Zuckerberg San Francisco General Hospital

Our mission is excellence in patient-centered perioperative care guided by innovative research, education, and an unwavering commitment to health equity. Our vision is to advance perioperative care by cultivating the next generation of leaders in our field. Over the past year, we have continued to strengthen our clinical, academic, educational, and operational missions, reflecting sustained growth, innovation, and resilience across our department.

Clinical Excellence and Growth

In our clinical domain, we expanded both scope and impact. The opening of a ninth operating room increased surgical capacity and improved patient flow, particularly for time-sensitive conditions such as acute spine injury and stroke. We further optimized clinical pathways, including new guidelines for preoperative neuraxial catheter placement and enhanced Epic builds supporting NORA blocks.

Trauma Anesthesia experienced continued growth, with total trauma patients increasing. We implemented new pediatric trauma transfer guidelines in collaboration with Mission Bay and BCH Oakland, improved emergent pediatric anesthesiology access, and welcomed a new Trauma Anesthesia Fellow while launching a structured resident trauma curriculum.

Obstetric Anesthesia maintained high clinical volumes, with cesarean deliveries increasing and labor epidurals rising. Our Women’s Options Center also maintained high volume during this period. Importantly, we significantly reduced general anesthesia use for C-sections, aligning with national benchmarks and sustaining recognition as a SOAP Center of Excellence. Enhanced Recovery After Surgery (ERAS) pathways and improved intraoperative temperature management were successfully implemented.

Our Preoperative Anesthesia Clinic streamlined workflows and strengthened ERAS pathways (including colorectal and OSA pathways), while introducing supportive patient access initiatives such as Lyft rideshare for visits.

The Acute Pain Service and Chronic Pain Clinic expanded non-opioid strategies, performing approximately 300 interventional procedures annually and managing thousands of clinic encounters. Low-dose ketamine infusions were implemented hospital-wide to reduce opioid reliance.

In Critical Care, we transitioned to a collaborative high-intensity SICU staffing model with consistent overnight fellow/attending coverage and 23 ICU weeks staffed by anesthesia intensivists. Resident feedback scores improved, reflecting strengthened educational and clinical integration.

Research and Academic Impact

Our academic mission continues to thrive. ZSFG Anesthesia researchers now hold over $33 million in active grant funding from NIH, DOD, FDA, PCORI, AHA, foundations, and industry partners. Our research portfolio spans data science, biomarkers, genomics, inflammation, immunotherapy, global health and equity, neuro-injury, and clinical trials. Between 2023–2025, our group produced over 130 publications, many in high-impact journals, reflecting strong cross-campus collaboration and national leadership in clinical research and perioperative data science.

Education and Training

Education remains a defining strength. ZSFG continues to be ranked highly by residents, reflecting the quality of mentorship and clinical exposure. The ZSFG–Paris collaboration continues to grow, with joint conferences and an expanding exchange program that strengthens our international academic partnerships.

We remain proud of our anesthesia techs, CRNAs, respiratory therapists, nurse practitioners, administrative professionals, faculty, and trainees. Their professionalism, compassion, and dedication are the foundation of our success.

As we move forward, we will continue to invest in innovation, sustainability, workforce development, and health equity—ensuring that ZSFG Anesthesia and Perioperative Care remains a model of excellence in patient-centered perioperative medicine.

Romain Pirracchio, MD, PhD
Chief of Anesthesia and Perioperative Care at ZSFG
Executive Vice Chair of Adult Anesthesia