Anesthesiology

The Acute Pain Service

The Acute Pain Service (APS) at HSS is committed to reducing postoperative pain and assisting with the early phases of rehabilitation from orthopedic surgery. Our goal is to provide effective and safe pain management for all of our surgical patients.

The APS consists of a specialized team of clinicians with expertise in postoperative pain control, including an anesthesiologist, a nurse with special training in pain management, a pharmacist, and a physical therapist. Physicians from the Musculoskeletal and Interventional Pain Management Division may be consulted as well, depending on your medical history and specific case.

You will receive state-of-the-art postoperative pain control from the APS both in terms of analgesic agents or “pain relievers” and in the techniques used to administrate them.

Comprehensive pain management

The APS at HSS typically employs a multi-modal regimen to control postoperative pain. This means that several different types of pain relievers are used to help reduce pain by different mechanisms. This helps to limit the side effects of high doses of one "pain reliever" while reaping the benefits of complimentary analgesia from each technique.

Epidural analgesia, nerve blocks, continuous nerve blocks, local anesthetics, opioids, anti-inflammatory drugs, and ice therapy are among the modes of painkillers currently employed at HSS. The use of alternative therapies like deep breathing exercises, may be incorporated into your treatment as well.

Most of our patients will be able to use an analgesic technique called patient-controlled analgesia (PCA). This technique allows patients to customize the delivery of your pain medication whether by intravenous, epidural, or continuous nerve block routes. Patients have the ability to give themselves small doses of pain medication on a frequent, as-needed basis. This flexibility is important, as every patient has different individual needs.

The APS will set limits and controls to help avoid side effects. Extra doses can be given to control pain during peaks of discomfort which may occur during physical therapy. This method of pain management has been associated with higher levels of patient satisfaction, better pain control, and fewer side effects. Nonetheless, you may still experience side effects including nausea, itching, sleepiness, and numbness.

Patients are transitioned to oral pain relievers, usually beginning on the first or second day after surgery, in anticipation of discharge. An anesthesiologist and a nurse on the APS visit every patient on the service once or twice per day. If questions, concerns, or problems arise, a physician from the team is in-house 24 hours a day, seven days a week.

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