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The Comprehensive Pain Service at Vanderbilt University Medical Center experienced major change and growth in 2010. A major advancement coincided with the move of the Holding Room to the old SICU. In addition to the increased space and better privacy for patients, coordination with the Holding Room staff was improved to provide a more streamlined process for patients receiving regional anesthesia. The goal was to improve success rates while reducing delays and enhancing efficiency. This new space and the teamwork of APS with the Holding Room have facilitated more opportunities to help patients that can benefit from epidurals, peripheral nerve blocks, and peripheral nerve catheters.
A major evolution of services has been the increased interest and appreciation for peripheral nerve catheters, by both the surgeons and the patients receiving post-operative care. These continuous infusions of local anesthetic are used for complex shoulder and arm surgery, knee arthroplasties, extensive ankle restorations, and repeated burn debridements. The ability to provide targeted pain control in the area of injury has produced better pain control, better patient and surgeon satisfaction, and the ability to reduce patients’ time in the hospital. Patients who were staying in the hospital for days requiring postoperative IV pain medication are now often discharged after a one-night stay. In fact, many operations that previously required extensive hospital stays have now been moved to the outpatient surgery centers where patients are discharged directly home after surgery with a small disposable pain pump.
An ambitious endeavor has been the addition of the first Regional Anesthesia and Acute Pain Fellowship. The fellowship was begun with one position for 2009-2010. For 2010-2011, the fellowship has been increased to two positions, for which there were more than 50 applicants. The fellows have the opportunity to enhance their procedural skills in advanced Regional Anesthesia, learn the complexities of acute pain management with multimodal analgesia, become educators for the residents at the bedside and in the lecture hall, and grow to be scholars by developing a research study for publication.
Visit the Adult Acute Pain Service website to learn more.