The PRAA Acute Pain service number more than 15 physician anesthesiologists. This is so that PRAA can provide in-house 24-hour/7 days-a-week acute pain control care!

We use a variety of pain-management techniques to reduce or eliminate postoperative pain. Generally, two of the most effective of these techniques include continuous epidural analgesia and regional nerve block techniques.

Continuous Epidural Analgesia: This technique entails the placement of a very small catheter (about the size of a fishing line) between the bones of the spine. A small amount of pain medicine (often a combination of a narcotic and a local anesthetic) is then infused continuously through the catheter into the “epidural” space. This epidural medicine blocks the transmission of pain signals and provides excellent, sometimes total postoperative pain relief. Also, this technique requires minimal doses of medication, thus it reduces the side effects from pain medications. Epidural analgesia is the same highly effective pain-relief method commonly chosen by women for childbirth. In fact, it is a safe procedure for pain relief after many types of major intra-thoracic or intra-abdominal surgery, and provides relief for days.

Regional Nerve Block Analgesia is the preferred method for pain relief after orthopedic surgery on a shoulder, arm or leg. For major orthopedic surgery such as knee or shoulder joint replacement we use a catheter for continuous regional nerve blocks that can reduce or eliminate pain for days after operation. For shoulder and upper extremity surgery we perform a single-shot or continuous Brachial Plexus Nerve Block. A single shot block will reduce or completely eliminate pain for 12-24 hours. If your surgeon feels that additional relief is needed a catheter would be placed.

For operations on the knee, ankle and foot we use a femoral nerve block alone, or in combination with a sciatic nerve block. After discussions with your surgeon, together we would decide the best postoperative plan for you.

An alternative means of easing pain is patient-controlled analgesia, commonly called “PCA”. PCA involves a specialized infusion pump that delivers pain medication through an intravenous line. The pump is programmed to release pain medication, and it also includes a button that patients push to increase the supply of pain medicine quickly, efficiently, and safely. The machine incorporates safety features that prevent patients from getting too much medication. The PCA is managed by the surgical team and may be used alone or in communication with an epidural or regional nerve block technique to decrease postoperative discomfort.