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Acute Pain Service

The Acute Pain Service (APS) seeks to uphold the philosophy that effective and safe treatment of acute pain is a vital component of quality patient care. The Acute Pain Service consequently has a goal of providing every patient they see with the best possible pain management throughout their inpatient hospitalization. Congruent with institutional and national accrediting directives, pain assessment and effective management are vital criteria when evaluating quality of patient care.

Patient Care

The APS helps manage both acute surgical and non-surgical pain as well as acute pain that affects patients with pre-existing chronic pain problems. Management of acute post-surgical pain comprises approximately half of the clinical care provided by the APS. This includes traditional systemic medication approaches (opiates and non-opiate analgesics) as well as neuraxial analgesia, primarily through placement and management of epidural catheters used for pain control during and after surgery. The APS also consults on hospital inpatients whose acute pain management is particularly complex or complicated by pre-existing conditions. In all situations, the APS partners with a patient’s primary service to develop a plan for effective pain management. In addition, we will also frequently work with specialists in the outpatient Pain Management Center to provide optimal care for our inpatients with chronic pain and timely follow up for patients after their hospital discharge. Our joint focus is timely, patient-centered care continually assessed for quality and effectiveness.


The APS team provides a robust educational experience that is a significant part of our academic and teaching vision for anesthesiology residents. Participating on the APS team helps residents develop critical skills for evaluating acute pain problems in the base year and then learning the requisite intellectual and manual skills to implement integrated pain management strategies during the following clinical years of anesthesia training. Residents are trained to implement acute pain management techniques within the framework of a complete and often complex inpatient experience. Pain Fellows, from the DHMC Pain Management Center, also participate on the APS during dedicated rotations when they practice both acute pain management and management of hospital inpatients with chronic pain problems. Another vital educational service of the APS is ongoing teaching for nursing staff who have widely varying backgrounds, experiences and responsibilities when it comes to managing acute pain problems in the hospital. This teaching service helps to promote best pain management practices throughout the hospital. Finally, the APS team is constantly reviewing, revising and developing protocols and guidelines for the care of acute pain patients. This activity is often linked to education of patients, families, and caregivers.


Ongoing creation and dissemination of new knowledge is critical to maintain the vitality of any specialty. The APS team frequently participates in both traditional clinical research and quality improvement initiatives that generate new insights into management of acute pain problems.