ASRA Pain Medicine Update

With the cancellation of the 45th Annual Regional Anesthesiology and Acute Pain Medicine Meeting in April 2020, several award winners did not have the opportunity to receive formal recognition at the Excellence in ASRA Awards Luncheon. We asked some of these recipients to share their thoughts on their respective honors for the ASRA News. Please join us in congratulating these deserving individuals who have worked very hard to get where they are today!

Dr. Guy Weinberg - ASRA 2020 Gaston Labat Award

Dr. Guy Weinberg has been honored for his contributions to the development, teaching, and practice of regional anesthesia with ASRA’s 2020 Gaston Labat Award and Lectureship. Dr. Weinberg developed a life-saving protocol and standard of care now used throughout the world. Patients undergoing medical procedures are at risk for local anesthetic cardiac toxicity (LAST), a rare but potentially fatal side effect associated with administration of local anesthetics. The toxicity often comes on quickly with dizziness, drowsiness, and confusion, followed by central nervous system symptoms such as seizure and loss of consciousness, ultimately leading to cardiovascular failure and death.

These effects were first described as early as 1887 with the use of cocaine as a local anesthetic. Today, although drugs and delivery mechanisms have evolved, LAST remains a serious concern – mitigated by the use of a Checklist for Treatment of Local Anesthetic Systemic Toxicity, developed by Dr. Guy Weinberg and a team of anesthesiologists.

It was 1998 when Dr. Weinberg discovered that lipid emulsion therapy could be used to treat and even prevent LAST. He developed LipidRescue in 2006 to inform the medical community about the cardiotoxicities of local anesthetics, but since then the approach has also been found to reverse neurological toxicities associated with local anesthetics as well as cardiac toxicities associated with other agents.

ASRA published the first LAST guideline in 2010, and it has been updated twice since. The guideline has also been incorporated into an iPhone App to facilitate immediate access in the clinical setting.

“It is extremely rare for an anesthesiologist to discover an intervention that actually saves patients’ lives. Dr. Weinberg’s two-plus decade research focus on using lipid emulsion as antidote for fat soluble medication overdose has spanned both local anesthetics (regional anesthesia) and other pharmaceutics (emergency medicine and critical care medicine). The impact of his research on our sub-specialty has been enormous,” wrote Dr. Joseph M. Neal in his letter of recommendation.

Given annually, the award honors Gaston P. Labat, MD (1843-1908), a pioneer in regional anesthesia and the first president of the American Society of Regional Anesthesia founded in 1923 (later abandoned and then “re-founded” in 1975). Labat’s Regional Anesthesia: Its Technique and Clinical Application was first published in 1922 and became “wildly successful” and a quintessential resource throughout the 20^th century.

Dr. Weinberg began his career in internal medicine and medical genetics and later completed his residency in anesthesiology at the University of Virginia in Charlottesville. He has served as professor of anesthesiology at the University of Illinois College of Medicine in Chicago since 2003 and also works at the Jesse Brown VA Medical Center. He received the ASRA Distinguished Service Award in 2011.

“The Gaston Labat award is, literally, the honor of a lifetime. Reviewing the names of earlier awardees provides context and requires, of necessity, self-effacement. The first two Labat awards were given to John Bonica and Daniel Moore in 1977, the year I finished my internship in medicine at UCSF. It took an additional six years for me to find my way to anesthesiology. I recognized the field as a good fit the day I started residency at University of Virginia.

“Labat awardees include many talented teachers and pioneers of regional anesthesia and I am honored to consider many among the more recent entries as friends and colleagues.  It is those who came before, as well as current members of the regional anesthesia community, to whom I owe the most. I am also thankful for the continued support of the faculty members at the University of Illinois, Jesse Brown VA Medical Center, and (the late) Michael Reese Hospital – a clinical ‘camelot’ where I met my wife, Mary. She clearly deserves my sincerest gratitude for standing by me and for her amazing forbearance over 30 plus years. Our children, Hannah, Isaac, and Joy get that credit, too. Thanks to the ASRA Board for their encouragement over the years.

“Finally, I wish to thank all the students and residents I’ve worked with over more than four decades; I love to teach because it’s the best way to learn and to satisfy my curiosity. I hope to continue honoring the legacy of Gaston Labat by teaching, learning and staying curious.”

— Guy Weinberg, MD

Dr. Joseph M. Neal - ASRA 2020 Distinguished Service Award

A former president of ASRA (2012-2015) and editor-in-chief of Regional Anesthesia and Pain Medicine (2002-2012), Dr. Neal has been an active member of ASRA for many years and is widely respected in the field. He received the Gaston Labat Award and Lectureship in April 2019. Although he retired from clinical practice in 2018 at Virginia Mason Medical Center, he continues research and writing. He serves as an affiliate investigator at Benaroya Research Institute at Virginia Mason and as a clinical professor of anesthesiology at University of Washington School of Medicine.

“Dr. Neal has long established himself as an international leader in regional anesthesia,” wrote Kevin E. Vorenkamp, MD, who worked for many years with Dr. Neal at Virginia Mason Medical Center. “He has instructed hundreds of anesthesiology residents and regional anesthesia fellows …  and his presentations and publications have easily reached thousands more.”

Dr. Neal received his undergraduate and medical training at Wake Forest University in Winston-Salem, NC, and the West Virginia University School of Medicine in Morgantown. He returned to Bowman Gray/Wake Forest University to complete residencies in emergency medicine and anesthesiology. After fellowship training in regional anesthesia at the Virginia Mason Medical Center in Seattle, WA, he joined that group in 1989. He directed the Virginia Mason regional anesthesia fellowship for over a decade as well as its anesthesiology residency program. He served as director of research from 2013-2017.

Dr. Neal has been a researcher on 12 grants, presented at hundreds of national and regional meetings, organized 24 meetings, authored over 74 peer-reviewed articles, and published four books on various topics in the regional anesthesia and pain medicine field.

The Distinguished Service Award is presented annually to an individual for his or her outstanding service to ASRA or to the fields of pain medicine or regional anesthesia and acute pain medicine.

“Thank you to the American Society of Regional Anesthesia and Pain Medicine for selecting me as its 2020 Distinguished Service Award recipient. I find it difficult to describe just how humbling, not to mention downright good, it feels to be recognized by the members of a society for which I have so much love and respect.

“As I reflect on 35 years as an ASRA member, I am grateful for the opportunities that I was given to serve. From my early days as a resident and fellow through my first few years of retirement, ASRA has been a major part of my professional life. The decade plus spent as editor-in-chief of Regional Anesthesia and Pain Medicine was perhaps my most rewarding professional endeavor. To have been a part of taking the Journal from a relatively small sub-specialty publication to a high impact international scientific medium was only possible because of the dedicated editors, reviewers, and talented physician scientists who entrusted us with publishing their work. I was equally blessed to have been part of ASRA leadership during its remarkable metamorphosis. As gratifying as those accomplishments have been, they were immeasurably enhanced by the development of professional and lifelong personal friendships with countless ASRA members and staff. To all of my ASRA friends and colleagues, thank you for your passion, your professionalism, and your friendship. Together we have made remarkable contributions to regional anesthesiology, acute and chronic pain medicine, and most importantly, to our patients.”

— Joseph M. Neal, MD

Dr. Priyanka Ghosh - ASRA 2020 Resident/Fellow of the Year

Dr. Ghosh is a fellow in interventional pain medicine at Weill Cornell Tri-Institute for Pain (New York Presbyterian, Memorial Sloan Cancer Center, and Hospital for Special Surgery). She is involved in research at each of these institutions in the areas of practice administration education in interventional pain medicine fellowships; osteoid osteoma diagnoses; dorsal root ganglion stimulation and dorsal column spinal cord stimulation in CRPS; and spinal cord stimulation studies. In fact, research has played a large role in her entire career as far back as when she attended Brown University as an undergrad. She earned her MD at the University of California, San Francisco, where she also served as an NIH Clinical & Translational Research Fellow. Her residency was in the department of anesthesia, critical care and pain medicine at Beth Israel Deaconess Medical Center at Harvard Medical School.

In addition to ASRA, Dr. Ghosh is active in the Society of Women Innovators in Pain Management, the World Academy of Pain Medicine Ultrasonography, and the Substance Abuse Prevention and Education Committee. She has presented posters at the North American Neuromodulation Society, the American Society of Anesthesiologists, and ASRA.

ASRA’s Resident/Fellow of the Year Award is given annually to a resident or fellow member of ASRA who has demonstrated outstanding contributions to regional anesthesia or pain medicine; has contributed to the advancement of the profession, welfare of residents, or quality of residency education; serves as a role model and mentor to his or her peers; and embodies the values of ASRA.

“It is truly an honor to be selected as a recipient of a 2020 ASRA Fellow of the Year award!  I am incredibly thankful to the amazing Dr. Shalini Shah, not only for serving as an incredible mentor and role model to me, but also for nominating me for this award and to the entire ASRA board for granting me the honor of this award.

“I have been a part of ASRA since my first year of anesthesia residency, introduced to this amazing organization by Dr. Christine Peeters-Asdourian (CPA).  From my first introduction to ASRA at the fall meeting of my CA-1 year, I’ve always had the same feeling about the ASRA community, that it is a hub of knowledge, support and innovation in which physicians from walks of life are welcomed. I am continuously amazed by the diversity of ideas and topics consistently presented at ASRA meetings and the incredible number of experts that converge in one organization to share their knowledge and help move the field forward. I’ve been fortunate enough to be included in ASRA in multiple arenas, from presenting my research to taking active leadership roles in special interest groups (SIGs) and committees. 

“Through these activities and increasing involvement in various facets of ASRA, I was fortunate enough to pursue and grow my interests in the field of pain medicine, especially my clinical research and advancing diversity and inclusion in the field of pain medicine. I’ve been so impressed with the deep level of scientific discovery and discourse at each ASRA meeting and I hope to continue to work with many mentors through ASRA, nationally and internationally, to contribute to meaningful clinical research to push the field forward. ASRA’s commitment to diversity and inclusion is the other arena in which they are leading the way. I hope to continue to contribute by creating and joining new and innovative initiatives to promote diversity and inclusion of all people. I am so heartened by the many initiatives in ASRA and hope to continue to help grow and participate in each of these.

“However, above all things, the most striking and wonderful facet of my time with ASRA has been the incredible mentorship I have gained. In each arena, through ASRA, I was able to gain amazing mentorship. Whether it was the SIGs I participated in, the resident and fellows section committee or just the general ASRA community, mentors of all levels and backgrounds were available to me anytime. I have been beyond lucky to have mentors nationwide, who are willing to advise me, help me and most importantly, sponsor me on papers, projects and initiatives that interest me. The mentorship I have gained, including the trust and respect that I am always given, has been truly the highlight of my time with ASRA. I feel incredibly lucky for my amazing experiences with ASRA thus far, and am beyond thrilled to receive this award. I hope to be involved with ASRA, in all areas, and hope to grow with and contribute to this amazing organization for my entire career.”

 — Priyanka Ghosh, MD