REGIONAL/ACUTE PAIN SERVICE
GOALS AND OBJECTIVES
DEFINITION
This is a one-month rotation during the CA-1 or CA-2 year with an emphasis on regional
anesthesia for surgery and post-operative pain management. Residents may complete an
additional month as an elective during their CA-3 year.
CURRICULUM
The resident will be exposed to a variety of regional anesthetic techniques for various
orthopedic, major abdominal, and thoracic surgeries. The most common techniques for include
femoral nerve catheters, thoracic epidurals, femoral/adductor canal, sciatic, and popliteal single
injection nerve blocks. In addition, the resident will be involved with daily patient rounds,
consult services, and management of intravenous patient controlled analgesia (PCA).
MEDICAL KNOWLEDGE
At the conclusion of this rotation the resident must be able to describe:
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Appropriate standards for patient monitoring during regional anesthesia
Relative and absolute contraindications for regional anesthesia
Appropriate regional techniques for use in surgical procedures involving the lower
extremity and thorax
The mechanism of action of local anesthetics
Prevention and treatment of local anesthetic toxicity
Mechanism of action and relative potency of opioids (fentanyl, morphine,
hydromorphone)
Pain management techniques for patients with complex pain syndromes
Pain management techniques and troubleshooting of difficult to control postoperative
pain in patients being managed on the APS
PATIENT CARE
At the conclusion of this rotation, the resident should be able to:
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Develop an appropriate regional anesthetic plan for a patient
Provide appropriate informed consent for regional anesthesia
Demonstrate the technical skills to perform the following neuraxial blocks: lumbar
epidural, thoracic epidural
Demonstrate the technical skills to attempt the perform the following single injection
peripheral nerve blocks: adductor canal, sciatic/popliteal, lumbar plexus, supraclavicular
Demonstrate the technical skills to perform the following catheter techniques: femoral,
sciatic/popliteal
Demonstrate moderate proficiency with ultrasound guided nerve blocks
INTERPERSONAL AND COMMUNICATION SKILLS
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Inform patients of the risks, benefits and alternatives for regional anesthesia
Interface with the surgical service about regional anesthesia plans
Interface with perioperative and floor nursing staff regarding patient management
Determine patient satisfaction with acute pain services
PROFESSIONALISM
During this rotation, the resident will:
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Be respectful of patients, families and other members of the health care team
Be responsible, punctual, responsive to pages or messages promptly
Acknowledge errors, self-assess
Be honest; adhere to a code of moral and ethical values; a “role model”
Respect ethical and personal values of others
Communicate effectively with appropriate self-confidence
React to stressful situations in an appropriate manner
Rev. 9/2015
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