Acute Pain Service

The Acute Pain Service, under the direction of Heather Werth, MD, provides a multimodal approach for the prevention and treatment of acute pain with the goal of improving patient comfort and satisfaction in the perioperative as well as non-operative hospital settings. The management of pain in the hospital setting can be a difficult task to accomplish especially after a pain signal has already been established. For this reason, the Acute Pain Service at the University of Arizona Medical Center takes a proactive approach in improving the hospital experience of our patients. Our acute pain team is facilitated by highly trained physicians who specialize in a holistic pain management approach using a combination of anatomical landmarks and advanced ultrasound technology for direct visualization of targeted therapeutic sites as well as adjuvant medications (both narcotic and non-narcotic formularies).

Acute Pain Management Techniques

  • Regional anesthesia consisting of peripheral nerve blocks and neuraxial techniques
  • Complex multimodal pain management, specializing in the use of non-narcotic adjuncts to decrease inflammation and pain signaling
  • Initial evaluation, treatment and referral of complex pain syndromes to the appropriate pain management services within the University of Arizona Health Network for long-term treatment

What is Regional Anesthesia?

Regional anesthesia is a way to "turn off" pain signals in a specific part of your body. An anesthesiologist injects local anesthetic to numb only the area of the body to be operated on. Depending on the surgical site, either peripheral nerve blocks or a neuraxial technique (spinal and epidural anesthesia) can be performed.

What is a Peripheral Nerve Block?

Peripheral nerve blocks are commonly used for surgeries on the upper and lower limbs. This is achieved by injecting local anesthetic close to the major nerves that innervate a particular part of the body, such as hand, wrist, arm, shoulder, breast, foot, ankle, knee, leg and hip. Peripheral nerve blocks can be single injections or via a small catheter to provide continuous infusion of numbing medication. Your anesthesiologist will discuss with you the most appropriate block for your specific surgery. Most single injection peripheral nerve blocks will last around 12 to 24 hours. As each block is different, the range can be between 8 to 36 hours.

The peripheral nerve blocks offered include the following:

  • Brachial plexus block
  • Bier block
  • Thoracid paravertebral block
  • Transversus abdominis plan (TAP) block
  • Femoral nerve block
  • Fasica iliaca block
  • Adductor canal block
  • Saphenous nerve block
  • Popliteal nerve block
  • Ankle block

What is Neuraxial Anesthesia?

Similar to peripheral nerve blocks, neuraxial technique involves numbing only parts of your body. This is done by giving the local anesthetic in your back near the nerves of pain transmission. Depending on your surgery, either epidural or spinal anesthesia is used.

  • Epidural anesthesia can be used for surgery of lower extremities and is commonly used in childbirth. It is similar to spinal anesthesia. This type of anesthesia is achieved by injecting anesthetic through a thin catheter that is placed into the space that is near the spinal cord and nerves. This causes numbness in the lower body.
  • Spinal anesthesia can be used for lower abdominal, pelvic, rectal or lower extremity surgery. This type of anesthesia is achieved by injecting anesthetic fluid into the fluid surrounding the spinal cord in your lower back, causing your lower body to be numb.

How Can Acute Pain Management Improve Your Hospital Experience?

  • A lower chance of having breathing problems during and or after surgery
  • Potential to avoid general anesthesia resulting in decreased sore throat after surgery
  • Less nausea and vomiting from decreased narcotic pain medication
  • Excellent pain relief
  • Shorter recovery period

Acute Pain Service History & Milestones

  • Over 10,000 peripheral nerve blocks and neuraxial anesthesia techniques performed since 2008
  • Novel regional pain techniques performed on complex malignant pain
  • First to introduce and perform ultrasound-guided nerve block techniques in the Tucson and surrounding Southern Arizona area
  • Since 2008, the program has trained and graduated over 50 anesthesiology consultants with the tools and knowledge to independently practice regional anesthesia, many of whom now offer their services all throughout the United States
  • The Acute Pain Service has formed treatment alliances with SALSA (Southern Arizona Limb Salvage Alliance), Trauma and Emergency Surgery, Orthopedic Surgery, Cardiac and Thoracic Surgery departments