Donna-Ann Thomas, MD, is an anesthesiologist and pain medicine specialist for Yale Medicine. She is division chief of both pain medicine and regional anesthesiology. She cares for patients at the Yale Spine Center and at Yale New Haven Hospital. Her specialty is managing acute pain, including acute pain in the addicted patient, and pain associated with spine, musculoskeletal problems, cancer, headaches and sickle cell crisis, as well as complex regional pain syndrome.
According to Dr. Thomas, the goal at Yale Medicine is to offer a variety of approaches to treat pain, and to emphasize the newest and most innovative approaches. Two advanced procedures available at Yale include paravertebral blocks and TAP blocks. Both are techniques for injecting local anesthetics to help reduce pain in patients receiving surgeries in the chest or abdominal areas. These procedures may not be available at smaller hospitals.
A priority for Dr. Thomas is finding ways to manage pain while reducing the use of opioids and eliminating opioid-related side effects and dependence, which is a growing public health and national concern. While acknowledging that “opioid medications help with surgical pain,” Dr. Thomas says they can be especially useful in the short term for patients who have had recently had surgery and for those with painful broken bones. However, she says, these medications pose a serious risk of addiction and misuse, especially if pain pills are used after surgery for reasons other than managing pain. Dr. Thomas does acknowledge that patients living with cancer pain are a special subset of the population that may require long- term opioids.
“Our goal is to reduce the use of opioid medications by using other types of medications and regional anesthesiology,” Dr. Thomas says. Options include using local anesthetics to block pain signals to nerves, medications that help with nerve pain and other non-opioid medications. "Sometimes we try to manage the pain with over-the counter medications, such as ibuprofen," she says.
Every patient reacts differently to pain, according to Dr. Thomas, an assistant professor of anesthesiology at Yale School of Medicine. “What works for one patient may not work for another. My philosophy is to treat every patient as I would a family member. If I tell a patient I think this is the best approach, I hope they understand that I would make the same recommendation for a family member or for myself.”