June 12, 2009

Service helps manage post-surgery pain

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Rajnish Gupta, M.D.

Service helps manage post-surgery pain

Vanderbilt's Adult Acute Pain Service has grown steadily over the last few years, yet it's still underutilized, according to Rajnish Gupta, M.D., assistant professor of Anesthesiology and director of the service.

The service helps surgeons and their teams manage pain in patients undergoing a variety of surgical procedures, including ambulatory surgery. It also helps teams manage rib fracture pain in patients admitted to the Trauma Unit.

With the help of the service, surgical teams are increasingly adopting alternatives to general anesthesia and traditional IV pain medication. Through increased use of ultrasound technology, disposable pumps and other techniques for post-surgery pain, the service is helping more patients achieve better pain control, reduce hospital stays and often avoid admission to the hospital and lower their cost of care.

Team members include an attending anesthesiologist (six faculty members currently rotate in this role), two anesthesiology residents and a pain nurse. In July, the team will expand to include its first clinical fellow.

The inpatient service operates seven days a week, currently assisting with nearly 20 procedures and rounding on nearly two dozen patients per day.

The service has an additional team operating at the Nashville Surgery Center (a Vanderbilt joint venture), performing approximately 15 procedures a day and sending approximately five patients a week home with an indwelling pain catheter and disposable pump.

Gupta has been meeting with surgeons to promote the service.

“We specialize in alternatives to intravenous opioids,” he said, referring to regional anesthesia (epidurals), peripheral nerve catheters and peripheral nerve blocks, all of which can provide targeted pain control to specific body areas and possibly render general anesthesia unnecessary.

“I think there's real opportunity for growth. My message to surgeons is ‘call me.’ Let's figure out a practical protocol that we can adopt to help your patients in the future.”
For more information, e-mail Gupta at raj.gupta@vanderbilt.edu.