The acute pain management fellowship offered by the University of Ottawa is unique in the country. During this 12-month fellowship, the fellows will acquire experience in the management of acute postoperative pain conditions and other acute painful conditions such as sickle-cell crisis, phantom pain crisis, and will assist in the transition of patients with acute on chronic pain, using a variety of pharmacologic, non-pharmacologic and regional anesthesia-based techniques. Of note, our institution is pioneer on the management of perioperative lidocaine and ketamine infusions, open hysterectomy enhanced recovery (HER pathway) and established protocols for rib fractures including the use of serratus anterior plane catheters.
In the Acute Pain Service (APS), rounds are conducted daily with a multidisciplinary team, on a patient population consisting of those with IV PCA pumps, in-situ neuraxial and peripheral catheters, those with IV lidocaine infusion and ketamine infusions. The management of a new acute pain consult, and placement of certain peripheral nerve blocks is a fundamental part of the APS experience.
The fellows also will obtain experience in the pediatric setting with one block rotation at the pediatric acute pain service at CHEO hospital, learn about the treatment of complex patients with opioid use disorder through a rotation at the Substance Use Program (SUP) inpatient consult service, becoming familiar with opioid agonist treatment prescribing: methadone, buprenorphine/naloxone, and will participate in the management of patients with acute on chronic pain, through rotation in the newly established Transitional Pain Program.
The fellows will acquire the knowledge and skills to establish an acute pain program in their respective institutions and the program will serve as well as a foundational fellowship program for those wishing to pursue a regional anesthesia fellowship.