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A word from our surgeons

	Robert J. Mulcare, M.D.P.C. Specialty: Vascular Surgery Assistant Clinical Professor of Surgery College of Physicians and Surgeons, Columbia University New York, NY Office: 3 East 74th Street, suite 1-E New York, New York 10021 (212) 744-1515 "When varicose vein surgery is indicated for patients with varicose veins, stripping of the saphenous vein only between the groin and the knee is becoming the method of choice. Because this procedure is minimally invasive, the anesthesia should be also tailored to this surgical technique. Based on extensive clinical experience in phlebology and our published papers, short acting, painless peripheral nerve block is the anesthesia of choice. This allows this vein stripping to be performed reliably on an outpatient basis, with the patient leaving the hospital only a few hours following the surgical procedure. Nerve blocks completely avoid the complications or unpleasant recovery frequently associated with spinal, general or epidural anesthesia."

	Paul Hobeika, M.D. Specialty: Adult orthopedic surgery; specializing in shoulder and knee surgery Associate Clinical Professor of Orthopedics College of Physicians and Surgeons, Columbia University New York, NY Office: 1090 Amsterdam Avenue New York, NY 10025 (212) 663-4594 "Regional anesthesia is vastly superior to general anesthesia when skillfully performed; the patients simply do better, they appear healthier after surgery and have much less pain than those who had general anesthesia. I especially think that regional blocks are beneficial in patients with co-existent diseases, such as diabetes, heart, lung or kidney disease. In orthopedic surgery, there is a compelling need for anesthesiologists who are trained in regional anesthesia. Many patients have co-existing diseases and in my opinion there is simply no questions that these patients do better, have less complications than when general anesthesia is used." Figure 1. Dr. Hobeika performing arthroscopic surgery in a patient with torn medial knee meniscus. The patient's knee is anesthetized by femoral-sciatic nerve blocks. Figure 2. Using arthroscopic equipment, Dr. Hobeika can perform delicate knee surgeries without having to perform an open knee procedure. With this technique, the healing time is shorter, possibility of infection smaller and the postoperative scars are minimal.

	Tarek Mardambey, M.D., P.C. Specialty: Adult and Pediatric Orthopedic Surgery Assistant Clinical Professor of Orthopedic Surgery College of Physicians and Surgeons, Columbia University New York, NY Office: 1090 Amsterdam Avenue, Suite 6E New York, NY 10025 (212) 663-8600 "Regional anesthesia is really the way to go in orthopedic surgery. When it is done skillfully, it is really a great technique and very beneficial to patients. Nevertheless, I feel that the regional anesthesia techniques, especially peripheral nerve block skills must be acquired through a structured program if one is take the full benefit of this type of anesthesia."

	Dr. Paul Greenberg, DPM, FACFAS Doctor of Podiatric Medicine Fellow of American College of Foot and Ankle Surgery Graduated from New York College of Podiatric Medicine in 1989 Residency: Ankle and foot surgery, Atlanta Hospital, Atlanta, GA

	Dr. Rick Delmonte, DPM Doctor of Podiatric Medicine Graduated from New York College of Podiatric Medicine in 1995 Residency: Western Pennsylvania Hospital Foot and Ankle Institute, Pitsburg, PA Office: 101 West 79th Street New York, NY, 10024 (212) 874-3578 "Nerve blocks are ideally suited for surgery on the foot and ankle. Patients who have nerve blocks for their foot and ankle surgery have less complications than those receiving general, spinal or epidural anesthesia. They results in a far superior pain relief after the operation, and better overall surgery and anesthesia experience for the patients. Compared to local anesthesia, nerve blocks provide better quality anesthesia, allow the use of a tourniquet and minimize postoperative swelling. Overall, nerve block anesthesia is very effective, economical and efficient anesthesia technique in podiatry surgery, which in addition to all these advantages results in a greater patient satisfaction."

	David Fox, MD Division of Vascular Surgery St. Luke's - Roosevelt Hospital Center Instructor of Clinical Surgery, Columbia University College of Physicians and Surgeons 425 West 59th Street New York, New York 10019 (212) 523-8700 e-mail: david_fox@slrhc.org website: http://slrsurgery.org/cgi-bin/profilesDisplay.cgi?memberId=35 "Patients undergoing vascular surgery typically have significant co-existing cardio-pulmonary and renal diseases. Because of that, these patients are amongst the greatest beneficiaries of regional anesthesia. Selective peripheral nerve blocks, are essentially devoid of hemodynamic complications, provide excellent intraoperative anesthesia, long lasting postoperative analgesia and a prolonged sympathetic blockade - all of which are ideal in vascular surgery patients. The combination of epidural, brachial plexus, lumbar plexus, sciatic, femoral and popliteal blocks are the most commonly used anesthetics in my practice. They present a clear advantage over general anesthesia and can be utilized for the majority of vascular surgery patients."

	Richard Karpinski, MD Plastic and Reconstructive Surgery St. Luke's - Roosevelt Hospital Center New York, New York

	Jeff Arliss, MD Hand Surgery General Surgery St. Luke's - Roosevelt Hospital Center New York, New York

	Alton Barron, MD Orthopedic Surgery St. Luke's - Roosevelt Hospital Center New York, New York

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