Anesthesiology
 
Anesthesiology
 

Regional Anesthesia & Acute Pain Medicine

Message from Division Chief Dr. Elilary Montilla Medrano

As regional anesthesiologists, we understand that experiencing post-surgical pain is a concern for many patients. As such, we partner with our patients to design an individualized plan to prevent or minimize postoperative pain and to ensure the comfort and safety of our patients throughout the perioperative period.

Superior Patient-Centric Care

The Regional Anesthesia & Acute Pain Medicine (RAPM) team provides pain relief to surgical patients safely and effectively before, during and after surgery. Even before surgery, our team utilizes multimodal analgesia -- an individually tailored combination of non-opioid medications – to decrease pain. We also administer local anesthetic numbing injections -- nerve blocks -- for a range of surgical procedures. Nerve blocks are very safe procedures which may require light sedation.

During the nerve block, our regional anesthesiologists monitor patients very closely and use ultrasound machines to ensure the highest level of safety and precision. After surgery, our anesthesiologists collaborate with the surgical specialist to create an individualized treatment plan to ensure the patient’s smooth and safe recovery.

Clinical Excellence

The Division of Regional Anesthesia & Acute Pain Medicine (RAPM) provides comprehensive pre-, intra-and post-operative pain management for our surgical patients using a combination of regional anesthesia techniques and multimodal therapies. The division also provides in-patient acute and chronic pain medicine consultation and follow-up services. Our team works closely with the orthopedic team as well as other surgical specialists to ensure the best outcomes for each patient. The RAPM Division is an integral part of Montefiore Einstein’s Joint Replacement Center and played a crucial role in the center receiving the Joint Commission’s Advanced Certification for Total Hip & Total Knee Replacement.

Annually, we perform more than 7,000 regional anesthesia procedures and provide in-patient care to more than 2,000 patients. All members of the RAPM team are experts in ultrasound guidance and utilize state-of-the-art technology to perform peripheral nerve blocks, catheters, and neuraxial techniques. Regional anesthesia techniques may be used as the sole anesthetic, supplemented with sedative medications, or primarily to provide pain relief (analgesia) after surgery.

Education and Training

Our team is a nationally recognized leader in RAPM education for both residents and fellows, and we regularly host workshops and lectures at regional, national and international conferences. Our fellowship training program – the Regional Anesthesia and Acute Pain Management Fellowship – was among the first accredited in the nation and has risen to national prominence. It is one of the largest Physical Medicine & Rehabilitation-based pain medicine fellowship programs in the country and consistently recruits candidates from the best centers in the nation. Our fellows complete their training ready to become leaders, researchers and innovators in Regional Anesthesia and Acute Pain Management.

Innovative Research

Our Regional Anesthesiologists are renowned for clinical research that improves patient experiences and improves health outcomes. We regularly present at international and national conferences and publish manuscripts in peer-reviewed journals. Recent research publications include:

  • Successful Use of Peripheral Nerve Blocks as the Primary Anesthetic in High-Risk Patients Undergoing Hip Surgery
  • Perioperative Management of Metastatic Paraganglioma-Pheochromocytoma of the Humerus with the Aid of Regional Anesthesia
  • Considerations for Epidural Blood Patch and Other Postdural Puncture Headache Treatments in Patients with COVID-19
  • Perioperative Management of Patients with Hip Fractures and COVID-19

Services Provided Include:

  • Inpatient Acute and Chronic Pain Medicine Consultation and Follow-up
  • Neuraxial procedures
    • Spinal
    • Thoracic epidural
    • Lumbar epidural
  • Peripheral Nerve Blocks and Catheters
    • Adductor Canal
    • Axillary
    • Erector spinae
    • Femoral
    • Iliohypogastric
    • Ilioinguinal
    • Infraclavicular
    • Intercostobrachial
    • Interscalene
    • IPACK
    • Lateral compartment
    • Lumbar plexus
    • Paravertebral
    • PECS
    • Popliteal
    • Quadratus lumborum
    • Rectus sheath
    • Sciatic
    • Superficial cervical plexus
    • Supraclavicular
    • TAP

Meet the Regional & Acute Pain Medicine Team.