Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF June 6, 2014 | Archived Issues

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Taking the Hurt out of Healing

Bahman Shamloo, MD, associate director of the Inpatient Pain Service, (left) speaks with Charles Louy, PhD, MD, MBA, medical director of the service.

Inpatient Pain Service Helps MDs Ease their Patients' Pain

More than 30,000 surgeries will be performed at Cedars-Sinai this year. Virtually all of them will require some form of pain management.

Because patients experience and deal with pain in their own individual ways, physicians may find that what works for one patient is not effective for another.

Enter the Inpatient Pain Service, a pain management program at Cedars-Sinai that focuses not only on acute perioperative pain management, but also on chronic pain and cancer pain among inpatients. The service is available as a 24/7 hospital resource with night on-call coverage by attending physicians, nurse practitioners and rotating fellows and residents. To reach the service, call 310-423-5870.

Under the supervision of Charles Louy, PhD, MD, MBA, medical director, Bahman Shamloo, MD, associate director, and Peachy Hain, MSN, RN, director of Medical, Surgical and Rehabilitation Services, the Inpatient Pain Service team consists of five pain board-certified nurse practitioners who work closely with patients, family members and the patients' physician team to conduct a comprehensive assessment of their pain.

This assessment includes psychological factors, patient expectations and history of substance dependence and abuse. It is used to formulate an individualized, evidence-based approach to pain management.

"Pain management is becoming increasingly complex. We are seeing greater numbers of patients who are taking high doses of pain medications at home, and typically these patients experience more pain because their tolerance is so high," Louy said. "In addition, people who suffer from chronic pain usually have pain in more than one site, so one problem leads to another."

"At the other end of the spectrum are patients who suffer with cancer pain, and we work closely with their oncologist to help manage their pain," Louy said. "Our current group of nurse practitioners has extensive backgrounds in critical care, family medicine, cancer pain and crisis management. Our team of providers collaborates with other services, such as Addiction Medicine, Hospice and Supportive Care Medicine, to provide a multidisciplinary approach to pain management."

Patients most appropriate for referral to the pain service include those who are or have:

  • Postoperative opioid tolerant and may benefit from a multimodal approach
  • Postoperative opioid-naïve
  • Severe intolerance or allergies to opioids
  • Airway problems including sleep apnea
  • Morbidly obese
  • Altered mental status
  • Complicated pain management histories, including those with intrathecal pain pumps and spinal cord stimulators
  • An acute exacerbation of chronic pain, requiring an interventional procedure
  • Cancer pain
  • Acute trauma pain, needing epidural and peripheral nerve catheters
  • Post-dural puncture (spinal) headaches and may require an epidural blood patch
  • Pediatric or neonatal patients needing pain management

For more information or to request consults, please call the Inpatient Pain Service at 310-423-5870.