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HomeClinics, Services & ProgramsA-Z DirectoryAnesthesiology and pain medicine

Anesthesiology and pain medicine

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The Department of Anesthesiology and Pain Medicine at CHEO is affiliated with the University of Ottawa. Our team of 20 anesthesiologists work with a multidisciplinary team to provide safe, family-centred care. We participate in 8,500 surgery cases each year. Our anesthesiologists work with the University of Ottawa to train the next generation of doctors. 

We support these teams at CHEO:

  • Cardiac surgery

  • Dental surgery

  • Ear Nose and Throat surgery

  • Pediatric General surgery

  • Neurosurgery

  • Ophthalmology

  • Orthopedics

  • Plastic surgery

  • Urology

  • Gynecology

  • Oncology

  • Gastroenterology, Nephrology, Endocrinology, Rheumatology

  • Interventional Radiology

  • Interventional Cardiology

  • Medical Imaging including more than 1700 MRIs and CTs per year

Our team also manages:

  • Pre-Anesthesia Clinic (PAC)

  • Acute Pain Service (APS)

  • Acute Pain Outpatient Clinic
  • Chronic Pain Team

Pain service

Acute pain service

CHEO has been instrumental in the development of Pain Scores for the assessment of pain in children, which are widely used around the world.

Children and their families are introduced to the post-surgery pain management options in the Pre-Anesthesia Clinic. The Acute Pain Service (APS) operates 24 hours a day, 7 days a week at CHEO and cares for children after painful surgical procedures as well as for patients with complex acute pain problems that are not associated with surgery. It is staffed by dedicated pain physicians, anesthesia residents and nurse practitioners.

The Acute Pain Service uses a wide range of pain management techniques. We use several medications together, such as Tylenol and Advil to prevent and treat pain. Other oral medications are added when needed. Intravenous morphine or morphine-like analgesics are delivered by continuous infusions, intermittent boluses or Patient Controlled Analgesia (PCA) methods. Regional anesthesia techniques such as epidurals and nerve blocks are also monitored, cared for and followed by the APS. Standard protocols of these pain practices are in place to ensure optimal pain control, safety and continuous quality improvement. The goal of the Acute Pain Service is to safely provide the best possible pain relief and comfort to a child in pain with the least side effects.

This video will demonstrate how to use Patient Controlled Analgesia (PCA) to control pain. PCA is one method used to control pain after surgery or a painful medical condition. This method allows the patient to have some control of their pain management. Your health care provider will arrange for this modality if they feel it would be beneficial to your care.

Videos

Pamphlets

PCA pamphlet

Epidural pamphlet

Sucrose pamphlet

 

Regional Anesthesia Program

Pamphlets

Continuous nerve block at home

Videos

Chronic pain service

Our approach

 Psychological
We know that your pain is real and that pain is often invisible. When pain lasts for a long time, it can be difficult to continue going to school, complete homework, spend time with friends and family, and participate in enjoyable activities. How do you cope with all of these changes and challenges? How do you get back to your everyday activities when you are worried that your pain will increase or worried about being misunderstood by others?

Your thoughts and feelings are very powerful when it comes to managing your pain. It is a normal reaction to feel worried, frustrated, angry, or upset when you have pain, or when pain keeps you from participating in all aspects of your life. It is often helpful to work with a psychologist to learn new skills and strategies on how to cope with managing chronic pain, and any associated feelings and reactions.

Using evidence-based Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and various relaxation and mindfulness techniques, our psychologists help children and youth:

  • Learn about stress management
  • Modify negative thoughts
  • Process emotions
  • Increase problem solving and goal setting skills
  • Restore function to their lives
  • Find acceptance and take action
For more information

Frequently used therapies and mindfulness

Information on anxiety

 

Family and School Support

We know that chronic pain affects the whole family. We also know that parental engagement has an effect on the outcome of each patient’s pain management journey. The more engaged parents are with our program, the more their children and youth know their parents are on their team and supportive of trying out new skills and strategies in managing their pain.

Our social worker provides family support and education, as well as school support and liaison services. Parents are encouraged to connect with the social worker should they have any questions regarding parenting a child with chronic pain or for any need for additional support or resources.

If you are having difficulty at school due to pain or the need for extra school support is identified by our interdisciplinary team, our social worker will work with you and your school to help with your identified needs.

Physical

Movement and the right amount and type of exercise are key to managing chronic pain. A physiotherapist is a great resource for managing your pain and increasing your level of physical activity. Having an assessment done by a physiotherapist is an important step. Your physiotherapist can help guide you as you adjust your activity levels.

Things to remember:

  • Start slow and little by little increase your activity level. You may need to adjust current activities to meet your needs.
  • How you physically feel, also affects how you feel emotionally; if you have not been physically active and your body is deconditioned, your pain will increase which will affect many aspects of your life
  • Regular physical activity as outlined by your physiotherapist will not worsen your pain, but will actually increase your level of physical functioning which in return can decrease the amount of pain you feel

Occupational Balance and Pacing

Chronic pain often means our function has decreased and our every day activities or “occupations” are unbalanced. Our occupational therapist is here to help you regain better occupational balance through a variety of hands-on methods.

While it is tempting to go all out or over-exert yourself when your pain is low and you’re feeling good, sometimes this will make you feel even worse for days or weeks afterward. This can cause further loss in function. Learning how to pace yourself is an important aspect of pain management. Pacing means slowly increasing your time and level of activity in a planned and controlled way.

 
Pharmacological (medications)
  • There is no single medication that works for everyone, and sometimes medications do not take the pain away entirely. The chronic pain team will work with you to try to find medications that reduce your pain so that you can participate more fully in your daily activities and physical functioning.
  • It can take up to 4-6 weeks to know whether a particular medication will work for you, and often more than one medication will need to be tried. During this process it is important to take your medications regularly.
  • It is important to let each member of your extended health care team know about the medications you are taking, and to tell them if you start something new or stop taking a medication. When medications are prescribed by different providers or care teams, it is important that you use only one pharmacy to ensure the combination of medications remains safe for you. It is a good idea to bring all of your medications to your medical appointments to make sure your medication records are kept up to date.
  • Remember to ask questions if you are unsure about something, and to report any side effects that concern you. Some side effects may decrease over time, but if side effects are interfering with your daily functioning or becoming too bothersome, the medication may need to be changed. Do not stop taking your medications or change the dosing regimen without first consulting with the chronic pain team.
  • Remember that when you go to your follow up appointments, the team will want to know how well your medications are working for you and if you have any concerns about taking them. Medications that are not helpful for your pain or are causing side effects will be reassessed by the team to determine if they should be continued.

What to expect

Every patient’s journey through our program begins in the same place: a referral to our program. Here is what to expect as your start the process.

Intake session

Patients and their parents attend this two hour session to learn more about the Chronic Pain Service with other families awaiting services, and complete our intake package while confirming previously acquired details.

 

You will be able to accept or decline intake to the Chronic Pain Service following this session

Initial appointment

Patients and their parents meet with our interdisciplinary team for a full assessment. The team will create a custom plan of care and present it to you at the end of the appointment with suggestions for what pathways will best suit your needs.


Please bring all medications to your initial appointment

Individual and group services

Patients who are already engaged in community services may require consultative services by our health care professionals with their community providers. Some patients may require individual and group services provided by CHEO which will be better outlined during the initial assessment.


Please remember to give 48 hours notice for all appointment cancellations

Follow-up

Patients and families are expected to attend follow-up clinics quarterly to check-in with the interdisciplinary team as to their progress and next steps.


Please bring all medications to your follow-up appointment

Discharge
As patients engage and progress through our program, learn how to apply pain management techniques, increase their function and decrease their pain, the team will discuss how to transfer your care to the community

Resources

Chronic Complex Pain Team pamphlet

 

Anesthesiology team

Anesthesiology team

 Dr. Dylan Bould
Chair of Canadian Anesthesiologist's Society International Education Foundation, World Federation of Societies of Anesthesiologists Education Committee, Cardiac Anesthesiologist

dbould@cheo.on.ca

 Dr. Antoinette Corvo
Equipment Manager for Anesthesiology Department

acorvo@cheo.on.ca

 Dr. Leslie Hall
Member of Sedation Guidelines Committee

lhall@cheo.on.ca

 Dr. Jarmila Kim
Anesthesiologist In Charge (AIC) Lead

kim@cheo.on.ca

 Dr. Christine Lamontagne
Director of Chronic Pain Services.

Co-Chair of the hospital-wide pain committee

Royal College examiner for Anesthesiology

 Dr. Deborah Mervitz
Director of the Acute Pain Service

Chronic Pain Team

 Dr. Philipp Mossdorf
Regional Anesthesia Team

pmossdorf@cheo.on.ca

 Dr. Kimmo Murto
Director of Clinical Research for the Department, Research Associate CHEO Research Institute

kmurto@cheo.on.ca

 Dr. Joanna Nawrocka
Staff Anesthesiologist

jnawrocka@cheo.on.ca

 Dr. Gillian Ramsey
Coordinator of Department Rounds

gramsey@cheo.on.ca

 Dr. Amy Roeske
Pre-Anesthesia Clinic (PAC) medical director
Department website facilitator

aroeske@cheo.on.ca

 Dr. Gail Ryan
Resident Coordinator, off-service residents

gryan@cheo.on.ca

 Dr. Anna Shadrina
Director of Regional Anesthesia Program

ashadrina@cheo.on.ca

 Dr. Robert Schwartz
Staff Anesthesiologist

rschwartz@cheo.on.ca

 Dr. Darlene Weekes

Regional Anesthesia Team, Fellowship Coordinator

dweekes@cheo.on.ca

 Dr. Phil Kruger
Cardiac Anesthesiologist, Scheduling Officer for Department

pkruger@cheo.on.ca

 Dr. David Rosen
Chief of the Department
Consultant, Pediatric Intensive Care Unit
Cardiac Anesthesiologist

drosen@cheo.on.ca

 Dr. Gopa Nair
Regional Anesthesia Team

Gsudhakarannair@cheo.on.ca

 Dr. Heather OReilly
Resident Coordinator

HOReilly@cheo.on.ca

Team members

 Jennifer Borup

Administrative Coordinator

jborup@cheo.on.ca

 Carrie Haffner

Billing Clerk

chaffner@cheo.on.ca

 Nancy Lauzon

Pre-Anesthesia Clinic nurse

nlauzon@cheo.on.ca

 Brenda L. Martelli

Acute Pain Nurse Practitioner

martelli@cheo.on.ca

Megan Greenough

Chronic Pain Nurse Practitioner

mgreenough@cheo.on.ca

Training Programs

The Anesthesiology department helps train residents, fellows, paramedics, respiratory therapy staff and students, nursing staff and medical students.

Residency Program

Anesthesia residents from the University of Ottawa, Queen's University and the Northern Ontario School of Medicine regularly rotate through our Department.

Visit the University of Ottawa Anesthesia Department website for further information.

Fellowship

We offer a one year Clinical Fellowship for those considering a subspecialty career or academic career. The fellowship has been offered for many years and has attracted fellows from all over the world. We provide advanced clinical exposure to Pediatric Anesthesia before undergoing a mixed adult/pediatric or sole pediatric anesthesia practice. There are opportunities to participate in research.

Prospective fellows should have completed full training in anesthesia and or be eligible for certification. Fellows should be eligible for licensure in the province of Ontario (Canada) and would be appointed by the University of Ottawa on an educational license.

Fellows are actively involved in supervised clinical practice and are offered protected research time to develop their academic interests. Fellows are given daily feedback and performance evaluations.

Application process

All applicants must apply though UO Campus by April 1st, the year prior to the desired fellowship. Please include your curriculum vitae, letter of intent and three reference letters. Application instructions can be found on the University of Ottawa Department of Anesthesiology & Pain Medicine Webpage.

For additional information about the program you can reach Dr. Weekes, our Fellowship Coordinator, at:

  • Email: dweekes@cheo.on.ca.
  • Address: Department Of Anesthesiology, CHEO, 401 Smyth Road, Ottawa ON K1H 8L1, Canada.
  • Telephone: 613-737-7600 x2431
  • Fax: 613-738-4815

Contact us

For general questions, please contact Jennifer Borup. Jennifer is the Administrative Coordinator of the Department of Anesthesiology. You can reach her at:

  • Address: CHEO, 401 Smyth Road, Ottawa ON K1H 8L1, Canada
  • Phone: 613-737-2431
  • Fax: 613-738-4815
  • Email: anesthesiology@cheo.on.ca

To reach specific teams, you can call:

  • Pre-Anesthesia Clinic: 613-737-7600 extension 2522
  • Day Care Surgery: 613-737-7600 extension 1446
  • Acute Pain Nurse Practitioner: 613-737-7600 extension 2129
  • Chronic Pain Nurse Practitioner: 613-737-7600 extension 3559

Research

CHEO's Department of Anesthesiology is at the forefront of clinical science research. While our ongoing research is widely acclaimed, new areas of research are being explored. Senior staff anesthesiologists guide the research and we are always working on new ideas and projects.

We encourage young investigators to join ongoing research or begin their own projects. We offer protected research and academic time to staff and fellows with research interests. We work closely with the CHEO Research Institute to ensure strategic statistical and epidemiological backup for our studies.

Learn more about Anesthesiology research at the CHEO Research Institute

 

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