Clinical Accolades

Duke Anesthesiology has long been associated with excellence in regional anesthesia and acute pain medicine, pioneering the use multiple nerve block techniques to keep patients comfortable and safe during and after surgery. Duke was one of the earliest centers to employ continuous perineural catheters to provide extended pain relief for several days following surgery, a technique that has been shown to significantly reduce or eliminate the need for opioids after many orthopaedic surgical procedures. The Regional Division at Duke has also been a leader in developing and popularizing the use of ultrasound guidance for nerve blocks, an innovation that has led to an explosion in the use of nerve and fascial plane blocks for perioperative pain control. All of the faculty in the Regional Division are highly skilled and experienced ultrasound experts who are not only innovators, but publish and teach internationally.

The Regional Division are leaders in creating pathways for Enhanced Recovery After Surgery (ERAS) for joint replacement surgery, and the innovations with multimodal analgesia and nerve block techniques have been shown to improve patient-related outcomes, such as pain control and satisfaction, as well as reduce length of stay and complications. Regional block techniques are now the core of similar clinical pathways for oncologic breast surgery and breast reconstruction, colorectal surgery, major urologic surgery, lower limb amputation, and others. Anesthesiologists from around the globe travel to visit the Regional Division and spend several days learning from their expert faculty.

As experts in the use of ultrasound, the Regional Division has advanced the use of Point of Care Ultrasound (POCUS) for perioperative patients at Duke, using bedside ultrasound to diagnose cardiac and pulmonary issues, evaluate patients’ volume status and effectiveness of preoperative fasting, and other applications. In 2016, Duke Anesthesiology’s Regional Division hosted the first POCUS workshop in the country aimed at perioperative physicians.

Duke Health is a global leader in hand transplantation, and under the leadership of Dr. Josh Dooley, these patients receive a carefully tailored anesthetic built around continuous brachial plexus block to not only provide excellent pain relief, but also to improve blood flow to the newly transplanted hand. Drs. Erin Manning and Neil Ray are anesthesiology co-directors of the Spine Co-Management group, who, along with their neurosurgical and orthopaedic colleagues, have kept spine surgery care at the forefront with advances in the use of multimodal analgesia, nerve blocks for spine surgery, and the development of spine-specific ERAS protocols.