The Program in Regional Anesthesiology at the University of Maryland comprises faculty dedicated to providing advanced regional anesthesia techniques to a wide variety of patients. Working primarily with our busy general and world-class Shock Trauma orthopedic services, our division performs many single-shot and/or continuous regional blocks for elective and urgent orthopedic procedures.
The majority of our regional anesthetics are provided at the University of Maryland Rehabilitation & Orthopaedic Institute. Under the leadership of Dr. Edwin Villamater, our anesthesiologists take pride in frequently administering peripheral nerve blocks as the sole anesthetic. Patients recover quicker with less pain and experience reduced side effects from narcotics. With leading experts in ultrasound-guided regional anesthesia, our physicians are solicited to train others nationally in the rapidly emerging field of regional anesthesiology.
While anesthesia for routine orthopedic operations are our most frequent provision, other surgical services - including vascular surgery, trauma surgery and the soft tissue infection surgical service - have requested our skills. Unique scenarios at the University of Maryland's Shock Trauma Center provide our division with experience that is unmatched. A coagulopathic elderly patient requiring a paraverterbral catheter for multiple rib fractures analgesia, a 36-week gravid woman needing continuous femoral and sciatic nerve catheters for a tibial fracture, and a patient status-post reconstruction of a nearly amputated arm requiring an ultrasound-guided continuous brachial plexus block for postsurgical immobility, analgesia and improved blood flow are among many of the patients who benefit from our expertise. Overall, the division performs approximately 3,000 blocks and 500 continuous perineural catheters per year.
Residents play an integral role in the placement and management of our regional anesthetics. Resident training in regional anesthesia is rich, with a large number of blocks performed by each resident, far surpassing ACGME requirements. Developed several years ago by the residency program director and implemented by our division faculty, a formal regional anesthesia curriculum with lectures, learning objectives and clinical skill sets prepares our residents with the knowledge and techniques to perform advanced regional anesthesia independently.
During the course of three years, residents learn how to rationally apply and manage regional anesthetics for surgical procedures and perioperative analgesia. The residents obtain experience with basic and advanced blocks such as single-shot and continuous interscalene; supraclavicular, infraclavicular, axillary, and forearm nerves blocks for the upper extremity; as well as lumbar plexus, sciatic, femoral and popliteal blocks for the lower extremity. Strong emphasis is placed on proper informed consent and preoperative evaluation, monitoring, positioning, equipment setup, sedation, selection of appropriate local anesthetics and adjuncts, documentation, and the rapid recognition and management of complications. Exposure to various techniques, including nerve stimulation and high-resolution ultrasound guidance, establishes confidence in our residents to function well in any regional anesthesia practice postgraduation. In addition, rotations with the acute pain services complete the trainees' experience by demanding appropriate management of our inpatient and outpatient perineural catheters.
The combination of a dedicated regional anesthesia staff, state-of-the-art equipment, superb patient variety and complexity and sheer quantity of regional block procedures makes University of Maryland an ideal site to learn and excel in the field of regional anesthesiology.
Ron Samet, M.D.
Assistant Professor of Anesthesiology
Director, Division of Regional Anesthesiology
Department of Anesthesiology, University of Maryland Medical Center
22 South Greene Street
Baltimore, Maryland, 21201
Edwin Villamater, M.D.
Assistant Professor of Anesthesiology
2200 Kernan Drive
Baltimore, Maryland 21207