Acute Pain Service Launches
The mission of the new Acute Pain Service is to provide excellence in patient care, advance clinical research in the field of perioperative pain management, and expand resident education.
The service, which is staffed for 24-hour coverage seven days a week, consults on the management of patients with post-operative, post-traumatic, or any acute pain condition requiring specialized interventions, such as epidural analgesia, continuous peripheral nerve blockade, or complex pharmacological management.
It also offers a full range of interventional procedures, such as blood patches, difficult lumbar punctures, fluoroscopy-guided epidural placement and ultrasound-guided regional blocks.
Director Dr. Padma Gulur said that the service, which started in January, previously existed as a combined Inpatient Pain Service, which also included the inpatient Chronic Pain service. However, acute perioperative pain management requires special skills and training possessed by anesthesiologists, such as epidural catheter placement and management and regional catheter placements, she said.
Chronic Pain, while primarily made up of anesthesiologists, also has some specialists from Neurology and Physiatry (physical medicine and rehabilitation).
"Before, we used to try to cover acute perioperative pain and chronic pain with the same staff, and it's very hard to find people who have both those specialized skill sets. The solution to improve patient care lay in ensuring the services were individually covered and in ensuring the Acute Pain Service was completely staffed by anesthesiologists," Dr. Gulur said.
The new service was launched on January 5, 2009, and has seen an exponential increase in its weekly volume of patients. The number of patients followed by this service increased by 30% over the last quarter, she said.
Dr. Gulur attributes the growth of the service to the tireless dedication of the service's founding members: Drs. Matthias Eikermann, Cosmin Gauran, Sonia Gupta, Brinda Kamdar, Torin Shear, and Jingping Wang.
The launch was truly remarkable, Dr. Gulur said, because it was done by a team of people with the same motivation a desire to improve perioperative pain management for Mass General patients and ensure that patients had access to a wide range of techniques to manage post-operative pain.
"Dr. Gulur's group has really changed the way we think about pain management in trauma patients. They are available 24/7 and have helped our patients significantly. Their dedication and expertise have really made a major impression on the trauma team," said Dr. George Velmahos, Chief of the Division of Trauma, Emergency Surgery and Surgical Critical Care, who has worked with the team.
As part of its mission, the service aims to address hospital-wide education needs with respect to pain.
"The Acute Pain Service is an integral part of the fabric of the hospital, working in close collaboration with Nursing and Pharmacy to ensure excellence in patient care. Patient safety is the highest priority," Dr. Gulur said.
Top (L to R): Drs. Dan Johnson, Horia Rus and Jingping Wang discuss neuroanatomy.
Bottom: Members of the Acute Pain Service prepare for an epidural placement.
Acute Pain Service
Featured Doctor: Padma Gulur
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