HOUSTON--Development of a specialized anesthesiology pain team
led to a jump in pain consultations by anesthesiologists and in
the number of anesthetic procedures performed for pain control
at The University of Texas M.D. Anderson Cancer Center.
Richard B. Patt, MD, director of Anesthesia Pain Services and
deputy chief of the Pain and Symptom Management Section, reported
that prior to 1993, "there was a strong pain initiative but
without dedicated anesthesiology personnel."
For the minority of patients who failed traditional pharmacological
therapies, more interventional approaches were not readily available,
Dr. Patt said.
With the formal integration of a team of anesthesia pain specialists
into the interdisciplinary Pain and Symptom Management Program
at M.D. Anderson, the number of interventions for pain that had
failed to respond to systemic therapy increased dramatically,
from about 40 in 1993 to more than 300 in 1995.
These interventions included anesthetic nerve blocks, primarily
neurolytic blocks for well-localized pain and spinal opioid analgesia
for more diffuse pain, delivered by means of an indwelling or
The rise in anesthesiology consultations, from about 20 in 1993
to close to 400 in 1995, demonstrates that the anesthesiologist
and neurosurgeon perform more than just a technical role in pain
"As with any academic physician, they have a role as clinician,
researcher, and educator, but to be effective, they need to be
closely integrated with the rest of the pain management team,"
Dr. Patt said.