Nalini Vadivelu, MBBS, DNB

Professor of Anesthesiology

Research Departments & Organizations

Anesthesiology

Faculty Research

Office of Cooperative Research

Research Interests

Health Care

Research Summary

My scholarly contributions and research have been in pain with an emphasis on ambulatory pain control.My clinical investigation and clinical observations in pain control at the ambulatory surgery center has helped guide my educational activities in the field of ambulatory pain and, have helped in advancing the reputation of our department as a center of clinical research and scholarly excellence. My clinical investigations have been conducted in the Ambulatory Surgery Center of Yale New Haven Hospital with scholarship related to this clinical research most often published with house staff,

Extensive Research Description

My research in ambulatory pain control can be divided into several subtopics as detailed below

1) Perioperative pain management in ambulatory surgery

My interest in the area of perioperative pain management in ambulatory surgery has led to clinical investigations, extensive literature searches and scholarship in this area. My pain research studies and scholarly contributions in the control of perioperative pain at the ambulatory surgery center aims at increasing awareness and improving pain control in ambulatory care centers worldwide. These works include:

. 2) Alternative therapies for perioperative treatment of pain in the ambulatory setting. Managing pain control in the presence of alternative therapies is a challenge and research in this area at the ambulatory surgery center in which I participate is ongoing

3) Analgesics for pain control in ambulatory surgery I have a long-term interest in the analgesics taken by patients for the control of pain who then present for ambulatory surgery. My scholarly writings and research efforts have been directed at increasing awareness of the use of these drugs, and suggesting ideal ways to manage pain in these patients safely within the ambulatory setting.

4) Regional blocks and Interventional pain management in ambulatory surgery

Regional blocks are one of the multimodal treatments used to control pain in the ambulatory setting. Patients with chronic pain presenting for ambulatory surgery sometimes have implanted pain control devices and perioperative management of these patients are a great challenge. My research studies and scholarship in these areas has always focused on safety first.

. 5) Research and Scholarship on perioperative pain control education for ambulatory surgery.

I have been involved in evaluating research surveys of patients undergoing ambulatory surgery at Yale, which found that physicians who are not trained in pain management treated 90 percent of patients for their painful conditions. This highlighted the need to educate all physicians and health care professionals in the field of pain management. The primary care provider helps to best achieve optimum pain management of pain patients in the ambulatory surgery center through preoperative preparation of these patients and postoperative care. This collaboration is best achieved by starting pain education early in one’s career, as in at the medical school level. Seeing this has led me to produce scholarly works in order to educate health care professionals so they can provide optimum pain management worldwide with special emphasis on pain management at the ambulatory surgery center.

6)Perioperative management of the opioid dependent, drug tolerant, drug dependent and substance abuse patient in ambulatory surgery

With the rapidly increasing numbers of patients with opioid dependence, substance abuse and addiction presenting for ambulatory surgery, I have an ongoing interest on how to improve the care of these patients in the ambulatory surgery center. As a result of clinical observations, intense literature searches and studies on the pain management of patients with drug tolerance, drug dependence and addiction, at the ambulatory surgery center, I and physicians from several national universities and international universities have researched and written several manuscripts on the topic and have also been an edited a textbook on the management of patients with Substance Abuse in the Outpatient Setting .

7) Pain management for specific surgeries performed in ambulatory surgery centers

I have focused my clinical research studies and scholarly works on pain control for specific surgeries in collaboration with several physicians who commonly performed these procedures in the ambulatory surgery center. My collaborative research efforts at the Yale Ambulatory Surgery Center have been performed in conjunction with Yale physicians in the Departments of Surgery Podiatry , Gynecology, Ophthalmology and Plastic Surgery.

8) Research in Caring for the palliative care patients in ambulatory surgery

. To further understand the problem of pain control in palliative care patients undergoing surgery in the ambulatory setting, as well to increase awareness of the challenge of caring for these patients.I have conducted research in collaboration with other physicians on the pain management of terminally ill patients and palliative care patients having surgery,

Selected Publications

  • Vadivelu N, Ramakrishnan S: HDl2/HdI3 Cholesterol and HDL/Total Cholesterol ratios in liver diseases. Indian Journal of Medical, Research 1986; 83:46-52.
  • Vadivelu N, Seshadri MS, Kanakasabapathy AS: Dextran coated charcoal is not suitable for suitable for phase separation of free TSH from receptor bound TSH in TSH binding inhibitory immunoglobulin assays. Indian Journal of Clinical Biochemistry 1988; 3:27-31.
  • Vadivelu N, Stephen DC, Kanakasabapathy AS, Seshadri MS: Thyroid stimulating hormone receptor antibody in thyroid diseases. Indian Journal of Medical Research 1990; 92:220-223.
  • Berger JM Angele R, Vadivelu N, Rever L, Harrison P: Ketamine-Fentanyl- Midazolam infusion for the control of symptoms in terminal life care. American J of Hospice & Palliative Care 2000; 17:2.
  • Vadivelu N, Harkness P, Richman S, Shelley KH: Special anesthetic concerns in mentally challenged patients undergoing gynecological procedures in an outpatient setting. Connecticut Medicine 2004; 68:359-362.
  • Young CF, Vadivelu N. Does the use of a laryngoscope facilitate orotracheal intubation with a Shikani Optical Stylet? Br J Anaesth. 2007; 99(2):302-3.
  • Young CF, Vadivelu N. Can the Shikani Optical Stylet facilitate intubation in simulated difficult direct laryngoscopy? Connecticut Medicine. 2007; 71(7):407-8.
  • Vadivelu N, Schreck M, Lopez J, Kodumudi G, Narayan D. Pain after mastectomy and breast reconstruction. The American Surgeon. 2008; 74(4):275-284.
  • Vadivelu N, Whitney C, Kodumudi G, Gudin M. Post dural puncture headache and hypertension. Current Hypertension Reviews 2008; 4(1):73-77.
  • Vadivelu N, Hines, R. Management of chronic pain in the elderly: Focus on transdermal buprenorphine Clinical interventions in aging. Clin Interv Aging. 2008; 3(3):421-30.
  • Souzdalnitski D, Bolinske T, Vadivelu N. Pain Quality Assessment Scale: Practical Implications of Factor Analysis. Clin J Pain 2009; 25(5):453.
  • Souzdalnitski D, Vadivelu N, Chung KS. Low-dose Ketamine as an adjunct to routine pain practice: Are we ready yet. Pain Pract 2009; 9(5):405-6.
  • Dabu-Bondoc S, Vadivelu N, Benson J, Perret D, Kain ZN. Hemispheric synchronized sounds and perioperative analgesic requirements. Anesth Analg 2010; 110(1):208-10.
  • Vadivelu N, Gesquire M, Mitra S, Shelley K, Kodumudi G, Xia Y, Blume P. Safety of local anesthesia combined with monitored intravenous sedation for American Society of Anesthesiologists 3 and 4 patients undergoing lower limb-preservation procedures. J Foot Ankle Surg 2010; 49(2):152-154.
  • Dabu-Bondoc S, Vadivelu N, Shimono C, English A, Kosarussavadi B, Dai F, Shelley K, Feinlieb J. Intravenous dextrose administration reduces postoperative antiemetic rescue treatment requirements and postanesthesia care unit length of stay. Anesth and Analg 2013; 117(3), 591-596.
  • Kurup V, Dabu-Bondoc S, Senior A, Dai F, Hersey D, Vadivelu N. Concern for pain in the preoperative period. Is the internet being used for information by patients? J Pain Practice, 2014; 14(2):E69-E75.
  • Wood SG, Dabu-Bondoc S, Dai F, Mikhael H, Vadivelu N, Roberts KE. Comparison of immediate postoperative pain after transvaginal versus traditional laparoscopic cholecystectomy. Surg Endosc and Other Interventional Techniques 2014; 28(4):1141-1145.
  • .Saraswathy R, Anand S, Kunnumpurath SK, Kurian RJ, Kaye AD, Vadivelu N. Chromosomal aberrations and Exon 1 Mutation in the AKR1B1 gene in patients with diabetic neuropathy. Ochsner J 2014;14(3):339-342.
  • Wood SG, Dai F, Dabu-Bondoc S, Mikhael H, Vadivelu N, Duffy A, Roberts KS. Transvaginal cholecycstectomy learning curve. Surg Endosc. 2015 Jul;29(7):1837-41. doi: 10.1007/s00464-014-3873-3. Epub 2014.
  • Vadivelu N, Sinatra RS: Recent Advances in Elucidating Pain Mechanisms. Current Opinions in Anesthesiology, October 2005; 18(5):540-547.
  • Vadivelu N, Bustos A, Sinatra, RS Pain Management for Orthopedic Procedures. Business Briefing: US Orthopedics Review, January 2006; 57-59.
  • Vadivelu N, Hines RS. Buprenorphine: A unique opioid with broad clinical applications. Journal of Opioid Management 2007; 3(1):49-58.
  • Fields AM, Vadivelu N. Sugammadex: A novel neuromuscular blocker binding agent. Curr Opin Anaesthesiol. 2007; 20(4):307-10.
  • Kunnumpurath S, Srinivasagopalan R, Vadivelu N. Spinal cord stimulation: Principles of past, present and future practice: A review. J Clin Monit Comput 2009; 23(5):333-9.
  • Vadivelu N, Mitra S, Narayan, N. Recent advances in postoperative pain management. Yale Journal of Biology and Medicine. Yale J Biol Med 2010; 83(1):11-25.
  • Vadivelu N, Chen IL, Kodumudi V, Ortigosa E, Gudin MT. The implications of urine drug testing in pain management. Curr Drug Saf. 2010; 5(3):267-270.
  • Vadivelu N. Anwar M Buprenorphine in postoperative pain management. Anesthesiol Clin 2010; 28(4):601-609.
  • Vadivelu N, Mitra S, Hines RL. Peripheral opioid receptor agonists for analgesia: A comprehensive review. J Opioid Manag 2011; 7(1):55-68.
  • Vadivelu N, Sinatra RS. Tapentadol extended-release for the treatment of chronic pain: A review. J Pain Res. 2011; 4:211-218.
  • Khandelwal MS, Roberts K, Kumar S, Vadivelu N. Pain relief in laparoscopic cholecystectomy – a review of the current options. Pain Pract 2012; 12(6):485-496.
  • Vadivelu N, Mitra S, Hines R, Elia M , Rosequist R. Acute pain in undergraduate medical education: An unfinished chapter! Pain Practice 2012; 12(8):663.
  • Vadivelu N, Huang Y, Kaye AD, Kodumudi V, Kai A, Adelman RA. Prevention and management of complications of regional orbital anesthesia. MEJ Anesth 2012; 21(6):775-784.
  • Kaye AD, Mayo ME, Vadivelu N, Kodumudi G, Kaye RJ, Baluch AR. Postoperative Apnea, Respiratory Strategies, and Pathogenesis Mechanisms: A Review. J Anesth 2013 Jun; 27(3):423-32.
  • Urman RD, Ahuja N, Mitra SM, Silasi D, Kaye A, Vadivelu, N. Anesthetic considerations in robotic-assisted gynecological surgery: A Review. Oschner J 2013; 13(4):517-524
  • 37) Vadivelu N, Huang Y, Mirante B, Jacoby M, Braveman F, Hines RL, Sinatra R. Patient considerations in the use of Tapentadol for moderate to severe pain. Drug, Healthcare and Patient Safety. 2013 Jul 3; 5:151-9.
  • Vadivelu N, Maria M, Jolly S, Rosenbloom J, Prasath A, Kaye AD. Clinical application of oxymorphone. J Opioid Manag 2013; 9(6):439-52. doi: 10.5055/jom.2013.0186
  • Vadivelu N, Singh-Gill H, Kodumudi G, Kaye AJ, Urman RD, Kaye AD. Practical guide to the management of acute and chronic pain in the presence of drug tolerance for the healthcare practitioner. Oschner J 2014; 14(3):426-433. Review.
  • Manjiani D, Paul DB, Kunnumpurath S, Kaye AD, Vadivelu, N. Availability and utilization of opioids for pain management: Global issues. Oschner Journal 2014 Summer; 14(2):208-215.
  • Kaye AD, Patel N, Bueno FR, Hymel, Vadivelu N, Kodumudi G, Urman RD. Effect of opiates, anesthetic techniques, and other perioperative factors on surgical cancer patients,Ochsner Journal 2014 Summer; 14(2):216-228.
  • Vadivelu N, Mitra S, Kaye AD, Urman RD. Perioperative analgesia and challenges in the drug addicted and drug dependent patient. Bailliere’s Best Practice & Research Clinical Anaesthesiology 2014; 28(1); 91-102.
  • Vadivelu N, Mitra S, Schermer E, Kodumudi V, Kaye AD, Urman RD. Preventive analgesia for postoperative pain control: a broader concept. Local and Regional Anesthesia 2014; 29(7):17-22.
  • Gritsenka K, Khelemsky Y, Kay A, Vadivelu N, Urman R. Multimodal therapy in perioperative analgesia. Best Pract Res Clin Anaesthesiol 2014 Mar; 28(1):59-79.
  • Vadivelu N, Gowda AM, Urman RD, Jolly S, Kodumudi V, Monisa M, Taylor R, Jr, Pergolizzi JV. Ketorolac Tromethamine – Routes and clinical implications. Pain Pract. 2015 Feb;15(2):175-93.
  • Czernicki M, Sinovich G, Mihaylov I, Nejad B, Kunnumpurath S, Kodumudi G, Vadivelu N. Intrathecal drug delivery for chronic pain management—scope, limitation and future. J Clin Monit Comput, Apr 2015
  • Vadivelu N, Kai MA, Maslin B, Kodumudi V, Antony S, Blume P. Role of regional anesthesia in foot and ankle surgery. Foot and Ankle Specialist. Foot Ankle Spec. 2015 Jun;8(3):212-219.
  • Vadivelu N, Kai A, Maslin B, Kodumudi G, Legler A, Berger JM. Tapentadol extended release in the management of peripheral diabetic neuropathic pain. Therapeutics and Clinical Risk Management. Ther Clin Risk Manag. 2015 Jan 14;11:95-105.
  • Hingula L, Maslin B, Rao S, Wood S, Roberts K, Kodumudi G, Schermer E, Vadivelu N. Perioperative pain control in gastroenterintestinal surgery. Middle East J Anaesthesiol. 2015 Jun;23(2):137-4 Epub 2015 Feb 5. Review
  • Thomas DA, Maslin B, Legler A, Springer E, Asgerally A, Vadivelu N. Role of Alternative Therapies for Chronic Pain Syndromes. Curr Pain Headache Rep. 2016 May;20(5):29
  • Maslin B, Springer E, Zhu R, Kodumudi V, Vadivelu N. Perioperative Safety of Warfarin Therapy and Reversal. Curr Drug Saf. 2015 Dec 17.
  • Vadivelu N, Lumermann L, Zhu R, Kodumudi G, Elhassan AO, Kaye AD. Pain Control in the Presence of Drug Addiction. Curr Pain Headache Rep. 2016 May;20(5):35
  • Maniam R, Kaye AD, Vadivelu N, Urman RD. Facial Pain Update: Advances in Neurostimulation for the Treatment of Facial Pain. Curr Pain Headache Rep. 2016 Mar;20(4):24.
  • Vadivelu N, Kai AM, Tran D, Kodumudi G, Legler A, Ayrian E. Options for perioperative pain management in neurosurgery.J Pain Res. 2016 Feb 10;9:37-47
  • Effects of Anesthetic Management on Early Postoperative Recovery, Hemodynamics and Pain After Supratentorial Craniotomy.Ayrian E, Kaye AD, Varner CL, Guerra C, Vadivelu N, Urman RD, Zelman V, Lumb PD, Rosa G, Bilotta F.J Clin Med Res. 2015 Oct;7(10):731-41.
  • Vadivelu N, Lumermann L, Zhu R, Kodumudi G, Elhassan AO, Kaye AD. Pain Control in the Presence of Drug Addiction. Curr Pain Headache Rep. 2016 May;20(5):35
  • Thomas DA, West M, Legler A, Maslin B, Kim RK, Vadivelu N. Efficacy and Safety of Nonopioid Analgesics in Perioperative Pain Control. Curr Drug Saf. 2016 Apr 26.
  • Berger JM, Vadivelu N. Ethics Case: Common misconceptions about opioid use for pain management at the end of life. Virtual Mentor 2013; 15(5):403-409.
  • Vadivelu N, Mitra S, Hines RL. Undergraduate medical education on pain managementacross the globe. Virtual Mentor 2013; May 1; 15(5):421-427.
  • Berger JM, Vadivelu N. Common misconceptions about opioid use for pain management at the end of life. Virtual Mentor 2013 May 1; 15(5):403-9.
  • Vadivelu N, Berger JM: Neuropathic Pain after anti HIV gene therapy successfully treated with Gabapentin. J of Pain and Symptom Management 1999; 17:3-155.
  • Vadivelu N and Tundis D: Chronic testicular pain in a patient with diverticulitis. Journal of Pain and Symptom Management 2003; 25(6):404.
  • Chung KS, Carson S, Glassman D, Vadivelu N: Successful treatment of Hydromorphone induced Neurotoxicity and Hyperalgesia. Connecticut Medicine 2004; 68:247-249.
  • Vadivelu N, Yusufali T, Braveman F: Successful Cesarean Section performed with inadvertent subdural anesthesia. Connecticut Medicine 2005; 69:71-72.
  • Vadivelu N, Mikhaeil H, Gordon M, Vindhya M, Holt N. Prolonged post dural puncture headache in a patient status post renal transplant. Connecticut Medicine 2006 Jan; 70(1):13
  • Vadivelu N, Freiberg C, Sinatra RS Epidural blood patch in patient on high dose Enoxaparin. Anesthesia and Analgesia September 2006; 103(3):88-9.
  • Vadivelu N, Kombo N, Hines RL. Do We Need to Incorporate Multidisciplinary Pain Management Education in the Medical School Curriculum? Academic Medicine 2009; 84(4): 408.
  • .Mikhaeil H, Vadivelu N, Braveman F. Safety of spinal anesthesia in a patient with achondroplasia for cesarean section. Curr Drug Saf 2011; 6(2):130-1.
  • Kaye AD, Alian A, Vadivelu N, Chung KS. Perioperative dilemma: Challenges of the management of a patient on mega doses of morphine and methadone. J Opioid Manag 2014; 9(6):439-52.
  • Kaye AD, Chung KS, Vadivelu N, Cantemir C, Urman RD, Manchikanl L. Opioid induced hyperalgesia altered with propofol infusion. Pain Physician 2014; 17(2):E225-E228.
  • Vadivelu N, Complications and Risk Management in: Obstetrics and Gynecologic Anesthesia. In: Braveman, FR: (Editor) Obstretical and Gynecologic Anesthesia:(Requisites in Anesthesiology). Elsevier Science, NY, NY, 2006, 118-125
  • Vadivelu N, Cancer In: Hines RL, Marschall KE (eds) Anesthesia and Co-ExistingDisease, 5th Edition, 2007, 501-520
  • Vadivelu N, Whitney C, Acute Pain Management in: Urman RD and Ehrenfield J. (eds) Pocket Anesthesia. Lippincott Williams & Wilkins, Philadelphia, PA, 2009,12-1 to 12-6.
  • Vadivelu N, Whitney C, Chronic Pain Management in: Urman RD and Ehrenfield J. (eds) Pocket Anesthesia, Lippincott Williams & Wilkins, Philadelphia, PA, 2009, 29-1 to 29-7
  • Vadivelu N, Whitney C, Sinatra RS. Pain Pathways and Acute Pain Processing in: Sinatra, R, DeLeon-Cassasola O, Viscusi E, Ginsberg B and McQuay H (eds) Acute Pain Management. Cambridge University Press, New York, NY, 2009, 3-20.
  • Dabu-Bondoc S, Zhang R, Vadivelu N. Managing Pain in the Addicted Patient in: Essentials in Pain Management, Springer Science and Business Media, New York, NY, 2011, 671-697..
  • Vadivelu N, Urman RD. Fibromyalgia, Arthritic and Myofascial Pain: Vadivelu N, Hines RL, Urman RD (eds) Essentials in Pain Management, Springer Science and Business Media, New York, NY, 2011, 557-556.
  • Vadivelu N. Buprenorphine, Intravenous, Neuraxial and Transdermal Applications in: Sinatra RS, Jahr, JS and Watkins-Pitchford JM (eds) The Essence of Analgesia and Analgesics, Cambridge University Press, Cambridge, UK, 2011, 157-160
  • Vadivelu N, Whitney C. Acute and Postoperative Pain Management In: Vadivelu N, Urman R, (eds) Pocket Pain, Lippincott, Williams and Wilkins, Philadelphia, PA, 2011, Chapter 19, pp. 1 – 9..
  • Mitra S, Vadivelu N. Pain Anatomy and Physiology In: Vadivelu N, Urman R, (eds) Pocket Pain, Lippincott, Williams and Wilkins, Philadelphia, PA, 2011, Chapter 2, pp. 1 – 5.65.
  • Mitra S, Vadivelu N. Mechanisms of Acute and Chronic Pain In: Vadivelu N, Urman R, (eds) Pocket Pain, Lippincott, Williams and Wilkins, Philadelphia, PA, 2011, Chapter 3, pp. 1 – 5
  • Kunnupurath S, Vadivelu N. Neuraxial Blockade: Epidural Anesthesia In: Kaye A, Vadivelu N, Urman R (eds) Essentials in Regional Anesthesia. Springer Press, New York, NY, 2012, 293-338.
  • Mitra S, Vadivelu N. Multidisciplinary Approach and Coordination of Care In: Vadivelu N, Berger JM, Kaye AD (eds) Essentials of Palliative Care. Springer Press,New York, NY, 2013, 7-21.
  • Mitra S, Vadivelu N. Guidance with Complex Treatment Choices In: Vadivelu N, Berger JM, Kaye AD (eds) Essentials of Palliative Care. Springer Press, New York,NY, 2013, 89-105
  • Mitra S, Ahuja V,Vadivelu N. Mechanisms of Pain In: Urman R, Vadivelu N (eds)Perioperative Pain Management. Oxford University Press, New York, NY, 2013, pp 11-19.
  • Kahn E, Vadivelu N. Cocaine abuse In: Kaye AD, Vadivelu N, Urman R (eds) Substance Abuse: Inpatient and Outpatient Management for Every Clinician, SpringerPress, New York, NY, 2014, pp 143-154.48.
  • Vadivelu N, Gowda AM, Thorp S, Kai A, Vadivelu A, Dabu-bondoc S. Nociceptive Chemical Mediators in Oral Inflammation In: Vadivelu N, Kaye AD (eds) Orofacial pain – A Clinician’s Manual, Springer International Press, Switzerland, 2014
  • Vadivelu N, Huang Y, Vadivelu A, Dabu-Bondoc S. The Neurobiology of OrofacialPain In: Vadivelu N, Kai A, Vadivelu A (eds) Orofacial Pain – A Clinician’s Manual, Springer Press, New York, NY, 2014
  • Basu D, Mitra S, Vadivelu N. Tobacco In: Kaye AD, Vadivelu N, Urman R (eds) Substance Abuse: Inpatient and Outpatient Management for Every Clinician, SpringerPress, New York, NY, 2014, pp 89-108.
  • Gevirtz C, Kaye AD, Vadivelu N. Post-operative Pain Control in Drug Abusing patients In: Kaye AD, Vadivelu N, Urman R (eds) Substance Abuse: Inpatient and Outpatient Management for Every Clinician, Springer Press, New York, NY, 2014,pp 379-388.

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Contact Info

Nalini Vadivelu, MBBS, DNB
Mailing Address
PO Box 208051
333 Cedar Street, TMP 3

New Haven, CT 06520-8051