Anesthesia to Pain | India’s Pain Medicine Pioneers on Grit, Setbacks, and Becoming a “Complete” Pain Physician

Introduction

At ICRAPAIN 2025, Dr Gautam Das seated seven giants of pain medicine in India—Dr Pankaj Surange, Dr Sunita Lawange, Dr Karthic Babu Natarajan, Dr Krishna Poddar, Dr Gaurav Sharma, Dr Madhan Pandian, and Dr Anand Murugesan. The brief sounded bold: skip slides, tell truths, and teach real practice. Consequently, the room leaned in.

Why They Chose Pain Medicine

First, each leader described a turning point. They wanted clinical agency, long-term patient outcomes, and deeper ownership than perioperative roles allowed. Next, they highlighted impact: a cancer patient finally slept without pain; a family thanked the doctor, not a department. Finally, they noted today’s landscape: corporate hospitals now build pain departments; insurance covers more interventions; fellows find clear career paths.

Takeaway: the market now rewards evidence-based interventional pain medicine and patient-centred care.

Black-Day Lessons That Forged Safer Practice

Then the panel shared the hardest days of their careers and the rules those days created:

• Monitor relentlessly. Track BP, pulse ox, and responsiveness during interlaminar epidural or caudal epidural; speak to the patient throughout.
• Treat “simple” procedures as serious. A carpal tunnel injection can spiral without resuscitation gear. Keep a crash cart ready.
• Double-check concentration and volume. Confirm local anaesthetic strength (e.g., 0.25% vs 0.5%); dose with intent; pause before mobilization.
• Choose safe ergonomics. Face the patient during shoulder procedures; avoid risky medial-to-lateral trajectories; respect anatomy.
• Own the indication and the setup. Evaluate the patient yourself; consent yourself; invest in your equipment; never “just do a procedure” for someone else’s case.
• Use single-use drugs and contrast. Never reuse opened vials; you protect patients and your licence.
• Charge transparently. Set clear, fair fees; free work often confuses expectations and undercuts trust.
• Teach what you learn. Share protocols, complications, and fixes; grow the field through candour.

Step-By-Step Advice for Young Pain Physicians

Moreover, the panel offered a crisp starter playbook:

1. Train deeply before you scale. Workshops start the journey; fellowships, proctorship, and repetition build mastery.
2. Standardize safety. Use checklists, time-outs, drug double-checks, and post-procedure observation.
3. Let evidence pick the modality. Use fluoroscopy or MSK ultrasound based on indication, not habit.
4. Document and debrief. Keep templated notes; record consent; review near-misses; improve weekly.
5. Build a team. Nurses, techs, coordinators, and consultants raise safety and throughput.
6. Invest in your tools and your brand. Buy reliable kits; publish, present, and mentor; grow E-E-A-T signals.

Watch, Learn, and Apply

Finally, learn these lessons straight from the source.

🎥 Watch the full ICRAPAIN 2025 session:

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