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Multimodal Pain Programs Proven Effective for Hand Surgery


29 October 2020


12:00 AM11:59 PM

Presented on 29 October 2020 11:00 EDT


  • Introduction and overview of the Opioid Crisis in America, David Nelson, MD
  • Pre-operative Counseling: A Surgeon’s Penance for Years of Overprescribing, Nicholas Pulos, MD
  • Intraoperative Strategies: Multi-modal intra-op pain strategies in Orthopaedic Surgery, Asif Ilyas, MD
  • 27 years’ Experience with a Post-operative Multi-modal Pain Management Program, David Nelson, MD

Presenter Biographies:

David Nelson, MD

Dr. Nelson is a hand surgeon in private practice who has been a member of IASP since 2002. He has presented widely on a multimodal pain program that he has used for about 26 years, with opioids rarely being used after hand surgery. He is the Director of the San Francisco Bay Area Hand Club and on the editorial board of the Journal of Hand Surgery for 28 years. He has an engineering degree and is on the Board of Directors for the Hand and Wrist Biomechanics Symposium. He is the chair of the Patient Safety Subcommittee for the American Society for Surgery of the Hand.

Nicholas Pulos, MD

Nicholas Pulos, M.D., is an orthopedic hand and microvascular surgeon with special interest in pediatric upper extremity injuries and congenital differences. His clinical focus includes; Providing comprehensive evaluation and surgical management of congenital hand and upper extremity differences; Upper extremity reconstruction in patients with brachial plexus injuries; Expertise in the management of complex upper extremity bone, soft tissue and nerve injuries; Promoting wide awake hand surgery in a variety of procedures; Using multimodal pain strategies to maximize comfort and minimize opioid use following surgery.

As a hand surgeon in United States Navy Reserves, Dr. Pulos previously served at Naval Medical Center San Diego treating Sailors, Marines, Veterans and their families. Dr. Pulos has authored several journal articles and book chapters on the treatment of adult and pediatric upper extremity conditions. Dr. Pulos is a candidate member of the American Society for Surgery of the Hand (ASSH) and the American Association for Hand Surgery (AAHS). He is passionate about resident education, mentoring and training the next generation of orthopedic and hand surgeons.

Asif Ilyas, MD, MBA, FACS

ASIF ILYAS, MD, MBA, FACS – is a board certified Orthopaedic Surgeon with a certificate of added qualification in Hand Surgery. He is a member of the Rothman Orthopaedic Institute and Professor of Orthopaedic Surgery at the Thomas Jefferson University in Philadelphia. He is also Past President of the Pennsylvania Orthopaedic Society and current President of the Rothman Orthopaedic Institute’s Foundation for Opioid Research and Education. Dr. Ilyas specializes in hand, wrist, elbow and orthopaedic trauma surgery. He has a particular interest in fracture surgery, nerve injury, opioids and pain management in orthopaedic surgery. He is considered an expert in opioids in surgical pain management as well as the newer safer and opioid-sparing technique, “wide awake hand surgery.”  Dr. Ilyas is an Alpha Omega Alpha graduate of MCP-Hahnemann College of Medicine of Drexel University. After medical school he completed his Orthopaedic Surgery training at Temple University Hospital. He subsequently completed his fellowship as a Harvard Fellow at the prestigious Massachusetts General Hospital in Boston prior to returning to the Philadelphia area. He has most recently completed his business school training through a joint international program between Brown University in the US and IE University in Spain. Dr. Ilyas has an extensive research portfolio. He has published over 150 scientific studies and papers, authored several textbook chapters, and serves as an editor and reviewer for multiple journals and textbooks. His research most recently has focused on opioids and pain management strategies to decrease post-operative opioid use and dependency. His work has culminated in launching of the new Rothman Orthopaedic Institute’s Foundation for Opioid Research and Education.

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