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Physician brings new approach to pain management to the Community Campus

Physician brings new approach to pain management to the Community Campus

SYRACUSE, N.Y.-- In September 2015, Upstate University Hospital’s Community Campus welcomed Lucien Catania, MD, who now offers patients a new approach to pain management. The board-certified anesthesiologist is expanding the acute perioperative pain management options available to patients undergoing surgery at the campus.

Catania specializes in performing nerve blocks for surgical anesthesia and pain control. He performs three new types of nerve blocks for acute pain management: paravertebral nerve blocks, lumbar plexus blocks and sacral plexus blocks. Paravertebral nerve blocks are performed for breast, thoracic, hernia, hip, abdominal, gynecologic and plastic surgery cases, and involve the injection of local anesthetic in a space adjacent to where the spinal nerves emerge within the back.

“The paravertebral block is a new modality for the Community Campus, and there is good data to support the benefits it affords patients,” said Catania. “This method does not require entering the spine, and thus avoids many of the risks and potential complications associated with entering the spine with an epidural block.”

Also new to the campus are the lumbar plexus and sacral plexus blocks, which Catania performs on patients undergoing hip surgery, knee surgery, vascular leg surgery or leg amputations. These nerve plexuses can be blocked to provide total analgesia-the inability to feel pain-in the leg.

Catania also performs the nerve blocks that were being offered at the Community Campus prior to his arrival: brachial plexus, femoral blocks and sciatic blocks. For these pain control methods, he also has the ability to perform different approaches to these blocks. This enables him to perform nerve blocks in patients that would be difficult or impossible with conventional approaches. For example, Catania is able to deliver the pain management modality to patients that ordinarily would not be able to receive the block due to their co-morbidities or discomfort with positioning.

“In addition to using the nerve blocks to control post-operative pain, nerve blocks can be used as the primary form of anesthesia coupled with sedation in order to avoid general anesthesia altogether,” said Catania. “This may be of benefit to high risk patients or patients who have had unpleasant side effects from general anesthesia in the past.”

The blocks are performed by Catania in the pre-operative area or in the operating room just before the procedure begins. The patient is then cared for by an anesthesia team that continues to provide anesthesia during the surgery.

As Catania performs these new pain management services at the campus, he is also planning to establish a standardized approach to managing acute post-operative pain based on best practice and evidence. “This will help to improve patient care, streamline the system and improve operating room efficiency,” Catania said.

He has begun working with surgeons at the campus to more effectively guide inpatient pain management. This can include prescribing preemptive pain medications that can begin in the pre-operative area prior to surgery, explained Catania.

“The current trend in pain management is multi-modal analgesia,” said Catania, “The goal of this strategy is to use multiple, different classes of pain medications in low doses to synergistically decrease pain while at the same time decreasing the need for narcotic type pain relievers and thereby decreasing their potential negative side effects.”

Catania hopes to soon build upon these services and further expand the options available to patients. He also wants to provide continuous nerve block catheters in the future, which would help alleviate pain for several days after surgery in patients that are expected to have severe post-operative pain.

Catania most recently served as the director of regional anesthesia at the Albany Medical Center. He also completed a fellowship in regional anesthesia and acute pain management at University of Pittsburgh Medical Center.

For more information about the anesthesiology patient care services available at Upstate, visit Anesthesiology.

Caption: Board-certified anesthesiologist Lucien Catania, MD, is expanding the acute perioperative pain management options available to patients undergoing surgery at the campus.

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