2003). A pilot study of the effect of the Queen's Square external bladder stimulator on urinary retention after knee replacement surgery. ANAESTHESIA, 58(6), 587-591.