Born of a tradition boasting world-class expertise in orthopedics and rheumatology, Brigham and Women's Hospital is a world leader in the field of regional anesthesia. The regional anesthesia program was developed in response to the challenges of caring for a huge number of orthopedic patients with extremely complex medical programs. The Division of Regional Anesthesia has flourished under the leadership of Mercedes Concepcion, MD, and other pioneers in the field who developed regional anesthetic techniques and agents. The strong tradition of excellence in regional anesthesia has led to widespread use of these techniques by all services. It has also encouraged development of innovative applications of regional anesthesia, such as thoracic epidural anesthesia for breast surgery and spinal anesthesia for back surgery.
The Obstetric Anesthesia Service at Brigham and Women's is one of the world's foremost. Our labor unit is the largest in New England and the third largest in the nation, with nearly 10,000 births annually. As a tertiary referral center, more than 25 percent of deliveries are high-risk, including patients with preeclampsia, as well as cardiac, pulmonary, and neurologic disease. More than 75 percent of patients receive anesthetic care. Headed by William Camann, MD, a world leader in obstetric anesthesia, the division has produced hundreds of research articles and features ongoing laboratory and clinical research efforts in every aspect of the discipline. Faculty serve in leadership roles in international societies and editorial boards, and have been honored with national research and teaching awards.
Nearly 900 vascular operations are performed yearly at Brigham and Women's Hospital, including carotid endarterectomy, thoracoabdominal aortic aneurysm repair, suprarenal abdominal aortic aneurysm repair, and a variety of peripheral vascular procedures. Led by Chairman Emeritus, Simon Gelman, MD, the Vascular Anesthesia Service manages a wide variety of cases, many involving significant coexisting diseases such as coronary artery disease, hypertension, obstructive lung disease, and diabetes.
The Brigham and Women's Hospital is a world-class referral site for the most complex thoracic surgical procedures, and the largest thoracic surgical center in New England. From volume reduction surgery to extrapleural pneumonectomy, lung transplantation to airway laser surgery, our Thoracic Anesthesia Service provides the absolute best in perioperative patient care. Under the leadership of Phillip Hartigan, MD, the Service and its top-notch trainees provide for the work-up, assessment, and development of a sound anesthetic plan for patients about to undergo complex clinical procedures.
The Neuroanesthesia Service offers many of the newest techniques in this rapidly evolving subspecialty. The Service manages anesthesia for real-time intraoperative magnetic resonance imaging, awake craniotomies for speech, motor, and seizure mapping, plus the latest in neural monitoring. With a caseload exceeding 1,300 per year, Neuroanesthesia has its own staff of monitoring technicians, as well as faculty under the leadership of Linda Aglio, MD, experts in both raw and processed EEG monitoring, burst suppression techniques, somatosensory, auditory, visual, and brainstem and motor-evoked potentials, and facial nerve monitoring.
Critical Care Medicine takes place in three 10-bed surgical intensive care units co-directed by the Department of Anesthesiology, Perioperative and Pain Medicine, and the Department of Surgery. In addition to anesthesiologist / intensivists and burn / trauma surgeons, thoracic surgeons and pulmonary medicine physicians participate in the staff coverage of these ICUs. This provides our staff and trainees an unusually broad perspective on the care of critically ill surgical patients.
More than 19,000 patients per year are seen in the Weiner Center for Preoperative Evaluation (CPE), which is directed by Angela Bader, MD, a faculty member in the Department of Anesthesiology, Perioperative and Pain Medicine. The CPE is an integral part of our expanding focus on the perioperative care of surgical patients. David Hepner, MD, also an anesthesiology faculty member, serves as associate director and oversees resident education in preoperative assessment. Using the principles of risk estimation, appropriate laboratory testing and interpretation, and in collaboration with consultants from other specialties, the CPE ensures that patients are medically and emotionally prepared for surgery.
Gynecologic and Ambulatory Anesthesia
The Day Surgery Unit performs more than 8,000 adult ambulatory and gynecologic procedures per year in most surgical specialties, including plastics, orthopedics, urology, ophthalmology, and general surgery. Tthe Gynecologic and Ambulatory Anesthesia Service meets the needs of patients using a multidisciplinary approach in which the anesthesiologist serves as team leader. The Service excels in pre-operative evaluation of medically and psychologically complicated patients, intra-operative care aimed at rapid recovery with minimal side effects, and post-operative management to enhance prompt discharge and return to normal function. Gynecologic and Ambulatory Anesthesia Service staff have expertise in clinical pharmacology, pharmacokinetics, team leadership, and cost effectiveness.
The Cardiac Anesthesia Service is one of the busiest and most dynamic services at Brigham and Women's Hospital. As a referral center for New England and the world, the staff sees numerous patients with complex cardiac problems, often with severe coexisting disease. Using the resources of the hospital and the Department, including our own intraoperative Transesophageal Echocardiography (TEE) Service, this group is able to provide an extremely high level of care to these very ill patients. Our diverse and challenging caseload includes Coronary Artery Bypass Grafting (CABG), valve repair and replacement, minimally invasive CABG and valve surgery, transmyocardial laser revascularization, repair of aortic aneurysms and dissections, placement of ventricular assist devices as a bridge to transplant, cardiac transplantation, and adult congenitive heart procedures.
Post-Anesthesia Care Unit
Anesthesiologists in the Post-Anesthetic Care Unit (PACU) manage acute post-surgical problems such as hemodynamic instability, acute pain, and acute respiratory problems, while caring for about 24,000 patients annually.
Center for Pain Medicine
The Center for Pain Medicine includes staff with backgrounds in anesthesiology, neurology, psychiatry, psychology, dentistry, acupuncture, and nursing, and stresses a unified approach to evaluation and management of simple and complicated pain problems. Through association with the Dana-Farber Cancer Institute, our practitioners are skilled in cancer pain assessment and palliative pain management. Our Pain Management Center sees more than 19,000 patients annually and performs nearly 7000 procedures. These include a variety of neural blockade procedures, interventions such as radiofrequency lesioning, chemical neuroablation, and implantation of spinal cord stimulators, intrathecal pumps, and epidural portacaths. Our associated Clinical Trials Center offers learning opportunities for clinical research for chronic and acute pain.
Center for Perioperative Research (C.P.R.)
Based in the Department of Anesthesiology, Perioperative and Pain Medicine, the Center for Perioperative Research (C.P.R.) serves the entire hospital organization. We strive to collaborate with hospital administration, clinicians from anesthesiology, surgery and other specialties, nurses, Information Systems administrators, biomedical engineers, pharmacists, clinical researchers and statisticians, electronic educational specialists, and various units of Harvard Medical School. Our mission is to improve patient care and operating room efficiency, promote clinical research, and provide educational opportunities. By coordinating a multidisciplinary effort, the Center can help increase efficiency in the perioperative setting, optimize quality of care while decreasing costs, improve patient safety, analyze short and long-term patient outcomes measures, encourage clinical research, and educate current and future generations of practitioners.
Acute Pain Service
Aggressively involved in perioperative analgesia, the Acute Pain Service provides information and pain management assistance to clinicians and patients. Working with 15 to 65 patients daily, the service uses a variety of modalities, including oral medications, patient-controlled analgesia perfusion devices, and regional techniques to mollify pain. These services are based on an understanding of the physiology of acute pain, the pharmacology of analgesics, and the techniques needed to provide perioperative comfort.
Clinical Bioengineering Service
Staff, residents, and fellows in the Clinical Bioengineering Service apply quantitative techniques to monitor, manage, and analyze clinical anesthesia. The clinical responsibilities of this unit are merged with research efforts aimed at optimizing monitoring and therapeutic modalities to provide state-of-the-art clinical care.
This page was last modified on 9/18/2015