Clinical Services

Division of Pain Medicine


Introduction

The Division of Pain Medicine in Department of Anaesthesiology, Queen Mary Hospital (QMH DA) is responsible for taking care of patients who are suffering from acute, chronic and cancer pain problems. Pain are referred from other medical specialists and health care professionals and seen at inpatient or outpatient clinics.

 

 

Structure

Director of Division (HKU and QMH)
Prof. Chi Wai CHEUNG
MBBS, MD, FHKCA, FFPMANZCA, FHKAM(Anaesthesiology), Dip Pain Mgt (HKCA)
Clinical Professor, Department of Anaesthesiology, The University of Hong Kong
Director, Laboratory and Clinical Research Institute for Pain, The University of Hong Kong
Honorary Consultant, Queen Mary Hospital, Grantham Hospital, Duchess of Ken Children Hospital

Clinical Director & Supervisor of Training (Pain Fellowship)
Dr. Timmy Chi Wing CHAN
MBBS, FANZCA, FHKCA, FHKAM(Anaesthesiology), FFPMANZCA, Dip of Pain Mgt (HKCA)
Consultant Anaesthetist
Honorary Clinical Associate Professor, Department of Anaesthesiology, The University of Hong Kong

Chronic Pain Coordinator:
Dr. Yu Fai CHUNG
MBBS, FHKCA, FHKAM(Anaesthesiology), Dip of Pain Mgt(HKCA)
Consultant Anaesthetist
Honorary Clinical Associate Professor, Department of Anaesthesiology, The University of Hong Kong

Acute Pain Coordinator
Dr. Stanley Sau Ching WONG
MBBS, MD, FHKCA, FHKAM(Anaesthesiology), FANZCA, FHKCA(Pain Med)
Clinical Assistant Professor, Department of Anaesthesiology, The University of Hong Kong
Honorary Associate Consultant(Anaesthesiology), Queen Mary Hospital

Nursing Team
Ms. Yan Sin KWOK
Advanced Practice Nurse
RN, BN, Post Registration Certificate Course in Pain Management for Nurses

Ms. Sin Man LAU
Advanced Practice Nurse
RN, MNurs, BN, Post Registration Certificate Course in Neuroscience Nursing

Ms. Shirley Wing Yi NG
Registered Nurse
RN, MNurs, BN, Post Registration Certificate Course in Perioperative Nursing

Ms. Josephine Yan Sin KIANG
Registered Nurse
RN, MNSP

Ms. Chiu IP TING
Registered Nurse
RN, BN

Clerical Officer
Ms. Sandy MOK

 

 

History

The QMH DA has been providing regular pain management services in QMH since 1990. This is the first formal pain management service in Hong Kong. The scope of services includes acute pain service (APS)—providing postoperative and other acute pain management; as well as chronic or cancer pain management—attending to all in-patient consultations from other specialties (with subsequent follow up care). The first out-patient clinic in pain management was jointly established by Department of Clinical Oncology and Department of Anaesthesiology in 1993. It serves patients with intractable cancer pain. The Division's own Pain Clinic was commenced in 1995 to look after out-patient referrals. In 1997, QMH DA was accredited by the Hong Kong College of Anaesthesiologists and became one of the first training centers of Diploma in Pain Management.

 

 

Scope of Clinical Services

Currently, the DA Division of Pain Medicine provides a comprehensive scope of pain management services in the QMH. These include APS, Chronic and Cancer pain management services (CPS).

APS
Our APS focuses on pain management of patients after major operations (more than 3,200 patients were treated in 2010 alone). We also receive other pain consultations to manage patients suffering from thermal injury and traumatic painful conditions (e.g. rib fractures). Analgesic medications, patient-controlled analgesia (PCA), epidural analgesia and nerve/plexus blocks are commonly used. The patients are reviewed daily by anesthesiologists and a pain nurse. A twenty-four hour acute pain service is provided by the Department's Emergency Team. On top of this, a member of the Division of Pain Medicine is designated to provide tertiary consultation on 24 hour basis upon the Emergency Team's request.

The Division offers various protocols for acute pain management and patient monitoring. Because of these, high quality acute pain service could be carried out in different clinical areas e.g. the intensive care unit, high dependency unit and general wards. To ensure quality of care, implementation of APS protocols and patient monitoring are supervised by the Pain Nurse, who conducts a daily ward round with anaesthesiologists, as well as providing regular training to ward nurses.


Chronic Pain Service
Our CPS provides a comprehensive tertiary pain management service to both in-patients and out-patients, who are suffering from cancer pain or chronic (non-cancer) pain. We provide regular out-patient Pain Clinic Sessions, as well as Joint Outpatient Pain Clinic Sessions with the Department of Clinical Oncology (for cancer pain patients). CPS commences as soon as we received referrals from other medical specialties. After thorough patient assessment, we will formulate a pain management plan/schedule which is tailor-made to the patient. Treatment modalities ranging from simple analgesic regimens to more sophisticated therapies are provided. These include interventional pain procedures, cognitive behavioral therapy (the SMILE Program) and other multidisciplinary pain management involving other health care teams.

Multidisciplinary involvement is almost mandatory in modern pain medicine. The Division works in close collaboration with other medical specialists, clinical psychologists, physiotherapists, occupational therapists as well as medical social workers in the Hong Kong West Cluster. We play a coordinating role in this multidisciplinary team so as to provide holistic care to our patients. This is achieved through effective patient referral system as well as interdisciplinary case conferences.

 

 

Medical Records and Quality Assurance


All APS and CPS patients, have special medical records, both in hardcopies and electronic copies to ensure accurate documentation of diagnosis, treatment and progress. These records are managed by a designated clerical officer of the Division and strict protocols are in place to ensure patient confidentiality. Medical reports are issued upon request by the patient or other medical teams through proper hospital request channels. Moreover, patient care data are computerized for analysis to allow clinical audit and quality assurance activities.

 

 

Training Activities


The Division of Pain Medicine is committed to the training of pain specialists, anaesthetic vocational trainees, pain nurses and medical students. The Hong Kong College of Anaesthesiologists has accredited two training posts for the Diploma in Pain Management since 1997. 26 pain physicians have graduated so far. All of them excel at pain medicine, delivering specialist care to acute, chronic and cancer pain patients. The Division also welcomes overseas clinicians for training in pain medicine. Short term clinical attachment and fellowship appointments up to one year are provided.

 

 

Academic Activities


In addition to clinical services, the Division of Pain Medicine also conducts research, in collaboration with the Department of Anaesthesiology, The University of Hong Kong. Numerous original articles, published in international peer-reviewed journals, and two medical textbooks and MD Thesis in pain medicine were harvested from this fertile ground of clinical research.

 

 

Academic Output, Division of Pain Medicine, DA QMH

 

 

Medical Textbooks


  • A Guide to Pain Medicine, edited by Joseph C.S. Yang and S.L. Tsui, Hong Kong University Press May 2002. ISBN 962 209 544 5.
  • Pain Medicine, a Multidisciplinary Approach, edited by S.L. Tsui, P.P Chen and Jacobus K.F. Ng, Hong Kong University Press August 2010. ISBN 978-988-8028-16-0.

 

 

MD Thesis, University of Hong Kong


  • Tsui SL. Postoperative Analgesia in Chinese Patients: An In-depth Analysis of Postoperative Pain Management in the Queen Mary Hospital of Hong Kong (1997).
  • Cheung CW. Role of Dexmedetomidine in Acute Postoperative Pain Management (2011).

 

 

Publications in Peer Reviewed Journals

Postoperative Analgesia - Patient Controlled Analgesia (PCA) Machine
Postoperative Analgesia - Infusion Pump for Epidural Analgesia
Postoperative Pain Control - Thoracic Epidural Analgesia
Postoperative Pain Control - Supraclavicular Brachial Plexus Block Infusion
Sphenopalatine Ganglion Block (1)
Sphenopalatine Ganglion Block (2)
Percutaneous Radiofrequency Lesioning of Trigerminal Ganglion (1)
Percutaneous Radiofrequency Lesioning of Trigerminal Ganglion (2)
Percutaneous Radiofrequency Lesioning of Trigerminal Ganglion (3)
Cervical Facet Joint Injection
Lumbar Facet Joint Injection
Two Radiofrequency Lesioning Machines
Percutaneous radiofrequency neurotomy of the lumbar medial branch nerves (1)
Percutaneous radiofrequency neurotomy of the lumbar medial branch nerves (2)
Percutaneous radiofrequency neurotomy of the lumbar medial branch nerves (3)
Cooled Radiofrequency for Sacroiliac Joint Pain
Lumbar Sympathetic Block - Neurolytic (1)
Lumbar Sympathetic Block - Neurolytic (2)
Caudal Epidural Steroid Injection (1)
Caudal Epidural Steroid Injection (2)
Ganglion of Impar Block
Coeliac Plexus Block (1)
Coeliac Plexus Block (2)
Coeliac Plexus Block (3)
Intercostal Nerve Block – Neurolytic
Intrathecal Pump Implantation
Spinal Cord Stimulator Implantation
Cognitive Behaviour Therapy - SMILE Program
SMILE Program (1)
SMILE Program (2)
SMILE Program (3) – Relaxtion
SMILE Program (4) – Exercise
 
SMILE Program (5) – Sharing