Pain Management Center

The Department of Anesthesiology's Pain Management Center (PMC) has been an integral component of the residency training program for over 25 years. Patients with all varieties of acute, chronic and cancer pain problems are referred by their physicians. The Center takes an interdisciplinary approach, with staff expertise in nursing, psychology, social work, and medicine/anesthesiology contributing to the evaluation of patients and planning for their treatment. The PMC is part of the Musculoskeletal Center, and collaborations with colleagues in Physical Medicine and Rehabilitation, Orthopedics, Rheumatology, Musculoskeletal Radiology and Physical Therapy occur frequently. Therapeutic prescription follows the comprehensive assessment which includes the consideration of data from consultants within and external to the PMC. Modalities employed include pharmacological treatment, TENS and other complementary therapies, an array of analgesic nerve blocks, exercise physiology, and a full gamut of psychology techniques. Interventional diagnostic and analgesic procedures are aided by onsite fluoroscopy. Implantable therapies are also part of the management. The PMC is also home to the ACGME approved Pain Management fellowship which enriches the resident experience.

Acute Pain Service

The Acute Pain Service (APS) has been operational since 1987. The APS guided the introduction of patient controlled analgesia (PCA therapy) into the University Hospital practice and was subsequently able to discharge oversight for this modality in the majority of cases. The management of patients with acute/postoperative pain via epidural, subarachnoid or peripheral nerve local anesthetics with or without opioids is routine, with an average daily census of 10 patients. Medical consults to the APS are received at any time and expand the breadth of problems encountered. There are a growing number of cancer pain-related consults and pediatric cases. The APS team is led by a resident or fellow on assignment to the pain services. All residents serve for 6-8 weeks on a scheduled basis. There is 24-hour attending coverage. Rounds are held daily at which all patients are discussed.

Areas of clinical and basic science research interest among the pain management faculty include the establishment of a comprehensive database for patients with chronic pain, therapeutic outcome studies, medication compliance studies, and studies evaluating safety and efficacy of innovative treatment approaches for patients with chronic spinal pain.

Overall, the group has a mix of clinical, research and professional interests which are reflected in the energized discussions at the weekly pain center conferences, the pain psychology seminars, and journal club meetings. The ABA and IASP curricula serve as the templates from which the total conference program is created. An up-to-date bibliography for topics directly and indirectly related to pain management can be accessed through a computerized reference manager program.

Pain Rotation Faculty

• Lora D. Baum, Ph.D.
  
• Dania C. Chastain, Ph.D., Director of Pain Psychology
• Robin J. Hamill-Ruth, M.D., Co-Director, Pain Management Center
  

• Robert B. Goldstein, M.D., Co-Director, Pain Management Center
  
• Lynn R. Kohan, M.D., Director, Pain Medicine Fellowship
  
• John C. Rowlingson, M.D., Director of the Acute Pain Service
• Xiaoying (Amy) Zhu, M.D., Ph.D.