HSS Anesthesiology 2010 Annual Report

d e pa rt m e n t of

anesthesiology 2010 annual report

excellence in regional a n e s t h e s i o lo gy a n d p a i n m e d i c i n e

2010 Annual Report

contents 1

MESSAGE FROM THE DIRECTOR

2

MISSION STATEMENT

2010 HIGHLIGHTS & STRATEGIC ACCOMPLISHMENTS

3

Establishing the Benchmark for Perioperative Performance

5

Improving Patient Safety Through Quality Assessment and Performance Improvement

6

Caring for Our Patients Through Effective Pain Management

8

Anesthesia and Pain Medicine Research

10

Serving as the Most Trusted Educator

12

Improving Patient Care Through Information Technology

13

HSS ANESTHESIOLOGISTS AROUND THE WORLD

14

DEPARTMENT GROWTH

15

PROFESSIONAL AND ADMINISTRATIVE STAFF

15

STAFF ACCOLADES

2010 NOTABLE ACHIEVEMENTS

17

Awards and Special Recognition

18

Leadership Positions and Appointments

18

Editorial Appointments

18

Grants

18

Selected Publications

department of anesthesiology

a message from the

director I

believe the Department of Anesthesiology at Hospital for Special Surgery to be analogous to the foundation of a home. The foundation, absolutely essential to the integrity of the structure, often goes unnoticed except to the acutely trained eye. So as you browse the first Annual Report for the Department of Anesthesiology, I hope to illuminate some of our key clinical, scientific and educational accomplishments in 2010. I am confident that you will share my immense pride in the excellence of our Department and the superlative care we provide to our patients at HSS.

GREGORY A. LIGUORI, MD

Anesthesiologist-in-Chief and Director

In 2010 the Department of Anesthesiology made significant strides toward achieving our vision to become the premier clinical, scientific and educational practice for regional anesthesia and pain medicine in orthopaedics. Every anesthesiologist and each member of our supporting team is singularly focused on excelling in this triad of clinical care, education, and patientfocused research.

CLINICAL CARE OF OUR PATIENTS HSS experienced extraordinary growth in clinical volume in 2010, providing care for over 25,000 patients. Most of these patients received innovative anesthetic techniques. In fact, 85 percent of all procedures were performed using very specific, tailored regional anesthetic and analgesic methods. Benefits of these regional techniques include decreased blood loss, fewer deep venous thrombosis and pulmonary emboli, and a lower surgical infection rate. We are proud that the highly specialized regional anesthesia care we provide contributes to exceptional clinical outcomes at HSS—helping HSS to achieve its rank as top hospital in the nation for orthopaedics in 2010 in the U.S. News & World Report “America’s Best Hospitals” issue.

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Given that orthopaedic surgery is often associated with significant postoperative pain, our anesthesiologists are acutely aware of how crucial effective pain management is to our patients. In 2010, we made tremendous advances minimizing pain and reducing the side effects of analgesia, and we continue to develop intra-operative techniques that bridge pain management into the post-operative period. Our Acute Pain Service is one of the largest and most sophisticated services in the world and remains physician-centered. Our pain specialists pride themselves on comprehensive analgesic care from non-invasive medications to interventional treatments and alternative therapies. Finally, our Recuperative Pain Service, the first of its kind in the world, is taking analgesic therapy to a new level by extending our pain management care beyond the inpatient experience.

department of

anesthesiology

mission statement

PATIENT-FOCUSED CLINICAL INVESTIGATION Over the last quarter century, the Department of Anesthesiology has been at the forefront of research in regional anesthesia and acute pain medicine as applied to orthopaedics.

2010 was one of our most productive and prolific research years to date— collaborative efforts with our medical, surgical and other colleagues at HSS led to over 57 publications and presentations at national and international meetings. The majority of our studies continue to be patient-centered, focused on improving the clinical outcomes of the surgical patient at HSS.

To achieve an international leadership role by providing the highest quality anesthetic care and pain management for patients undergoing orthopaedic surgery, to advance the science of regional

EDUCATION A core objective of our mission as a Department is to provide educational opportunities to all students of regional anesthesia and pain medicine and 2010 was a complete success from this perspective. Our fellowships in regional anesthesia and pain medicine remain among the most competitive in the nation. In 2010 we maintained our formal collaborative agreements with residency programs at Cornell and Johns Hopkins. In addition, trainees from some of the finest residency programs in the country spent time at HSS to learn our anesthetic techniques and practice patterns. Visitors from around the world, including our formal program with the University of Florence, traveled to HSS to observe the latest techniques in anesthetic and analgesic care of the orthopaedic patient. We hosted our 14th Annual Symposium entitled, “Controversies and Fundamentals in Regional Anesthesia” in May 2010. This internationally recognized conference remains one of the finest educational experiences in regional anesthesia for orthopaedics in the world.

anesthesia, pain management, and orthopaedic critical care through clinical and translational research, and to promote educational opportunities to all students of regional anesthesiology and pain medicine.”

clinical care

I hope you enjoy our 2010 annual report, and learn a little more about the Department of Anesthesiology at HSS, and our highly-skilled peri-operative role at the nation’s oldest and finest orthopaedic hospital.

HSS DEPARTMENT OF ANESTHESIOLOGY

education

research

department of anesthesiology

Gregory A. Liguori, MD Anesthesiologist-in-Chief and Director

de-

2010 Annual Report

x

highlights 2010

&

strategic accomplishments

â?Ż ESTABLISHING THE BENCHMARK FOR PERIOPERATIVE PERFORMANCE

The Department of Anesthesiology at Hospital for Special Surgery is the premier department in the world for the practice of regional anesthesia and acute pain medicine for orthopaedics. In 2010 we performed over 33,000 regional anesthetics for patients undergoing the full spectrum of orthopaedic procedures. Our exceptional clinical outcomes are the direct result of the extensive experience, unparalleled skill and advanced training of our anesthesiologists. Although we work in a highly specialized environment, our anesthesiologists have a diverse

anesthetics

& anesthetic blocks performed 2006–2010

35,000 32,500

30,000 37,500 25,000 2006

2007

background with subspecialty training in regional, pediatric, thoracic and cardiac anesthesia, as well as pain medicine and critical care. Our philosophy is to embrace new and innovative equipment and techniques while maintaining the highest level of

2008

2009

2010

clinical care and patient safety.

In 2010, over 85 percent of the 33,192 operating room (OR) anesthetics were performed using regional anesthesia techniques. This was a 6.6 percent growth in OR anesthetics since 2009 and a 28 percent growth since 2006.

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highlights & strategic accomplishments 2010 was an extremely successful year for HSS and the Department of Anesthesiology.

Developments in the use of ultrasound-guided regional anesthesia and the expansion of our pediatric anesthesia subspecialty were two areas of particular clinical focus.

The Department is committed to continued investment in equipment, technology, and training to enhance our patient’s safety and improve the perioperative experience. Over the last several years we witnessed the emergence of portable, high-quality ultrasound technology used in the practice of regional anesthesia at HSS. In 2010, we experienced exceptional growth using this technology in the performance of anesthetic and analgesic techniques.

Our anesthesiologists performed 7,276 ultrasound-guided blocks, including some procedures that simply were not possible in prior years. Examples of new procedures include ultrasoundguided trans-sartorial saphenous blocks for analgesia following knee surgery and ultrasound-guided supraclavicular blocks for surgery on the upper extremity.

To maintain our significant leadership role in the field of regional anesthesia, our doctors are committed to remaining in the forefront of innovation and technology. As our case volume continues to grow, so will the practice of ultrasound-guided regional anesthesia at HSS. Our Department’s quest for excellence in pediatrics goes hand in hand with the Hospital’s commitment to improve the lives of young people with complex musculoskeletal conditions.

Dr. Victor Zayas, Medical Director of Pediatric Anesthesia, leads a team of physicians with highly specialized

ultrasound-guided blocks

performed 2008–2010

2008

2009

2010

0

4

1,000

2,000

3,000

department of anesthesiology

4,000

5,000

6,000

7,000

8,000

training in pediatric anesthesiology and the management of pediatric pain.

These dedicated and caring physicians have many years of experience treating children before, during, and after surgery. Our doctors performed 1,272 anesthetics on pediatric patients in 2010.

Pediatric patients at HSS receive care specialized for their specific orthopaedic diagnosis. With advances in surgical procedures and intraoperative monitoring, an increasing number of medically complex patients are undergoing life-enhancing procedures every year. A typical pediatric patient at HSS could be an active toddler with a broken bone or complex cerebral palsy patient who has undergone multiple surgeries.

Regardless of the underlying disease, our patients receive peri-operative care that parallels the best academic children’s hospitals around the country.

Since children at HSS reap the same benefits from regional anesthesia as adult patients, perfecting the performance of regional anesthesia for children will always be a priority for

the Department. As HSS focuses on expanding its pediatric services with the development of a new Children’s Pavilion, we continue to recruit the highest caliber of anesthesiologists with fellowship training in pediatric anesthesia. Further, to fulfill our role in the Hospital’s dedicated and multidisciplinary pediatric team, we continue to enthusiastically collaborate with HSS surgeons, pediatricians, nurses and therapists to offer cuttingedge anesthesia and pain management, regardless of how big or small our patients may be. ❯ IMPROVING PATIENT SAFETY THROUGH QUALITY ASSESSMENT AND PERFORMANCE IMPROVEMENT

In accordance with the Hospital’s strategic initiative to elevate quality to the highest possible level, the Department maintains a rigorous Quality Assessment and Performance Improvement (QA/PI) program under the leadership of Dr. Chris Edmonds, Medical Director, QA/PI, and Maureen Stanton, RN, Manager, QA/PI. The

program’s goals include upholding the highest possible standard of patient care, decreasing risk to patients and hospital personnel, and educating the Department of Anesthesiology staff in the provision of exemplary clinical care.

The Department implemented several new QA/PI initiatives in 2010. We joined the American Heart Association’s national “Get With The Guidelines-Resuscitation” database, which collects information on resuscitation events from hospitals across the U.S., and started using this valuable information to benchmark HSS resuscitation practices and patient outcomes against 1,490 participating hospitals. To satisfy the Joint Commission’s National Patient Safety Goal of reducing the risk of health care associated infections, we developed a central-line insertion protocol and procedural checklist for use in the operating rooms and PACU. The new protocol and checklist will be most valuable in helping to prevent central line-associated bloodstream infections at HSS.

providing a patient experience that is

unsurpassed

Combining excellent clinicians with advances in new technology results in exceptional clinical care and the ability to provide a patient experience that is unsurpassed. Here are some of the great things our patients said about us in Press-Ganey Patient Satisfaction Surveys in 2010:

❯ “My anesthesiologist is a true professional and

an outstanding doctor. He was attentive to my questions/concerns that I discussed with him well in advance of my surgery. He is a patient, kind, dedicated, outstanding anesthesiologist, and he is attentive to all patients in the PACU post-op. I couldn’t ask for anyone better.”

❯ “My anesthesiologist was one of my very best

experiences. He told me everything he was going to do. He kept me very calm and secure.

He told me he would be there when I woke up and he was.”

❯ “The anesthesiologist was thorough and

knowledgeable. He was understanding of my special circumstances and agreed to respect my wishes.”

❯ “The anesthesiologists were compassionate,

professional and made us feel comfortable when taking my son in for surgery.”

❯ “The anesthesia doctor went with me and the

transportation person to CT Scan Room, helped with moving me to the CT scan bed (I could not move easily) and stayed with me until I was returned to the recovery station.

He really cares.”

❯ “If there was a higher rating than “very good” Our Q/A Team: Sarah Kennedy; Chris Edmonds, MD; and Maureen Stanton, RN

for my anesthesiologist, I’d give it to him. He knew exactly what I needed and what my fears were. That made a bigger impression on me than anything in my entire experience.”

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held many educational programs for physicians, nurses, and patients in 2010.

The Fourth Annual Pain Management Educational Program, “Pain Relief: A Challenging Journey for the Elderly and the Caregiver” was held on September 27 and was regarded as a major success by attendees. Lectures for HSS clinical staff were given throughout the year by APS nurses; topics included opioid conversion and management, pathophysiology of pain, and regional anesthesia techniques for pain control.

The staff continued monthly nursing orientation presentations on the use of peripheral nerve catheters and the general operation of the Acute Pain Service. The Acute Pain Service Guide was revised in 2010 and distributed to all new clinical staff involved in direct inpatient care.

Chronic Pain Specialist Daniel Richman, MD

❯ CARING FOR OUR PATIENTS THROUGH EFFECTIVE PAIN MANAGEMENT

“The pain management staff is excellent.

My nurse was outstanding – she explained everything, checked on me frequently and followed up with me at home. I attribute the speed of my recovery in large part to her efforts and expertise.”

The Anesthesiology Department’s multi-faceted Pain Medicine Division is comprised of the Acute, Recuperative, and Chronic Pain Services. Along with our talented group of physicians, Barbara Wukovits, RN, Director of Pain Services, and her team of exceptional nurses and staff are dedicated to the care of patients struggling with a multitude of pain conditions.

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department of anesthesiology

Recuperative Pain Medicine Service The Recuperative Pain Medicine (RPM) Service, a The Acute Pain Service SPENCER LIU, MD unique and relatively new Medical Director, (APS), an integral part specialty service, helps to Acute & Recuperative Pain Medicine of the inpatient hospital fulfill our mission as world experience for many of leader in innovative medical our patients, provides pain control and care. The RPM is a transitional service management in the immediate postthat extends our treatment of nonoperative period. routine pain management issues beyond the immediate post-operative period.

In 2010, the APS team, under the The RPM team managed the care of medical direction of Dr. Spencer Liu, 1,311 patients in 2010. cared for over 11,600 patients. As evidence of our clinical excellence, our One of the Department’s most exciting Press Ganey patient satisfaction scores patient care initiatives in 2010 was the for inpatient pain control were in the expansion of the RPM Service to include 99th percentile in every quarter of 2010. outpatient care. In a joint collaboration

Acute Pain Service

To enable the fulfillment of the Hospital and Department mission to serve as the most trusted educator, the APS staff

with the Department of Orthopaedic Surgery’s Adult Reconstruction and Joint Replacement (ARJR) Service, the RPM Service began to provide post-operative

highlights & strategic accomplishments outpatient pain management care for up to eight weeks after surgery.

Under the direction of Dr. Vladimir Kramskiy, this exciting new program provides continuity of care for ARJR patients who experience atypical pain after discharge from the Hospital.

acute pain medicine service volume 12,000

11,000 10,000

9,000 8,000

The RPM Pain Hotline also serves as a “safety net” so that our patient’s pain concerns never go unanswered. In 2010 there was a 277 percent increase in calls to the Pain Hotline, primarily due to the expansion of our RPM service to the outpatient population.

2006

2009

2010

2008–2010

1,200

900

Division of Musculoskeletal and Interventional Pain Management

Under the direction of Dr. Seth Waldman, the CPS staff provided care to over 15,000 patients in 2010. Our team treated 8,288 outpatients and

2008

1,500

600

The Division of Musculoskeletal and Interventional Pain Management, known internally as the Chronic Pain Service (CPS), provides consultation, assessment and specialized treatment to patients in need of extended pain management care.

2007

recuperative pain medicine service volume

VLADIMIR KRAMSKIY, MD

Medical Director Ambulatory Recuperative Pain Medicine

2006–2010

2008

2009

2010

division of musculoskeletal and interventional pain management volume 2006–2010 20,000

15,000

10,000

5,000

2006

2007

2008

2009

2010

MY PAIN MANAGEMENT DOCTOR IS OUTSTANDING. HE LISTENED TO MY CONCERNS AND MADE SURE I WAS COMFORTABLE WITH MY PAIN MANAGEMENT PLAN. HE IS ONE OF—IF NOT THE MOST—COMPASSIONATE PHYSICIANS I HAVE EVER MET.

—EXCERPT FROM A 2010 PRESS GANEY PATIENT SURVEY

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The Department of Anesthesiology Research Assistant team

3,689 inpatients, a growth of 32 percent and 26 percent respectively, and the special procedures unit SETH WALDMAN, MD also experienced Medical Director, Chronic Pain Medicine an increase in volume. In our clinic, a weekly program directed and managed by Dr. Semih Gungor, we provided outreach and pain control to hundreds of patients.

One of the CPS highlights of 2010 was the development of our Chronic Pain Registry. This ongoing effort, supported by an NIH grant, ensures HSS’ integration into a tri-institutional CP registry. It will provide our pain clinicians with much needed statistical information about chronic pain symptom development, treatment efficacy and patient outcomes.

As we work to provide a unique triad of pain management care via our Acute, Recuperative, and Chronic Pain Services, we look forward to continued collaboration with other hospital disciplines to provide our patients

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department of anesthesiology

with the best possible pain control throughout their hospitalization and recovery. â?Ż ANESTHESIA AND PAIN MEDICINE RESEARCH

The clinical research endeavors in the Department of Anesthesiology, under the direction of Director of Clinical Research Jacques Ya Deau, MD, PhD, are fundamental to our mission to advance the field of regional anesthesia through discovery and innovation.

achievement of our research goals.

Key to the success of our research program are our multi-disciplinary collaborations within HSS and beyond.

In 2010, we maintained a mutually advantageous formal collaboration with the HSS Epidemiology and Biostatistics Core and began a relationship with the Division of Biostatistics and Epidemiology of the Department of Public Health, Weill Cornell Medical College. These collaborations provide us with expert statistical, methodological, and epidemiological support for all aspects of our research.

Through our research, we attempt to gain a better understanding of how to best use regional In 2010, led by Clinical anesthetics and analgesics Research Manager Carey JACQUES YA DEAU, MD to provide optimal care to Medical Director, Ford, our dedicated team Clinical Research our patients. Subsequently, of research staff assisted publication of our in conducting 35 studies of varying research in prominent peer-reviewed protocol designs. journals allows these advances to be shared with the international Randomized Controlled anesthesia community. To this end, our Trials (RCT) commitment to support our physician Considered the gold standard in investigators in conducting high research methodology, we were proud quality research is paramount to the to have 16 active RCT studies in 2010.

highlights & strategic accomplishments Dr. Ya Deau spearheaded two interdisciplinary collaborations focusing on post-operative pain management.

Along with six of our attending anesthesiologists, Dr. Ya Deau established a formal ongoing collaboration with eight surgeons in the Adult Reconstruction and Joint Replacement Division, together forming the Total Joint Research Collaboration. The group meets regularly to discuss ways to improve pain-related patient outcomes, reduce length of stay in the hospital, and design the protocols that can lead to advances in patient care practices. The group is currently completing enrollment for a RCT entitled, “Analgesia and Total Knee Arthroplasty: Peri-Articular Injection vs Epidural + Femoral Nerve Blockade.”

THROUGH

additives can prolong the length of the nerve block post-operation to extend the time in which the patient experiences no pain.

Registries

science. Knowledge and data gained from these large scale observations is valuable when interpreted and analyzed, often leading to clinical studies and ultimately improvements in medical care.

Clinical research registries provide a wealth of clinical information and data to assist physicians in better understanding their patients.

Several years ago, Dr. Spencer Liu recognized the lack of clinical registries documenting the efficacy and safety of ultrasound-guided regional anesthesia in shoulder arthroscopy patients, prompting him to start his registry entitled “Prospective Registry of Regional Anesthesia for Ambulatory Shoulder Surgery.” The registry was completed in 2010 and enrolled a total of 1,669 patients. The data concluded

In 2010, Dr. Stavros Memtsoudis maintained a collaboration with colleagues to study data accessed from orthopaedic patient databases such as the National Hospital Discharge Survey, National Inpatient Sample Database and National Survey of Ambulatory Surgery. Using database research methodology, the research team was able to link certain complications related to intraoperative embolic phenomena to high rates of death. They found that mortality was highest in patients who developed acute respiratory disease, strokes, and pulmonary OUR RESEARCH, WE ATTEMPT TO GAIN embolisms, all of which could Dr. Ya Deau also A BETTER UNDERSTANDING OF HOW TO BEST be explained by established an effective intraoperative USE REGIONAL ANESTHETICS AND ANALGESICS research collaboration embolization of bone with foot and ankle marrow, cement TO PROVIDE OPTIMAL CARE TO OUR PATIENTS. sub-specialist surgeons, and bone debris to Dr. Matthew M. the pulmonary and Roberts and Dr. systemic circulation, David S. Levine. resulting in lung injury, increased that ultrasound-guided interscalene This collaboration stemmed from pulmonary pressures, and venostasis. and supraclavicular blocks are effective a discussion about the surgeons’ They were able to support this theory and safe for shoulder arthroscopy, post-operative analgesic concerns, by looking at clinical statistics such and that temporary and permanent particularly in the first and second as the pulmonary pressure increase neurological complications are post-operative days. Together, they are during hip arthroplasties. uncommon. currently conducting a study entitled, “Duration of Analgesia after Popliteal Dr. Memtsoudis’ database research Database Research Fossa Nerve Blockade: Effects of work on outcomes after bilateral knee Dexamethasone and Buprenorphine” Medical database research is a arthroplasty has advanced the field which examines the addition of a multidisciplinary field that requires of regional anesthesia, answering narcotic and/or steroid to the standard the collaboration of clinicians, questions such as: “Is it safe to stage regimen for nerve blockade. The aim statisticians, computer analysts and bilateral knee arthroplasties during of the study is to determine if the researchers interested in translational the same hospitalization?” In 2010,

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highlights & strategic accomplishments findings suggesting that complications may be increased with this approach influenced the new guidelines for bilateral total knee replacement at HSS. Using data from the research, Dr. Memtsoudis and his colleagues have authored a manuscript, currently in review, outlining risk factors for major complications among patients undergoing bilateral total knee replacement and calling for national guidelines on the topic. In addition, Dr. Memtsoudis published other papers analyzing outcomes in patients with sleep apnea and pulmonary hypertension which support our careful approach to these patients at HSS.

Research Fellowship In 2010, the Department awarded our first Research Fellowship to Anna Maria Bombardieri, MD, from the University of Florence, Italy.

Dr. Bombardieri’s primary research collaboration with Dr. Nigel Sharrock gave her the opportunity to study the design and implementation of the following protocols to evaluate the brain function during regional anesthesia using a Transcranial Doppler, a non invasive and reliable monitoring device: “Effect of Epinephrine Versus Phenylephrine on Transcranial Doppler Cerebral Blood Flow Velocity During Hypotensive Epidural Anesthesia”; “Cerebral Blood

Flow Velocity Evaluation During Spine Surgery, Shoulder Surgery and Total Knee Replacement” and “Transcranial Doppler Cerebral Blood Flow Velocity during Hypotensive Epidural Anesthesia.” ❯ SERVING AS THE MOST TRUSTED EDUCATOR

To provide exceptional patient care, we believe it is necessary to foster an environment in which the highest level of academic excellence is established. This is accomplished through the Department’s multiple academic endeavors, coordinated and spearheaded by Dr. David Lee, Medical Director, Education and Mary Hargett, Administrative Director, Education.

The cornerstone of our educational program is our Grand Rounds Lecture Series, which provides participants with a complete anesthesia educational program via speakers who are renowned experts in the field. 2010 highlights of our extensive Grand Rounds program included lectures by Dr. Christopher Wu, Johns Hopkins School of Medicine; Dr. Kenneth Drasner, University of California, San Francisco; and Dr. Sandra L. Kopp; Mayo Clinic. An expansive

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department of anesthesiology

highlights & strategic accomplishments series of Case Conferences, Journal Clubs, Complications’ Management Conferences, Interdisciplinary Panels, Research Seminars and Teaching Seminars rounded out the Department’s educational offerings in 2010.

To share our knowledge and expertise in the field of regional anesthesia, the Department offers an annual Regional Anesthesia Symposium entitled “Controversies and Fundamentals in Regional Anesthesia”. This course is designed to educate anesthesiologists, nurse anesthetists, residents and fellows in the practice of regional anesthesia for the orthopaedic surgical patient.

Our 14th Annual Symposium took place on Saturday, May 15th, 2010. The program, featuring guest faculty from Wake Forest Baptist Medical Center in North Carolina, focused on optimizing safety while maintaining resources in regional anesthesia practices during the next decade.

We also held several other successful educational conferences in 2010.

Our 4th Annual Pain Awareness and Management Symposium took place at HSS in September. This soldout course, primarily designed for clinicians involved in the treatment of acute pain, featured international experts in the field. Additionally, we continued our annual sponsorship of international conferences in Istanbul, Turkey, and Florence, Italy. Chaired

by Dr. Semih Gungor and Dr. Leonardo Paroli respectively, these conferences allow us to extend the HSS brand internationally and have been exceedingly well received by the European anesthesia community.

teachers of the year 2010

❮❮ Dr. Enrique Goytizolo, Fellows’ “Teacher of the Year,” 2010.

Dr. Goytizolo was a previous recipient of this award in 2006.

❮❮ Dr. Kethy Jules-Elysee, Weill Cornell Medical College Residents’ “HSS Teacher of the Year,” 2010.

Dr. Jules-Elysee previously received the same honor in 2007.

Departmental Training Programs “I learned so much and was able to work with some of the nicest Attending staff that I have ever met. This rotation was the best educational experience that I have had in residency.”

—2010 CA3 Rotating Resident ■ Residency Programs

The Department’s commitment to teaching residents, fellows and medical students is paramount. Our long-standing formal affiliation with Weill Cornell Medical College has remained the cornerstone of our residency program for more than two decades. We are also very proud of our educational affiliation with the residency program at Johns Hopkins Medicine, a program now in its ninth year. Over the past several years, we have also entered into new academic affiliations with the University of California-San Francisco, the University of Washington, Virginia Mason Medical Center, and Harvard Medical School-Massachusetts General Hospital. We are dedicated to these

relationships and to the opportunity to continually evaluate and improve the educational experience we provide to our residents.

■ Fellowship in Regional Anesthesiology and Acute Pain Medicine

Crucial to our educational mission to train the next generation of regional anesthesia consultants is our Regional Anesthesiology and Acute Pain Medicine Fellowship Program.

Our 2010 graduates, chosen from an application pool of over 60 excellent candidates, participated in a one-year fellowship allowing them to develop regional anesthesia-specific clinical expertise and a more academic approach to regional anesthesia. In 2010, we reached a milestone when our Department graduated HSS’ 75th Fellow in Regional Anesthesiology and Acute Pain Medicine.

Our Department has also led the initiative to formalize standards for regional anesthesia fellowships across North America. We are responsible

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highlights & strategic accomplishments specific software applications have been developed focusing on these central themes.

Highlights of our 2010 technology initiatives include the development of an Acute Postoperative Pain Clinical Registry, Anesthesia Records Archive and CliniCIS Rounding Report.

for creating and leading a group of Fellowship Directors who meet twice annually to work collaboratively on initiatives to improve the advanced training experience. As this national fellowship initiative marks its first decade, we continually evaluate and refine our program as interest in our subspecialty grows.

■ Medical Students

Along with our commitment to fellowship and residency programs, we also play an active role in the Weill Cornell Medical College medical student program and participate in an International Academic Observership Program in conjunction with the University of Florence in Italy. In 2010, we welcomed numerous medical students to the HSS campus, where they were given an introduction to the practice of regional anesthesia through specialized orientation and academic

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department of anesthesiology

In an effort to improve patient care by reducing pain after surgery, the IRBapproved Acute Postoperative Pain (AcutePOP) Clinical Registry was developed to track outcomes associated with the management of acute postoperative pain.

Under the direction of Dr. 2010 Fellows Spencer Liu, lead investigator of the clinical registry study, a programs. The students also had the new automated process was created to opportunity to visit our clinical settings extract data from HSS’ CliniCIS patient under the supervision of an attending database and transfer it into the newly staff member and fellow. created AcutePOP database. Through December 2010, the AcutePOP ❯ IMPROVING PATIENT CARE database collected information on THROUGH INFORMATION over 22,250 patient TECHNOLOGY visits, including 532,000 In conjunction with our laboratory results, physicians, staff and 1,050,000 orders, and the HSS Information 317,830 pain scores. The Technology Department, study of these patient our Information outcomes will allow us Technology (IT) Manager to improve patient care Mike Bieltz created by reducing pain after and developed many surgery.

MIKE BIELTZ IT projects designed to Anesthesiology To improve departmental align with the Hospital’s Department Information Technology Manager efficiency and productivity, strategic plan. The goals of the Anesthesia Records these IT initiatives include Archive and CliniCIS Rounding improving the quality of patient care Report were developed. The Anesthesia and increasing employee engagement, Records Archive significantly shortens productivity and efficiency. To date, anesthesia record retrieval time. more than 25 unique, department-

hss

anesthesiologists

around

Anesthesia records are now scanned and uploaded to a server daily, allowing our physicians and staff members to locate a record within seconds.

Our Acute Pain Service team uses the electronic CliniCIS Rounding Report to automate the collection of patient-controlled analgesia (PCA) information. Through the new report, daily patient PCA data is now available to the APS Team via CliniCIS, making it more readily accessible to all members of our patient care team.

the world

As part of our efforts to improve patient education and enhance the patient experience at HSS, in 2010 the following new and updated content was added to our website: “Safety and Side Effects” was created to address the most common concerns HSS patients expressed in a survey conducted regarding their anesthetic experience.

“Managing Your Surgical Pain” features information on our PACU, Acute Pain Service, and Recuperative Pain Service, including a listing of Pain Management FAQ’s.

“Pediatric Anesthesia and Pain Management” provides an overview of the anesthesia services available for our pediatric patients, discusses pain management options, and addresses the common anesthetic concerns of parents and caregivers. A list of helpful definitions is also provided.

“What to Expect” was expanded to include new articles about total shoulder arthroplasty and knee arthroscopy. ■

❯ Haitian Relief Medical Missions Attending Anesthesiologists Dr. Michael Urban, Dr. Douglas Green and Dr. Kethy Jules-Elysee participated in HSS’ first Medical Mission to Haiti shortly after the catastrophic earthquake in January 2010. HSS orthopaedic surgeons, anesthesiologists, and nurses performed more than 120 surgical procedures on those impacted by the earthquake. Junior Rigby, Chief Anesthesia Technician, coordinated the organization of anesthesia equipment and supplies for the mission, which lasted for four days.

Dr. Enrique Goytizolo and 20092010 Fellow Dr. Archana Apte traveled to the Dominican Republic on a second Medical Mission to aid victims of the Haitian earthquake in early February.

❯ Operation Smile

DR. DELPIZZO

Operation Smile, a charity organization that provides reconstructive surgery for children born with facial deformi-

ties such as cleft lip and cleft palate, has provided free surgeries to children around the world through the help of dedicated medical volunteers. In February 2010, Dr. Kathryn DelPizzo joined volunteers from Paraguay, Mexico, Peru, Ecuador, Canada and the USA on an Operation Smile mission in Nicaragua. Dr. DelPizzo provided anesthesia for babies and children undergoing surgery for the repair of facial deformities. In five days the team provided surgeries for 124 patients.

Dr. DelPizzo joined a second mission in Bolivia in October 2010, where a team of 80 volunteers from around the world provided reconstructive surgery to an additional 115 children.

❯ Braving the Northwest Passage Emmy-award winning filmmaker and HSS patient Sprague Theobald recently DR. WAGNER led a Northwest Passage sailing expedition which took a crew of sailors, divers and filmmakers from Newport, RI, to Seattle, WA, via the Arctic Circle. Their mission was to capture the adventure on film in dramatic and compelling ways that highlight environmental and political issues surrounding the Passage. Dr. Philip Wagner served as Expedition Physician for the five month adventure and continued to be involved with the project in 2010.

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department

growth

The Department of Anesthesiology was proud to announce the addition of four outstanding physicians to our staff in 2010: Sean Garvin, MD, Assistant Attending Anesthesiologist Dr. Garvin earned a medical degree with research honors from the University at Buffalo School of Medicine. He completed an internship and residency in anesthesiology at New York-Presbyterian Hospital/ Weill Cornell Medical College, where he was also chief resident. Dr. Garvin received the Distinguished Housestaff Award from Weill Cornell Medical College and the Joseph F. Artusio, MD, Award for Outstanding Resident in Anesthesiology.

In addition, he completed fellowships in Critical Care Medicine and Cardiothoracic Anesthesiology from Brigham and Women’s Hospital in Boston. Dr. Garvin is board certified in Anesthesiology, Critical Care Medicine, and Advanced Perioperative Transesophageal Echocardiography (TEE).

Vladimir N. Kramskiy, MD, Director, Ambulatory Recuperative Pain Medicine Dr. Kramskiy is the newest member of our Pain Medicine staff. He earned

his medical degree from Mount Sinai School of Medicine, completed a neurology residency at North ShoreLong Island Jewish Health System and a Pain and Palliative Care fellowship at Memorial Sloan-Kettering Cancer Center. Dr. Kramskiy then continued his education through the Tri-Institutional Interventional Pain Medicine Fellowship at Weill Cornell Medical Center, Memorial SloanKettering Cancer Center, and HSS, where he served as chief fellow. He is board certified in Neurology.

Fani Nhuch, MD, Assistant Attending Anesthesiologist Dr. Nhuch was honored as the Research Resident of the Year in Anesthesiology and given the E.M. Paper Memorial Award for the Outstanding Graduating Resident by the University of Miami/Jackson Memorial Hospital. She earned a medical degree from Pontificia Universidade Catolica do Rio Grande do Sol in Porto Alegre, Brazil. She completed an internship and residency at the University of Miami/Jackson Memorial Hospital and a fellowship in critical

care and cardiothoracic anesthesiology at Brigham and Women’s Hospital in Boston. Dr. Nhuch is board certified in Anesthesiology, Critical Care Medicine, and Advanced Perioperative Transesophageal Echocardiography (TEE).

Michael Nurok, MB, ChB, PhD, Assistant Attending Anesthesiologist Dr. Nurok served as an instructor in Global Health & Social Medicine and Anesthesia at Harvard Medical School, and has delivered presentations on medical ethics nationally and internationally. He earned a degree in Medicine from the University of Cape Town, South Africa, and a Ph.D. in Sociology from the Ecole des Hautes Etudes en Sciences Sociales in Paris. He completed a residency in Anesthesiology as well as fellowships in Thoracic Anesthesia, Cardiac Anesthesia, and Critical Care Anesthesia at Brigham and Women’s Hospital in Boston. Dr. Nurok is board certified in Anesthesiology, Critical Care Medicine and Advanced Perioperative Transesophageal Echocardiography (TEE).

❯ In addition to our new physicians, we welcomed 10 new staff members to our talented team in 2010.

Garrick Austin Anesthesia Technician James Bae, MS Research Assistant Susan Cardamone, MBA Assistant Administrative Director

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Kate Collins, MS, ANP-BC, RPM Nurse Practitioner

Elizabeth Garden Office Manager for Dr. Kramskiy

Michele Mangini-Vendel, DNP, ANCP-BC, CCRN, Nurse Practitioner

Cheryl Conwell, DNP(s), ANP-BC Nurse Practitioner

Raul Latchman Anesthesia Technician

Tara Thompson Research Assistant

department of anesthesiology

Dana Libov Scheduling Coordinator

professional

staff &

ANESTHESIOLOGIST-IN-CHIEF AND DIRECTOR Gregory A. Liguori, MD ATTENDING ANESTHESIOLOGISTS Spencer S. Liu, MD Medical Director, Acute and Recuperative Pain Medicine Nigel E. Sharrock, MB, ChB ASSOCIATE ATTENDING ANESTHESIOLOGISTS Stephen N. Harris, MD Stavros G. Memtsoudis, MD, PhD Jeffrey Y.F. Ngeow, MD Cephas P. Swamidoss, MD, MPH Michael K. Urban, MD, PhD Medical Director, PACU William F. Urmey, MD Victor M. Zayas, MD Director, Pediatrics ASSISTANT ATTENDING ANESTHESIOLOGISTS Jonathan C. Beathe, MD Director, Training Programs James D. Beckman, MD Devan D. Bhagat, MD Bradford E. Carson, MD Mary F. Chisholm, MD Kathryn DelPizzo, MD Christopher A. DiMeo, MD Chris R. Edmonds, MD Medical Director, Quality Sean Garvin, MD Michael A. Gordon, MD Enrique A. Goytizolo, MD Douglas S.T. Green, MD Semih Gungor, MD Medical Director, Chronic Pain Research Michael C. Ho, MD Kethy M. Jules-Elysee, MD Richard L. Kahn, MD Medical Director, Ambulatory Surgery

administrative

David H. Kim, MD Richard S. King, MD Vladimir N. Kramskiy, MD Medical Director, Ambulatory Recuperative Pain Medicine Vincent R. LaSala, MD Andrew C. Lee, MD Medical Director, Clinical Initiatives David L. Lee, MD Medical Director, Education Yi Lin, MD, PhD

Daniel B. Maalouf, MD, MPH John G. Muller, MD Fani Nhuch, MD Michael Nurok, MB ChB, PhD Joseph Oxendine, MD Leonardo Paroli, MD, PhD Thomas J. Quinn, MD, MBA Daniel I. Richman, MD James J. Roch, MD Lauren Turteltaub, MD Assistant Director, Training Programs

staff accolades 2010

In 2010, the Department was honored to have two staff members selected as HSS Employee of the Month. We were delighted to join the Hospital in recognizing the outstanding contributions of Grell Barnes, May 2010 Employee of the Month, and Kenneth Van Ora, July 2010 Employee of the Month.

❮❮ Grell Barnes has been a member of the HSS family since December 2004. As an Anesthesia Technician, Grell ensures our ability to provide the highest level of patient care by preparing and stocking our operating rooms before our cases. He is eternally cheerful and always respectful. Grell’s sense of teamwork and dedication are truly an asset to the Department.

❮❮ Kenneth Van Ora, RPA-C, a Physician Assistant in the PACU, has been a member of the HSS family since November 2008. Ken’s excellent clinical skills, positive demeanor and tireless work ethic contribute to an outstanding patient experience at HSS.

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professional & administrative staff Philip J. Wagner, MD Director, Website Seth A. Waldman, MD Medical Director, Chronic Pain Medicine David Y. Wang, MD, MS, MPH Medical Director, Chronic Pain Education Jacques T. Ya Deau, MD, PhD Medical Director, Clinical Research 2009-2010 FELLOWS IN REGIONAL ANESTHESIOLOGY AND ACUTE PAIN MEDICINE Archana Apte, MD Kaili T. Dilts, MD Russell M. Flatto, MD Jason Jacobs, MD Benjamin Kong, MD Karlyn R. Powell, MD Kimberly M. Richardson, MD Anna C. Westrick, MD 2010-2011 FELLOWS IN REGIONAL ANESTHESIOLOGY AND ACUTE PAIN MEDICINE Cindy Chen, MD Carrie R. Guheen, MD Cassie Kuo, MD Lei Li, MD Jiabin Liu, MD PhD Marco Lotano, MD Asha Manohar, MD Dawn Yan, MD 2010-2011 ANESTHESIA RESEARCH FELLOW Anna Maria Bombardieri, MD, PhD ADMINISTRATIVE DIRECTOR Roberta Stack, MS ADMINISTRATION Mary J. Hargett, BS Administrative Director, Education Susan Cardamone, MBA Assistant Administrative Director Maureen Stanton, RN Manager, QA/PI Ilene Bacine Manager, Finances Mike Bieltz, MBA Manager, Information Technology Sarah Kennedy Coordinator, QA/PI Dana Libov Scheduling Coordinator Sheryl Stebel Administrative Assistant to Dr. Liguori Ellen Segal Staff Secretary

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PAIN MEDICINE Barbara Wukovits, RN, BSNC Director, Pain Services Acute Pain Mary Kelly, RN, BC, ONC Evening Nurse Coordinator Erin Hutton, RN, BSN, MA, ONC Eileen Moynihan, RN Recuperative Pain Brian Philips, MS, RN, FNP Assistant Director RPM Kaitlin Collins, MS, ANP-BC Chronic Pain Donna Lawrence, NP Neiza Lugo Registrar/Billing Dr. Gungor’s Office Elvi Taveras Office Manager Mozelle LaFleur, LPN Dr. Kramskiy’s Office Elizabeth Garden Office Manager Dr. Ngeow’s Office Susan Ngeow, CPA Office Manager Cyndi Ma Secretary Sherrene Wan Secretary Dr. Richman’s Office Audrey Bucknor Office Manager Alexandra Jacobs, RN, BSN, MA Lilia Macias Secretary Yvette Staff Secretary Dr. Waldman’s Office Bonnie Urquhart Office Manager Diane Leistman, RN Dr. Wang’s Office Sandra Simpson, LPN Office Manager Annette Villafane Staff Secretary

RESEARCH Carey Ford, CCRC Manager, Research Pamela Shaw Assistant Coordinator, Research Senior Research Assistants Valeria Buschiazzo George Go Jennifer Stanton Gordon Research Assistants James Bae, MS Raymond Daniel Dorothy Marcello Matthew Rade Sarah Wilfred Tara Thompson Ansara Vaz Steffan Wolfe NURSE ANESTHETISTS Donna Hasil, CRNA Chief CRNA Carol Bohne, CRNA Elizabeth Caliwara, CRNA Claire Karlick, CRNA Sara Listokin, CRNA Mary Maher, CRNA Lisa Nigro, CRNA Sesle Olsen, CRNA Niles Perlas, CRNA NURSE PRACTITIONERS Cheryl Conwell, DNP(s), ANP-BC Michele Mangini-Vendel, DNP, ANCP-BC, CCRN PHYSICIAN ASSISTANTS Christy Loughlin, RPA-C, PA Service Manager, PACU Kelly Culot, RPA-C Michael Lichardi, RPA-C Kenneth Van Ora, RPA-C ANESTHESIA TECHNICIANS Junior Rigby Supervisor/Chief Anesthesia Technician Garrick Austin Grell Barnes Raymond Daniels Raul Latchman Hector Pineda

notable 2010

achievements

AWARDS AND SPECIAL RECOGNITION Christopher A. DiMeo, MD Guest Lecturer, First Annual Intensive Ultrasound-Based Regional Anesthesia Conference, Long Island, NY Enrique Goytizolo, MD Fellows’ “Teacher of the Year” Award, 2010 Invited Speaker, Winter Anesthesiology Conference, Cochin, India Invited Speaker, II International Symposium of Regional Anesthesia, Trujillo, Peru Invited Speaker, Annual Meeting of the Brazilian Society of Anesthesia, Porto Alegre, Brazil Semih Gungor, MD Invited Speaker, AnestezIstanbul Conference, Istanbul, Turkey Invited Speaker, Current Concepts and Controversies in Orthopaedic Surgery, Ankara, Turkey Kethy Jules-Elysee, MD Cornell Residents’ “Teacher of the Year” Award, 2010

Spencer S. Liu, MD Invited Speaker, Department of Anesthesiology, University of Maryland, Baltimore, MD Invited Speaker, Annual Meeting American Society of Anesthesiologists, San Diego, CA Invited Speaker, Annual Meeting of the American Society of Regional Anesthesia, Toronto, Canada Invited Speaker, Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, MA Stavros Memtsoudis, MD Best Poster Selection (3rd place), European Hip Society Meeting, Athens, Greece Visiting Professor, Department of Anesthesi ology and Critical Care, University of Massachusetts Medical Center Visiting Professor, Anesthesiology Grand Rounds, Brigham and Women’s Hospital Invited Speaker, European Hip Society Meeting 2010, Athens Greece

Jeffrey Ngeow, MD Invited Speaker, AnestezIstanbul Conference, Istanbul, Turkey Invited Speaker, International Marketing Group, Pfizer Company Listed in New York Magazine’s “Best Doctors” Edition Featured in public service announcement, Reflex Sympathetic Dystrophy Syndrome Association Nigel E. Sharrock, MB ChB Invited Speaker, AnestezIstanbul Conference, Istanbul, Turkey Michael K. Urban, MD Guest Lecturer, Auckland, New Zealand, Anesthesia Society Visiting Professor, Hartford Hospital, Hartford, CT Invited Participant, European Society of Spinal Surgery Update Seth A. Waldman, MD Director-at-Large, New York Society of Interventional Pain Physicians Invited Speaker, Second International Headache Summit, Tel Aviv, Israel

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notable achievements Certification by the World Institute of Pain, Fellow of Interventional Pain Practice (FIPP) Listed in New York Magazine’s “Best Doctors” Edition Jacques Ya Deau, MD, PhD Invited Speaker, AnestezIstanbul Conference, Istanbul, Turkey Invited Speaker, Joint Anesthesia/ Arthroplasty Conference, Hospital for Special Surgery Guest Lecturer, HSS Physical Therapy and Rehabilitation Grand Rounds William F. Urmey, MD Invited Speaker, ASA Annual Meeting, San Diego, CA Invited Speaker, ASRA Annual Meeting, Toronto, Canada Invited Speaker, SMART Congresso, Simposio Mostra Anestesia Rianimazione E Terapia Intensiva, Milan, Italy Invited Speaker, 3rd SIMPAR San Matteo International Meeting on Pain Research, Pavia, Italy Invited Speaker, 64th Post Graduate Assembly of the New York State Society of Anesthesiologists, New York, NY

LEADERSHIP POSITIONS AND APPOINTMENTS Jonathan C. Beathe, MD Member, ASA Advisory Council Semih Gungor, MD Symposium Chair, International Anesthesia Symposium, Istanbul, Turkey David L. Lee, MD Member, Medical School Admissions Committee, Weill Cornell Medical College Spencer S. Liu, MD Examiner, American Board of Anesthesiology Chair, Committee for American Society of Regional Anesthesia and Pain Medicine AQI Taskforce Jeffrey Ngeow, MD Member, Review Committee for Grant Application, Cornell Clinical and Translational Science Center Member, Pain Committee, New York State Society of Anesthesiologists William F. Urmey, MD Board of Directors, American Society of Regional Anesthesia and Pain Medicine Chair, Distinguished Service Award Committee, American Society of Regional Anesthesia and Pain Medicine

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department of anesthesiology

EDITORIAL APPOINTMENTS Jonathan Beathe, MD Scientific Reviewer, Journal of Clinical Anesthesiology Gregory A. Liguori, MD Associate Editor, Regional Anesthesia and Pain Medicine Associate Editor, Anesthesia and Analgesia Spencer S. Liu, MD Senior Editor, ABA/ASA Joint Council on In-Training Examinations Editor, Regional Anesthesia & Pain Medicine Section Editor, Pain Medicine, Anesthesia & Analgesia Stavros Memtsoudis, MD Scientific Reviewer, Anesthesiology Scientific Reviewer, Anesthesia and Analgesia Scientific Reviewer, Clinical Anatomy Scientific Reviewer, The Journal of Thoracic and Cardiovascular Surgery Scientific Reviewer, Critical Care Scientific Reviewer, Journal of Clinical Orthopaedics and Related Research Scientific Reviewer, Cleveland Clinic Journal of Medicine Scientific Reviewer, Journal of Clinical Anesthesiology Scientific Reviewer, Annals of Thoracic Surgery

Scientific Reviewer, Journal of Critical Care Medicine Scientific Reviewer, HSS Journal William F. Urmey, MD Scientific Reviewer, Anesthesiology Scientific Reviewer, Regional Anesthesia & Pain Medicine Seth A. Waldman, MD Scientific Reviewer, The Medical Letter Jacques Ya Deau, MD, PhD Scientific Reviewer (Top Reviewer), Anesthesia and Analgesia Scientific Reviewer, Regional Anesthesia and Pain Medicine Scientific Reviewer, HSS Journal

GRANTS “Comparative Effectiveness of Interventions for Chronic Pain Management.”

National Institute of Health RC2 Award November 2009–November 2011 Principal Investigator: Charles Inturrisi, PharmD; Weill Cornell Medical College Co-Investigators: Semih Gungor, MD, and Seth A. Waldman, MD The goals of this project are to establish a retrospective chronic pain data registry for patients of four New York City academic hospital-based pain clinics that employ

interdisciplinary pain management treatments; use Practice Based Evidence (PBE) methodology to create a comprehensive, prospective chronic pain data registry, using the retrospective registry as a foundation; and use both registries to identify specific pain management interventions that are most effective for specific patient types with chronic pain.

“Chronic Pain Management Costs in a Multi-Institutional Patient Registry.”

Clinical and Translational Science Center (CTSC) Pilot Award June 1, 2010–May 31, 2012 Principal Investigator: Bruce R. Schackman, PhD, Weill Cornell Medical College Co-Investigators: Semih Gungor, MD and Seth A. Waldman, MD In collaboration with Dr. Inturrisi’s NIH sponsored chronic pain registry, this project will collect cost information from a subset of patients across the four institutions.

“Implementation of Electronic Medical Records to Initiate a Chronic Pain Registry.”

Clinical and Translational Science Center (CTSC) Pilot Award June 1, 2010- May 31, 2012 Principal Investigator: Seth A. Waldman, MD Conversion of paper based office charts to electronic format enabling participation in the NIH sponsored chronic pain registry lead by Dr. Inturrisi. Registry will include detailed patient characteristics (including severity of illness) and assessments, treatments, interventions and outcomes data that have been standardized across four participating pain clinics during the first year of the project.

2010 SELECTED PUBLICATIONS Original Articles Bang H, Chiu YL, Memtsoudis SG, Mandl LA, Gonzalez-DellaValle A, Mushlin AI, Marx RG, Mazumdar M. Hip and knee arthroplasties: Trends and disparities revisited. American Journal Orthopaedics 2010 Sept; 39(9): E95 [Epub ahead of print].

Edmonds CR, Liguori GA, Stanton M, Kennedy S. Eliminating Wrong-Site Peripheral Nerve Blocks. HANYS 2010 Profiles In Quality and Patient Safety: 4.

Jules-Elysee K, Lipnitsky J, Patel N, Anastasian G, Urban MK, Sculco TP. Use of low dose steroids in decreasing cytokine release during bilateral total knee replacement. Regional Anesthesia and Pain Medicine 2011; 36: 36-40.

notable achievements Liu S, Ngeow J, John RS. Evidence basis for ultrasound guided block characteristics: Onset, Quality, and Duration. Regional Anesthesia and Pain Medicine 2010 MarApril 35 (2): S26-S42.

Liu SS, Bieltz M, Wukovits B, John RS. Prospective survey of patient controlled epidural analgesia with bupivacaine and hydromorphone in 3,736 postoperative orthopaedic patients. Regional Anesthesia and Pain Medicine 2010; 35 (4): 351-4.

Liu SS, Chisholm MF, John RS, Ngeow J, Ma Y, Memtsoudis SG. Risk of postoperative hypoxemia in ambulatory orthopaedic surgery patients with diagnosis of obstructive sleep apnea: A retrospective observational study. Patient Safety in Surgery 2010 Jun 21: 4(1): 9.

Liu SS, Chisholm MF, Ngeow J, John RS, Shaw P, Ma Y, Memtsoudis SG. Postoperative hypoxemia in orthopaedic patients with obstructive sleep apnea. HSS Journal: The Musculoskeletal Journal of Hospital for Special Surgery (accepted for publication).

Liu SS, Gordon MA, Shaw PM, Wilfred S, Shetty T, Ya Deau JT. Prospective clinical registry of ultrasound guided regional anesthesia for ambulatory shoulder surgery. Anesthesia & Analgesia 2010 Sep; 111 (3): 617-23.

Liu SS, John RS. Modeling cost of ultrasound versus nerve stimulator guidance for nerve blocks with sensitivity analysis. Regional Anesthesia and Pain Medicine 2010 Jan-Feb 35(1): 57-63.

Ma Y, Passias P, Gaber-Bylis LK, Girardi FP, Memtsoudis SG. Comparative in-hospital morbidity and mortality after revision versus primary thoracic and lumbar spine fusion. Spine Journal 2010 Oct; 10(10): 881-9.

Marawar A, Girardi FP, Sama AA, Ma Y, Gaber L, Besculides M, Memtsoudis SG. National trends in anterior cervical fusion procedures. Spine 2010 Jul 1;35(15):1454-9.

Memtsoudis SG, Bombardieri AM, Walz JM, Ma Y, Chiu YL, Mazumdar M. Mortality of patients with respiratory insufficiency and adult respiratory distress syndrome after surgery: The obesity paradox. Journal of Intensive Care 2011 (accepted with revision).

Memtsoudis SG, González Della Valle A, Besculides MC, Esposito MA, Gaber LK, Koulouvaris P, Salvati E. Risk factors for perioperative mortality after lower extremity arthroplasty: A population based study of 6,901,324 patient discharges. Journal of Arthroplasty 2010 Jan; 25 (1): 19-26

Memtsoudis SG, Gonzalez-DellaValle A, Jules-Elysee K, Poultsides L, Reid S, Starcher B, Ma Y, Sculco TP. Perioperative inflammatory response in total knee arthroplasty patients: impact of limb preconditioning. Regional Anesthesia and Pain Medicine 2010 Sep-Oct; 35 (5): 412-6.

Memtsoudis SG, Hughes A, Ma Y, Chiu YL, Sama AA, Girardi FP. Increased complication rates after primary posterior versus anterior cervical spine fusion.

Clinical Orthopaedics and Related Research 2010 Sep 9. [Epub ahead of print].

Memtsoudis SG, Kuo C, Ma Y, Edwards A, Mazumdar M, Liguori GA. Changes in anesthesia related factors in ambulatory knee and shoulder surgery: United States 1996-2006. Regional Anesthesia and Pain Medicine 2011 (accepted for publication).

Memtsoudis SG, Liu SS, Ma Y, Chiu YL, Walz JM, Mazumdar M. Perioperative pulmonary outcomes in patients with sleep apnea after non-cardiac surgery.

Anesthesia & Analgesia 2011 Jan; 112(1): 113-21.

Memtsoudis SG, Ma Y, Chiu YL, Walz JM, Voswinkel R, Mazumdar M. Perioperative mortality in patients with pulmonary hypertension undergoing major joint replacement. Anesthesia & Analgesia 2010 Nov; 111 (5): 1110-6.

Memtsoudis SG, Ma Y, González Della Valle A, Besculides MC, Gaber LK, Koulouvaris P, Liu SS. Demographics, outcomes and risk factors for adverse events associated with primary and revision hip arthroplasties in the United States.

American Journal of Orthopaedics 2010 Aug;39(8):E72-E77.

Memtsoudis SG, Salvati EA, Go G, Ma Y, Sharrock NE. Perioperative pulmonary circulatory changes during bilateral total hip arthroplasty under regional anesthesia.

Regional Anesthesia and Pain Medicine 2010 Sep-Oct; 35 (5): 417-21.

Memtsoudis SG, Starcher B, Ma Y, Buschiazzo V, Urban MK, Girardi FP. The utility of urine desmosine as a marker of lung injury in spine surgery. HSS Journal: The Musculoskeletal Journal of Hospital for Special Surgery 2010; 6: 160-63.

Memtsoudis SG, Vougioukas VI, Ma Y, Gaber-Byliss LK, Girardi FP. Perioperative morbidity and mortality after anterior, posterior and anterior/posterior spine fusion surgery. Spine 2010 May 5 [Epub ahead of print]

Nurok M, Czeisler CA, Lehmann LS. Sleep deprivation, elective surgical procedures, and informed consent. N Engl J Med. 2010 Dec 30;363(27):2577-9.

PubMed PMID: 21190452.

Nurok M, Lipsitz S, Satwicz P, Kelly A, Frankel A. A novel method for reproducibly measuring the effects of interventions to improve emotional climate, indices of team skills and communication, and threat to patient outcome in a high-volume thoracic surgery center. Arch Surg. 2010 May;145(5):489-95. PubMed PMID: 20479349.

Nurok M, Eslick I, Carvalho CR, Costabel U, D’Armiento J, Glanville AR, Harari S, Henske EP, Inoue Y, Johnson SR, Lacronique J, Lazor R, Moss J, Ruoss SJ, Ryu JH, Seyama K, Watz H, Xu KF, Hohmann EL, Moss F. The International LAM Registry: a component of an innovative web-based clinician, researcher, and patient-driven rare disease research platform. Lymphat Res Biol. 2010 Mar;8(1):81-7. PubMed PMID: 20235890.

Philips BD, Liu SS, Wukovits B, Boettner F, Waldman S, Liguori G, Goldberg S, Goldstein L, Melia J, Hare M, Jasphey L, Tondel S. Creation of a novel recuperative pain medicine service to optimize postoperative analgesia and enhance patient satisfaction. HSS Journal: The Musculoskeletal Journal of Hospital for Special Surgery 2010 Feb; 6 (1): 61-65.

Rade, MC, Ya Deau JT, Ford C, Reid MC. Postoperative delirium in elderly patients after elective hip or knee arthoplasty performed under regional anesthesia. HSS Journal: The Musculoskeletal Journal of Hospital for Special Surgery; Accepted: January 2011 Sinha SK, Abrams JH, Barnett JT, Muller JG, Lahiri B, Bernstein BA, Weller RS . Decreaseing the local anesthetic volume from 20 to 10 mL for ultrasoundguided interscalene block at the cricoid level does not reduce the incidence of hemidiaphragmatic paresis. Regional Anesthesia and Pain Medicine 2011 JanFeb; 36 (1): 17-20.

Su EP, Chatzoudis N, Sioros V, Go G, Sharrock NE. Markers of thrombin generation during resurfacing and noncemented total hip arthroplasty. Clinical Orthopaedic and Related Research 2011; 469: 535-540.

Urmey WF. Electrical stimulation and ultrasound in regional anesthesia. European Journal of Pain Supplements 2010 Nov; 4 (4): 319-322.

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notable achievements Walz JM, Memtsoudis SG, Heard ST. Prevention of central venous catheter bloodstream infections. Journal of Intensive Care Medicine 2010 May-Jun; 25 (3): 131-8.

Letters Kahn RL, Quinn, T. “Minimizing Seizure Incidence During Peripheral Nerve Blockade.” Regional Anesthesia and Pain Medicine. Volume 35, Number 3, May-June 2010 Memtsoudis SG, Gonzalez Della Valle A, Mazumadar M. Don’t patients have 2 knees? Reply Letter to Editor.

Anesthesiology 2010; 113 (1): 257-8 Memtsoudis SG, Sharrock NE. Duration of clopidogrel therapy with drug-eluting stents. New England Journal of Medicine 2010 Jul 29; 363 (5):488-490.

Ramlogan R, Manickam B, Chan VWS, Liang L, Adhikary SD, Liguori GL, Hargett MJ, Brull R. Challenges and training tools associated with the practice of ultrasound-guided regional anesthesia: A survey of the American Society of Regional Anesthesia and Pain Medicine. Regional Anesthesia and Pain Medicine 2010 MarchApril; 35 (2): 224.

Abstracts and Presentations Bombardieri AM, Go G, Drummond JC, Sharrock NE. Cerebral blood flow velocity is preserved under hypotensive epidural anesthesia. American Society of Anesthesiologists (ASA) Annual Meeting 2010, October, San Diego, CA. Bombardieri AM, Go G, Memtsoudis SG, Sharrock NE. Pulmonary circulatory changes in patients after bilateral total knee arthroplasty. 64th Postgraduate Assembly in Anesthesiology, December, New York, NY. Bombardieri AM, Go G, Sharrock NE. Changes in cerebral blood flow velocity during epidural injection. European Society Regional Anesthesia, September, Porto, Portugal.

Bombardieri AM, Go G, Drummond J, Sharrock NE. Cerebral blood flow velocity is preserved under hypotensive epidural anesthesia in controlled hypertensive patients. 64th Postgraduate Assembly in Anesthesiology, December, New York, NY. Bombardieri AM, Go G, Sharrock NE. Changes in cerebral blood flow velocity during epidural injection. 64th Postgraduate Assembly in Anesthesiology, December, New York, NY.

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Bombardieri AM, Ma Y, Chiu YL, Mazumdar M, Memtsoudis SG. Perioperative pulmonary complications in patients with sleep apnea after abdominal surgery. American Society of Anesthesiologists (ASA) Annual Meeting 2010, October, San Diego, CA. Bombardieri AM, Walz JM, Ma Y, Chiu YL, Mazumdar M, Memtsoudis SG. Mortality of patients with respiratory insufficiency and acute respiratory distress syndrome after surgery: The obesity paradox.

American Society of Anesthesiologists (ASA) Annual Meeting 2010, October, San Diego, CA. DiMeo CH, Cameron A, Cook C, Zayas V, Marcello D. Supraclavicular vs interscalene brachial plexus block for shoulder surgery.

American Society of Regional Anesthesia and Pain Medicine (ASRA) 2010 Annual Meeting, April, Toronto, Canada.

Gritsenko K, Marcello D, Jules-Elysee K, Liguori G. Incidence of meningitis or epidural abscess in patients undergoing neuraxial block for removal of infected prosthesis in hips and knees. American Society of Regional Anesthesia and Pain Medicine (ASRA) 2010 Annual Meeting, April, Toronto, Canada.

Jules-Elysee K, Reid S, Edmonds C, Kahn R, Urban M. Effects of interscalene block on the diaphragm. American Society of Regional Anesthesia and Pain Medicine (ASRA) 2010 Annual Meeting, April, Toronto, Canada.

Jules-Elysee K, Wilfred SE, Memtsoudis SG, Kim D, Urban MK, Ya Deau JT, McLawhorn A, Sculco TP. Effect of steroids given over 24 hours on cytokine release and urinary desmosine level in patients undergoing bilateral total knee replacement. 2010 Knee Society Members Meeting, September, Rochester, MN. Kuo C, Edwards A, Ma Y, Liguori G, Mazumdar M, Memtsoudis SG. Trends in anesthetic variables in ambulatory surgery: United States 1996-2006. 64th Postgraduate Assembly in Anesthesiology, December, New York, NY. Liu SS, Chisholm MF, John RS, Ngeow J, Ma Y. Risk of postoperative hypoxemia in ambulatory orthopaedic surgery patients with diagnosis of obstructive sleep apnea.

American Society of Regional Anesthesia and Pain Medicine (ASRA) 2010 Annual Meeting, April, Toronto, Canada.

Liu SS, Gordon MA, Shaw P, Wilfred S, Ya Deau JT. Does intraneural needle placement during ultrasound guided block increase risk of nerve injury? American Society of Anesthesiologists (ASA) Annual Meeting 2010, October, San Diego, CA.

Liu SS, Ya Deau JT, Shaw P, Wilfred S, Gordon MA. Cerebral oximetry in patients undergoing shoulder arthroscopy in the sitting position. American Society of Anesthesiologists (ASA) Annual Meeting 2010, October, San Diego, CA. Muller J, Ma Y, Chiu YL, Muller J, Mazumdar M, Poultsides L, Memtsoudis SG. The prevalence of comorbidities in patients with pulmonary hypertension undergoing total knee arthroplasty.

American Society of Anesthesiologists (ASA) Annual Meeting 2010, October, San Diego, CA. Poultsides L, Gonzalez DellaValle A, Memtsoudis S, Roberts T, Sharrock N, Salvati E. Systematic review of cause of death following elective THR and TKR performed with different thromboprophylaxis regimens. European Hip Society Meeting 2010, September, Athens, Greece.

Poultsides L, Ma Y, Gonzales DellaValle A, Chiu YL, Gaver-Baylis L, Mazumdar M, Sculco TP, Memtsoudis SG. In-hospital surgical site infection after primary total hip and knee arthroplasty - Incidence and risk factors. European Hip Society Meeting 2010, September, Athens, Greece.

Poultsides LA, Ma Y, Gonzalez Della Valle A, Chiu YL, Gaber-Baylis L, Mazumdar M, Sculco TP, Memtsoudis SG. In-hospital surgical site infection after primary total hip and knee arthroplasty Incidence and risk factors. European Bone and Joint Infection Society Meeting 2010, September, Heidelberg, Germany

notable achievements Liguori GA. “Hemodynamic Complications.”

Complications in Regional Anesthesia and Pain Medicine, 2nd Edition, Eds. Neal JM, Rathmell JP, Saunders, Philadelphia (in progress) Memtsoudis SM. “Critical Care Issues in the patient after lower extremity arthroplasty.” Protocols in Critical Care, Ed. Rodriguez VS, Marban, Spain. (in press) Ngeow JY, Wang DY. “Low Back Pain.”

Anesthesiology: Problem Oriented Pain Management, 7th Edition, Eds. Yao F, Fontes M, Malhotra V, Lippincott, Williams & Wilkins, Philadelphia (in progress).

Ngeow JY, Wang DY. “Nerve Blocks of the Lower Extremity.” Anesthesiology: Problem Oriented Patient Management, 7th Edition, Eds. Yao F, Fontes M, Malhotra V, Lippincott, Williams & Wilkins, Philadelphia (in progress).

Rade M, Go G, Ma Y, Sharrock NE, Memtsoudis SG. Perioperative pulmonary circulatory changes during bilateral total hip arthroplasty. American Society of Regional Anesthesia and Pain Medicine (ASRA) 2010 Annual Meeting, April, Toronto, Canada.

Sculco TP, Jules-Elysee K, Wilfred SE, Memtsoudis SG, Kim D, Urban MK, Ya Deau JT, McLawhorn AS. Steroid modulation on cytokine release and desmosine level in bilateral total knee replacement. The American Academy of Orthopaedic Surgeons 2011 Annual Meeting, February, San Diego, CA

Ya Deau JT, Rade M, Lin Y, Coleman S, Kelly B, Kim D. Antiemetic prophylaxis for postdischarge nausea and vomiting after hip arthroscopy. International Anesthesia Research Society (IARS) 2010 Annual Meeting, March, Honolulu, Hawaii Ya Deau JT, Rade M, Liu S, Gordon M, Liguori GL. Performance characteristics of the opioid related symptom distress scale after orthopaedic surgery. American Society of Regional Anesthesia and Pain Medicine (ASRA) 2010 Annual Meeting, April, Toronto, Canada.

Book Chapters

Westrick A, Gonzalez-DellaValle A, Ma Y, Stanton J, Memtsoudis SG. The perioperative inflammatory response in total knee arthroplasty patients: The impact of limb preconditioning. American Society of Regional Anesthesia and Pain Medicine (ASRA) 2010 Annual Meeting, April, Toronto, Canada

Beathe JC. “Knee Arthroscopy.” Essence of Anesthesia Practice, 3rd Edition, Eds. Roizen MF, Fleisher LE, Elsevier, Philadelphia, 2011.

Westrick A, Ma Y, Chiu YL, Mazumdar M, Memtsoudis SG. Perioperative pulmonary complications in patients with sleep apnea after lower extremity arthroplasty. American Society of Regional Anesthesia and Pain Medicine (ASRA) 2010 Annual Meeting, April, Toronto, Canada.

Gordon M. “Anesthesia for Hand Surgery.” Green’s Operative Hand Surgery, 6th Edition, Eds. Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Churchill Livingstone, Philadelphia, 2011.

Wukovits B, Kelly M, Urban M, Liu S. A review of twenty year experience of an acute pain service (APS) in an orthopaedic specialty hospital. 31st Annual Congress of the National Association of Orthopaedic Nurses, May 2010, Baltimore, MD.

Beathe JC. “Regional Anesthesia Education.” Practical Regional Anesthesia, Ed. AD Kaye, N Vadivelu and R Urman, Springer, New York (in press).

Kehlet H, Liu SS. “Postoperative Pain.”

American College of Surgeons: ACS Surgery: Principles and Practice, Eds. Souba W, Fink MP, Jurkovick GJ, WebMD Inc, New York (in press).

Turteltaub L, Cook C. “Anesthesia for Foot and Ankle Surgery.” Sports Medicine of the Foot and Ankle, Eds. Altchek D, Dines JS, Positano R, Lippincott, Philadelphia (on press).

Urban MK. “Orthopaedic Anesthesia.”

Miller’s Anesthesia, 7th Edition, Eds. Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL, Churchill Livingstone, Philadelphia, 2010.

Urban MK. “Knee Arthroplasty.” Essence of Anesthesia Practice, 3rd Edition, Eds. Roizen MF, Fleisher LE, Elsevier, Philadelphia (on press).

Urban MK. “Anesthesia for Complex Spine.”

Anesthesia en Cirugia Ortopedica y en Traumatologia. Madrid (on press).

Urban MK, Mackenzie RC. “Preoperative evaluation.” Perioperative Care of the Patient with Rheumatic Disease (in progress).

Urmey WF. “Brachial Plexus Block.”

Anesthesiology: Problem Oriented Patient Management, 7th Edition, Eds. Yao F, Fontes M, Malhotra V, Lippincott, Williams & Wilkins, Philadelphia (in progress).

Urmey WF. “Pulmonary Complications.”

Complications in Regional Anesthesia and Pain Medicine, 2nd Edition, Eds. Neal JM, Rathmell JP, Saunders, Philadelphia (in progress).

Waldman SA. “Medial Branch Blocks: Lumbar, Thoracic and Cervical.”

Interventional Pain Management, Eds. Deer T, Benzon H (in progress).

Ya Deau JT, Kong B. “Patient-controlled Analgesia.” Essentials of Pain Medicine, 3rd Edition, Eds. Benzon H, Srinivasa R, Fishman S, Liu S, Cohen S, Hurley R, Malik K, Narouze S, Elsevier, Philadelphia (in progress).

2010 Annual Report

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Department of Anesthesiology Hospital for Special Surgery 535 East 70th Street New York, NY 10021 www.hss.edu The 2010 Annual Report of the Department of Anesthesiology is produced by Hospital for Special Surgery's Department of Anesthesiology and Education & Academic Affairs.

Managing Editor Susan Cardamone, MBA Editor Bobby Stack, MS Contributors Mike Bieltz, MBA Kathryn DelPizzo, MD Carey Ford, CCRC Mary J. Hargett, BS Daniel B. Maalouf, MD, MPH Maureen Stanton, RN Barbara Wukovits, RN Design Christina Fisher, MFA Photography Robert Essel George Go Brad Hess About Hospital for Special Surgery Founded in 1863, Hospital for Special Surgery (HSS) is a world leader in orthopaedics, rheumatology and rehabilitation. HSS is nationally ranked No. 1 in orthopaedics, No. 3 in rheumatology and No. 16 in neurology by U.S. News and World Report. HSS has also received Magnet Recognition for Excellence in Nursing Service from American Nurses Credentialing Center and has one of the lowest infection rates in the country. For the last three years HSS has received the HealthGrades Joint Replacement Excellence Award. A member of the NewYork-Presbyterian Healthcare System and an affiliate of Weill Cornell Medical College, HSS provides orthopaedic and rheumatologic patient care at NewYork-Presbyterian Hospital/ Weill Cornell Medical Center. All Hospital for Special Surgery medical staff are on the faculty of Weill Cornell Medical College. The Hospital’s research division is internationally recognized as a leader in the investigation of musculoskeletal and autoimmune diseases.

Š 2011 Hospital for Special Sugery.

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