What a beautiful day in Houston! I’m halfway done with my first acute pain rotation and really enjoying my time back at the #1 cancer hospital in the country – MD Anderson Cancer Center. 🙂
Our service provides 24/7 in-house coverage primarily managing/placing epidurals, peripheral nerve blocks, and adjusting pain medication regimens postoperatively. Many patients have already been on chronic narcotic therapy, so acute pain management can become quite difficult. In the last two weeks, I’ve learned more about multimodal analgesia and its role in optimizing pain control for these patients.
Although Exparel (liposomal bupivacaine) has taken a large role in perioperative pain control, we’re still doing a fair share of epidurals and blocks (TAP, supraclavicular, femoral, and sciatic to name a few). This past week I had the privilege of working with an exceptionally kind and laid back attending who exemplified what it meant to be an academician. Each day I found myself using ultrasonography and neuraxial skills I’ve learned over my training thus far to work on more advanced techniques like the paramedian approach to a thoracic epidural. These skills will prove to be invaluable from time to time. 🙂
Another pleasant surprise on this rotation has been the call room. Oh my goodness – easily the BEST call room I’ve EVER had. It’s like a hotel room with a massive bathroom, shower, microwave, mini fridge, storage space, computer desk, and comfy bed. I’m looking forward to reclaiming this room next week when I’m back on night shifts. 😉