Regional Anesthesia/Acute Pain Management

We offer comprehensive training in a Regional Anesthesia and Acute Pain Medicine (RAAPM) one-year fellowship; with the goal of developing expert consultants in the subspecialty. Working with our team of innovative, nationally recognized, Regional and Acute Pain Medicine service; the fellow will learn techniques and theories for treating, preventing and managing postoperative pain for a variety of surgical procedures. This includes cutting-edge truncal blocks and modern regional anesthesia techniques. Within the busy Acute Pain service the fellow will also learn to manage analgesic infusions such as; ketamine and lidocaine.  The fellow will also gain experience with buprenorphine and the complexities of hospitalized patients with opioid use disorder and chronic pain disorders.

An opportunity for general operating room anesthesia cases is also available. The fellow will design and implement ideas to participate in at least one clinical, laboratory, or database research project during the year.  In addition, the fellow will gain experience by participating in ongoing clinical trials within the division. The fellow will be supported to attend and participate in multiple local, regional, and national meetings along with the ability to submit abstracts and/or papers at other meetings presentations.

Finally, the fellow will present a departmental Grand Rounds on a topic of his or her choosing in the Spring.

Please contact the Fellowship Coordinator, Kymberley Ballato, CPC, for information about the Regional and Acute Pain Management Fellowship.

1. Develop the technical, interpersonal, communication, and systems-based practice skills necessary to become an expert consultant in regional anesthesia and acute pain.
2. Proficiency in the application of a wide variety of blocks for surgical anesthesia and pain management including:
   • the upper and lower extremity (including continuous catheter techniques)
   • the superficial cervical plexus
   • intercostal nerve block
   • intravenous regional anesthesia
   • spinal anesthesia
   • epidural anesthesia
   • combined spinal epidural (CSE)
   • thoracic and lumbar paravertebral
   • truncal blocks, including but not limited to erector spinae plane block, transversus abdominus plane block, pectoralis block, quadratus lumborum block
3. Proficiency in the operation management of an acute pain medicine service and management of the complex acute pain patient
4. In- depth knowledge of:
   • anatomy of nerves
   • the pharmacology of local anesthetics
   • Pharmacology of opioids including buprenorphine
   • Buprenorphine induction
   • the pharmacology of adjuvants to local anesthetics for peripheral nerve blocks and neuraxial blocks
   • neuraxial opioids
   • complications of regional anesthesia and their treatment
   • multimodal analgesia, including non-steroidal anti-inflammatory drugs, gabapentinoids, acetaminophen, ketamine, lidocaine, opioids
   • Management of acute pain in the presence of opioid use disorder,  chronic opioid use, chronic pain
5. Fellows will be exposed to anatomic dissection to enhance their understanding of blind procedures and spatial relationships
6. Each fellow will participate in a research project

The fellowship can be structured to meet the individual's career goals. Regional anesthesia, acute pain management and pain related research could be portioned to accomplish these goals as long as all ACGME requirements are met. Research opportunities include clinical and laboratory programs, clinical trials and pain management outcome studies. Upon completion of the fellowship, the candidate will be proficient in a wide variety of blocks, able to manage an acute pain service, and design and carry out a research project.

Possible fellowship structures to meet the individual's career goals:

• Regional focus with acute pain management, some OR anesthesia commitment, research project, anatomic dissection. Research focus, including working with faculty who perform clinical research. This would be an option for those wishing to pursue academic anesthesiology for their careers.
• Regional acute pain with a broader clinical focus possibly including OB analgesia/anesthesia, research project, some OR commitment that provides a broader clinical base than I. This could be structured to include a concentration in another clinical area. Quality improvement focus. This option includes spending some time designing and executing quality improvement projects under the supervision of a faculty member with experience in this area.

Jaime Baratta, MD
Fellowship Program Director
Director, Regional Anesthesia

Eugene Viscusi, MD
Chief of Pain Medicine
Director, Acute Pain Service

Eric Schwenk, MD
Associate Director
Director, Orthopedic Anesthesia

Thomas A. Witkowski, MD
Associate Professor

David Beausang, MD
Assistant Professor

John Wenzel, MD
Assistant Professor

Stephen Goldberg, MD
Assistant Professor

Jeffrey Mojica, DO
Assistant Professor
Acute and Chronic Pain Medicine

Deepti Harsharvardhana, DO
Assistant Professor

Amanda Monahan, MD
Associate Professor

Aaron Ocker, DO
Assistant Professor