With opioid prescriptions and opioid overdoses rising over the last decade and physicians across the country expressing concern, a public health emergency was declared in 2016. The CDC released new prescribing guidelines in efforts to reduce the numbers of opioid prescriptions and doses of narcotics available. Over four years later where do we stand? Together we have made changes towards improving patient safety. Opioid prescribing in the state of Virginia saw a decrease in the daily Morphine milliequivalent (MME) per prescription across the … [Read More...]
Main Content
President’s Message
Patient Safety and Comfort Will Always Be Our Concern
By Jeffrey Green, MD, FASA
President, Virginia Society of Anesthesiologists
and Marie Sankaran Raval, MD
President-Elect, Virginia Society of Anesthesiologists
As anesthesiologists, one of our biggest concerns is and always will be relieving pain. This will never change, but the strategies we employ to manage our patients’ pain continues to evolve. As the pain literature grows, we continue to learn more about the importance of minimizing physiologic stressors during surgical procedures using non-opioid, multi-modal pharmacologic and non-pharmacologic approaches. The days of escalating opioids to control pain are over, and here to stay are specialized protocols and techniques that more precisely … [Read More...]
Letter to the Editor
Letter to the Editor: Comments on Language Reflecting Gender Bias
Anneke Schroen, MD, MPH
Associate Professor, Surgery
University of Virginia
Dear Editor: I read your Fall 2020 issue on Women and Diversity with great interest. Drs. Kamilla Esfahani and Allison Bechtel highlighted leadership development seminars at the University of Virginia titled, Women in Anesthesia and Women in Surgery, conducted in early 2020. Among the featured topics, the role of language in reflecting, and likely furthering, our gender biases. My own research into gendered language in letters of recommendation for surgery residency demonstrated that letters for male applicants are longer, more likely … [Read More...]
Theme – Pain Management
Anesthesia Trainees and Pain Management: Learning through the Global Pandemic Lens
By Daniel H. Gouger, MD
VCU Health Department of Anesthesiology
Resident Editor, VSA Update
Lately, my task list at the hospital is anchored around a select few things. Answer stat pages to intubate people with COVID, and with diligence, restock my PPE for intubating people with COVID. But then intercom lullabies for newborn deliveries let me float away, for just a moment, to my baby nieces and older nephew. The mental reprieve fades, so … [Read More...]
Spinal Cord Stimulators and Intrathecal Pumps: Anesthetic Considerations, Perioperative Evaluation, and Management
By Elysha Dinh, MD
Fellow, Pain Management, PM&R
VCU, Richmond, VA
and Robert J. Trainer DO, MBA
Anesthesiologist and Pain Management Physician
Director, Spinal Cord Stimulator Program, CVHCS
Richmond, VA
Spinal Cord stimulation (SCS) and intrathecal drug delivery systems (IDDS) are becoming increasingly important in the management of chronic pain. It will be progressively more common for the anesthesia team to encounter patients with these devices. This article aims to discuss possible concerns regarding the management of patients with SCS and IDDS … [Read More...]
ERAS Pain Control Protocol Explained
By Lynda T. Wells, MBBS
Associate Professor of Anesthesiology
University of Virginia
Charlottesville VA
The significance of pain control in enhanced recovery after surgery (ERAS) was first described by George Washington Crile in 1912. He observed that outcomes for patients who received ether anesthesia alone for surgery did very poorly compared to those who also received nitrous oxide and/or morphine. The best outcomes, he noted, were in patients who … [Read More...]
The Influence of Sex, Gender, and the “X” Chromosome on the Pain Management Experience
By Chinwe Anumudu, MD
Chief Anesthesiology Resident
Virginia Commonwealth University
Richmond, VA
and Denise D. Lester, MD
Anesthesiologist and Pain Physician
Assistant Professor Anesthesiology and Physical Medicine & Rehabilitation
VCU/ MCV/CVHCS
Richmond, VA
The patient-specific individual experience and treatment of pain is currently a highly debated point of discussion. No longer are pain management consultants using a “standardized” concept to manage pain in their patients. It is well known that many variables such as our personal immune system and our individual unique gene expressions alter our … [Read More...]
Access to Interventional Pain Management in Virginia
By Gabriel Beluchukwu, MD
Anesthesiology Research Resident
Virginia Commonwealth University
Richmond, VA
In Virginia, like the rest of the country, pain is one of the most common causes of medical consultation. Pain can be either acute or chronic. Acute pain is the sudden onset of pain sensation triggered by the nervous system secondary to specific events like accident injuries, surgical site pain, child labor and delivery, etc. Acute pain usually … [Read More...]
The Opioid Crisis: Four years later
By Matthew D. Riley, MD
Resident Physician
Department of Anesthesiology
University of Virginia
Charlottesville, VA
With opioid prescriptions and opioid overdoses rising over the last decade and physicians across the country expressing concern, a public health emergency was declared in 2016. The CDC released new prescribing guidelines in efforts to reduce the numbers of opioid prescriptions and doses of narcotics available. Over four years later where do we … [Read More...]
Member News
Dr. Marc Huntoon Receives 2020 ASRA Distinguished Service Award
Dr. Marc Huntoon has received The American Society of Regional Anesthesia and Pain Medicine ‘s 2020 Distinguished Service Award. ASRA thanked him for his commitment and service to your many colleagues, fellows and patients and to advancing the specialty of regional anesthesia and pain management. Join us in congratulating Dr. Huntoon on some of his myriad contributions: Editor-in Chief of RAPM 2012 - 2019 Doubling the growth of submissions to RAPM since assuming leadership Creating the highly popular ‘Daring Discourse’ section … [Read More...]
Practice Spotlight
Richmond Spine Interventions and Pain Center
By Peyman Nazmi, MD
Anesthesiologist and Interventional Pain Specialist
Richmond Spine Interventions and Pain Center
Richmond, VA
I have had the privilege of being a part of an interventional Pain management practice in the greater Richmond, Virginia area for the past 20 years. This could be a good point in time to share some of our experiences with our other colleagues. Being an independent, or more correctly interdependent, medical specialty practice comes with many … [Read More...]
Community Memorial Hospital
By Manhal Saleeby, MD
My name is Manhal Saleeby and I am living the dream! I am an anesthesiologist/pain specialist physician employed by a community hospital in the town of South Hill, Virginia. Community Memorial Hospital affiliated with Virginia Commonwealth University in 2014. The affiliation enabled our community hospital to grow and expand to multiple specialty … [Read More...]
Legislative News
Senator Emmett Hanger Awarded as VSA’s 2020 Legislator of the Year
The VSA Board of Directors chose Senator Emmett Hanger as the 2020 VSA Legislator of the Year. Senator Hanger joined our board meeting on January 8th so that we could formally thank him for his work. VSA chose Senator Hanger for this award because he carried the budget amendment to increase the Medicaid reimbursement rates for anesthesiologists … [Read More...]
Legislative Update
By Lauren Schmitt
Commonwealth Strategy Group
The 2021 legislative session is rapidly approaching! The General Assembly will convene on January 13 and it will be much different than usual. The House of Delegates will be 100% virtual and never meet in person. The Senate will meet at the Science Museum of Virginia, as they did during the recent Special Session. However, no one from the public … [Read More...]
Dr. Moses Running for the House of Delegates
By Ben Moses, MD
Assistant Professor of Anesthesiology
University of Virginia
Charlottesville, VA
Whenever my department meets for grand rounds, or M&M conference, invariably one of the old heads in the room will stand up and argue why this policy or that practice is backwards, or how ridiculous it is that we still do certain things, or don’t do others. For some, these are treasured moments of glee, hearing a loud, confident, voice shout … [Read More...]