The rotation is combined with the Pediatric Pain Management Program, enabling the resident to intervene and optimize post-surgical pain relief at the earliest interval possible. Residents gain exposure to all aspects of analgesic management, including assessment of pain instensity, testing and replacement of epidural catheters, stabilization of vital signs and treatment of side effects. The goal of this rotation is for each resident to learn the uniqueness of each patient's perception of acute pain and their response to the newest forms of analgesic therapy. Residents are instructed in the theory and application of epidural patient-controlled analgesia, intermittent dose and continuous infusion of epidural opioids, intrathecal opioids and continuous neural blockade. Approximately ten to fifteen in-house patients are followed daily by the acute pain team, which consists of attending and resident anesthesiologists, a clinical nurse coordinator and an assistant clinical coordinator.
Patients range from sixteen to over ninety years of age.
In recent years, basic and clinical research here at Yale, and at other major medical centers, has increased our understanding of pain pathways and has helped to develop new pain medications and novel routes of administration that have improved analgesic efficacy and postoperative outcome. Research efforts and current therapeutic regimens emphasize these concepts. Numerous research opportunities are available for residents and fellows assigned to the Acute Pain Service. Neonatal pain management is especially warranted for infants with a long stay in the newborn ICU who may have been intubated or had multiple surgeries. Within the pediatric pain program three distinct services are provided including perioperative services, consultation for inpatients, and the chronic pain management program.