Regional Anesthesiology and Acute Pain Medicine

The Department of Anesthesiology at the McGovern Medical School, UTHealth offers 3 Acute Pain Services and two dedicated regional anesthesia service “Block Teams”. UTHealth performs over 2,000 regional and acute pain procedures per month.

UTHealth Acute Pain Services at Memorial Hermann Texas Medical Center (TMC) and the UTHealth Block Team are lead by Dr. Nadia Hernandez, an internationally renowned regional and acute pain physician. Dr. Hernandez incorporates regional anesthesia into every enhanced recovery program at Memorial Hermann Hospital and serves on Memorial Hospital System Committees to apply these practices into the other 16 Memorial Hermann Hospitals. In addition to perioperative pain management, several protocols for acute inpatient pain have been developed including acute pancreatitis, headache, rib fracture and preoperative traumatic pain. Ultrasound guided interventions for refractory ventricular tachycardia are offered at our Heart and Vascular Institute.

The UTHealth Pediatric Acute Pain Service at Children’s Memorial Hermann Hospital – TMC is run by Dr. Sarah Tariq and the internationally renowned Dr. Maria Matuszczak, and provides expertise in pediatric regional anesthesia.

The pediatric pain service at Children’s Memorial Hermann Hospital comprises of a select few pediatric anesthesiologists passionate about pediatric pain management. The pain team is committed to preventing and alleviating pain and suffering in children of all ages utilizing the most advanced, evidence based and safest treatment options with the goal of improving children’s quality of life and reducing pain related disability.

Our comprehensive and robust pain service provides pain management 24/7 for inpatients. We utilize numerous regional blocks and multimodal analgesia to minimize opioid use. Adopting a multidisciplinary approach, we have developed protocols for pain management for spine fusions, pectus repairs, dorsal rhizotomy, osteotomies and major abdominal surgeries. Children’s Memorial Hermann Hospital has a 118-bed level IV neonatal intensive care unit, and our pain team physicians are adept in providing pain management to our smallest and premature neonates employing regional and neuraxial techniques as well as pharmacologic management.

We are equipped to manage a wide variety of pain conditions. These include, but are not limited to; postoperative pain, procedural pain, neuropathic pain, pain related to trauma and burns, musculoskeletal pain, sickle cell pain crisis, cancer pain, headaches, abdominal pain, complex regional pain syndrome and pain associated with hypermobility syndromes.

The UTHealth acute pain service at Harris Health System’s Lyndon B. Johnson Hospital is led by Dr. Sara Guzman-Reyes who has been chief of this busy service for 15 years and serves as Assistant Program Director for the residency program.

The UTHealth Block Team at Memorial Hermann Ambulatory Surgery Center (ASC) is led by the center’s Medical Director and UT Health regional and acute pain fellowship trained, Dr. Daniel Shoham. At the ASC, we provide regional and acute pain services to professional athletes from around the world and conduct research.

Resident Training

Resident education in regional anesthesia is directed by a UTHealth regional and acute pain fellowship trained specialist, Dr. Xuan Langridge. Each month four residents are exclusively assigned to regional anesthesia; two at Memorial Hermann–TMC, one at Houston Methodist Hospital, and one at Harris Health System’s Lyndon B. Johnson Hospital. In addition, two residents are assigned to the UTHealth Acute Pain Service at Memorial Hermann- TMC. Resident acute pain education is directed by an Interventional Pain Fellowship trained specialist, Dr. Michelle Ge.

Memorial Hermann–TMC is one of the largest Level I trauma centers in the nation, and the busiest as of 2012. Our trainees are exposed to a variety of procedures in complex trauma patients. All enhanced recovery programs include regional anesthesia making the rotation one of the most intense training months. Residents generally exceed their peripheral nerve block and neuraxial anesthetic graduation requirements in their first week on the service, with most residents graduating with two to four times the ABA requirements. The division is highly involved in clinical research so trainees are exposed to all types of ultrasound guided peripheral nerve blocks as well as placement of indwelling catheters for postoperative pain management, for both inpatient and outpatient surgeries.

The regional and acute pain team at UTHealth consists of several fellowship-trained faculty from all over the nation, including Mount Sinai Hospital, University of Pittsburgh Medical Center, Hospital for Special Surgery, University of Iowa, and UTHealth.  One highly-trained faculty member is in charge of the dedicated “block room” and provides supervision to the residents and fellows. Another dedicated faculty member supervises the UTHealth acute pain service at Memorial Hermann Hospital – TMC which manages nearly all perioperative patients and provides indwelling epidural and perineural catheter management as well as analgesic medication management. The service places a heavy emphasis on optimizing patient outcomes using narcotic sparing, multi-modal perioperative acute pain management. Residents are given the opportunity to initiate and manage medically complex and opioid tolerant patients by optimizing complex medications, initiating lidocaine and ketamine infusions, and placing ultrasound-guided peripheral nerve blocks and catheters during the Acute Pain Medicine rotation. Trainees find that this division offers many research opportunities due to their innovative techniques.

Fellowship Training

UTHealth is home to a highly competitive regional and acute pain fellowship that incorporates point of care ultrasound education. It is the largest regional and acute pain fellowship in Texas. The fellowship director is a nationally renowned regional and acute pain specialist, Dr. Johanna de Haan. Fellows learn over 100 ultrasound guided regional anesthesia interventions for acute and persistent postsurgical pain as well as with a certificate in transthoracic cardiac ultrasound and diagnostic point of care ultrasound. Basic Transesophageal Certification is available. 1-4 fellowship spots are offered each year. UTHealth fellows graduate to become leaders in regional and acute pain.

Faculty Training

Our team offers a yearly Basic Focus Assessed Transthoracic Echocardiography Course. Fore more details please click here.

A faculty shadowing program is offered, and practicing anesthesiologists in the community are able to shadow and observe our practice at UTHealth. Please contact Marshandra Cooper for more information.

 

Nadia-HernandezNadia Hernandez, MD
Division Chief, Regional Anesthesiology & Acute Pain Medicine Division
Associate Professor, Department of Anesthesiology
Johanna Blair De Haan, MDJohanna de Haan, MD
Assistant Professor, Department of Anesthesiology
Michelle GeMichelle Ge, MD
Assistant Professor, Department of Anesthesiology
Sara Guzman-Reyes, MDSara Guzman-Reyes, MD
Associate Professor, Department of Anesthesiology
Xuan Langridge, MDXuan Langridge, MD
Assistant Professor, Department of Anesthesiology
Maria Matuszczak, MDMaria Matuszczak, MD
Professor, Department of Anesthesiology
Daniel ShohamDaniel Shoham, MD
Assistant Professor, Department of Anesthesiology
Sarah TariqSarah Tariq, MD
Associate Professor, Department of Anesthesiology