Pain Management

Acute Pain Service

The Acute Pain Service takes a biopsychosocial approach to chronic pain management that includes the integration of Primary Care, Pain Psychology, Psychiatry, Neurology, Neurosurgery and Physical Therapy services. The Service provides:

  • Didactic teaching
  • Simulation-based learning
  • Hands-on training

Upon completing of this program, students will have fulfilled their ASA requirements.

This service provides pain control for patients recovering from major surgery and those suffering from medically-related and oncological pain. The program emphasizes didactics, as well as hands-on experience and is committed to alternative methods of pain control, including acupuncture and transelectrical neural stimulation.

Resident Training

Residents learn the uniqueness of pain perception and patient responses to analgesic therapy. They are taught how to assess patients, how to formulate and initiate therapies and how to follow up with patients.

The Patient

Patients range in age from 16 to 95 and include:

  • Individuals recovering from highly invasive and painful procedures
  • Debilitated elderly who are opioid sensitive
  • Patients who are opioid dependent and can tolerate standard doses of analgesics
  • Patients allergic to morphine and demerol

Residents accompany the attending or nurse pain specialist on morning and evening Pain Service rounds. A 30-to-45- minute lecture is provided every Wednesday through Friday and papers on the syllabus are discussed.

Residents must prepare a "Pain Service Case of the Week," in which they present a clinical summary of an interesting or unusual patient. Residents and the Pain Fellow also attend a 48-week lecture series that follows the outline of the American Board of Anesthesiology examination in pain management.

Pain Management Rotation

The chronic pain management rotation takes place at the VA Connecticut Healthcare System in West Haven under the direction of Gerald W. Grass, M.D., chief of the Pain Management Center. Patients with a range of chronic pain states are treated. These include: myofacial pain, neuropathic pain, cervicogenic headache, trigeminal neuralgia, complex regional pain syndromes, herniated disc, post-laminectomy syndrome, spinal stenosis and post-herpetic neuralgia.

When eliminating the cause of pain is not possible, the goal becomes symptom management. We use a team approach with participation from the patients and their families. Treatment modalities may include non-pharmacologic approaches such as cognitive behavioral therapy, acupuncture, biofeedback, neurofeedback or chiropractic interventions.

Emerging Modalities

Besides conventional pharmacologic approaches, such as oral or transdermal medications, we employ a range of interventional techniques, including epidural injections, facet joint injections, radiofrequency ablation, spinal-cord stimulation and peripheral nerve stimulation.

Our service is committed to exploring new translational forms of pain treatment modalities, such as repetitive transcranial magnetic stimulation, fluoroscopically guided percutaneous electrical nerve stimulation and intravenous infusions of NMDA antagonists and biphosphonates.