Dr Tacson Fernandez

Dr Tacson Fernandez

Dr Tacson Fernandez
Dr Tacson Fernandez
Position:
Clinical Lead for Neuromodulation Service
Consultant in Anaesthesia, Acute Pain Management and Chronic Pain Medicine
Honorary Senior Lecturer at UCL
Private Patient Unit Enquiries:
Email:
ppu@rnohppu.com
NHS Contact Details:
Email:
rno-tr.chronicpainservice@nhs.net
Telephone:
+44 (0)203 947 0043
Specialties:
Acute Pain
Anaesthesia
Chronic Pain
Specialist clinical interests:
Chronic Pain Medicine: Management of neuropathic pain states, Persistent post surgical neuropathic pain, Complex regional pain syndrome, Sympathetically mediated pain, Persistent, Lower back pain despite spinal surgery, Mechanical axial pain states, Coccydynia, Phantom limb pain, Brachial plexus injury induced neuropathic pain, Peripheral nerve injury induced neuropathic pain.
Research interests:
  • Neuropathic pain states
  • Early management of acute lumbar radiculopathies
  • Neuromodulation in neuropathic pain
  • Persistent lower back and neuropathic leg pain despite spinal surgical interventions
  • Neuromodulation in brachial plexus injury induced neuropathic pain and peripheral nerve injuries.
Professional profile:

Dr Tacson Fernandez completed his Anaesthetic training at the Imperial School of Anaesthesia in London and obtained CCT in 2009. His training in Pain Medicine was obtained by working and visiting pain clinics across the UK, centres in Europe and USA. He completed his fellowship in Pain Medicine at Chelsea & Westminster Hospital in 2008. Dr Fernandez also obtained the Fellowship in Pain Medicine - Ireland, Fellowship of Interventional Pain Practice awarded by the World Institute of Pain in 2009 and has been an invited examiner for Interventional Pain management by the World Institute of Pain.

Dr Fernandez held Consultant roles in Pain Medicine & Anaesthesia at Chelsea & Westminster Hospital and Imperial College Healthcare - St Mary`s Hospital, Paddington, and Charing Cross Hospitals prior to moving to the Royal National Orthopaedic Hospital at Stanmore. At the Royal National Orthopaedic Hospital at Stanmore, Dr Fernandez set up the Neuromodulation centre offering complex chronic pain patients the option of Spinal Cord stimulators and Peripheral nerve stimulators according to NICE guidelines (TA159).

Dr Fernandez conducts weekly ward rounds in Acute Pain management to assist management of acute post operative pain in complex pain patients. He has regular out-patient clinics for Chronic Pain Management and theatre sessions for interventional procedures in pain management including dedicated theatre sessions for Spinal Cord Stimulator and Peripheral Nerve Stimulator  implants.  In addition Dr Fernandez also has weekly sessions in Anaesthesia for Major Spinal surgery and Regional anaesthesia lists for Shoulder and upper limb surgery.

He is involved with developing pathways for complex pain patients with an aim to create a seamless integrated pathway for excellent patient care.

As a Pain Medicine Specialist, Dr Fernandez’s areas of interest include:

  • Neuromodulation in Neuropathic pain
  • Cognitive Behavioural Modelling
  • Management of persistent neuropathic pain states
  • Peripheral Nerve Injury Pain
  • Persistent Lower back and neck pain
  • Cervicogenic pain and cervical radiculopathy
  • Complex regional Pain Syndrome
  • Phantom limb pain
  • Persistent post surgical pain

As an Anaesthetist, Dr Fernandez’s areas of interest include:

  • Regional anaesthesia
  • Orthopaedic/trauma anaesthesia
  • Anaesthesia for complex spine surgery
  • Regional anaesthesia for shoulder and upper limb surgery

As an Interventional Pain Management Specialist, Dr Fernandez’s areas of interest include:

Interventional Pain Management

Dr Fernandez’ practice of interventional pain management include a wide range of therapies including diagnostic and therapeutic selective nerve blockade, neuromodulation via spinal cord stimulators and peripheral nerve stimulators, including but not limited to:

  • Interlaminar epidurals in the cervical, thoracic, lumbar areas
  • Transforaminal Epidurals in the cervical, thoracic, lumbar areas
  • Selective dorsal root ganglion blocks in the cervical, thoracic, lumbar areas
  • Pulsed radiofrequency procedures to a range of nerves including; stellate ganglion, dorsal root ganglion and sympathetic plexuses
  • Peripheral electric nerve stimulation (PENS) techniques to areas of neuropathic pain including; scar site pain, post thoracotomy pain, etc.
  • Management of persistent knee and shoulder pain through electrical stimulation techniques and selective nerve blockade
  • Radiofrequency denervation techniques to different areas including cervical, thoracic and lumbar (facet joint) medial branch rhizotomy
  • Management of Sacro-iliac joint pain via selective blockade or radiofrequency denervation techniques
  • Spinal cord stimulators for neuropathic leg pain and in persistent neuropathic pain states, complex regional pain syndrome, peripheral nerve injury induced neuropathic pain, brachial plexus induced neuropathic pain, etc.
  • Peripheral nerve stimulators for peripheral nerve injury related neuropathic pain states.

Pharmacological, Cognitive and Rehabilitative strategies

Dr Fernandez has a wide range of pharmacological management options to manage nociceptive, neuropathic and mixed nociceptive-neuropathic pain states and is well versed in opioid management strategies including assistance with opioid reduction.

Dr Fernandez uses a multi dimensional, multi disciplinary approach for management of pain. He has been an invited speaker on Cognitive approaches into pain management both nationally and internationally and believes in active application of these techniques in his daily practice.

Education and training:

MBBS, FRCA, FCARCSI, FFPMCAI, FIPP
CCT Anaesthesia – Royal College of Anaesthetists, UK, 2009

Memberships:
General Medical Council (UK)
Medical Defence Union
British Medical Association
Royal College of Anaesthetists, UK
College of Anaesthetists, Ireland
Faculty of Pain Medicine
British Pain Society
World Institute of Pain
International Association for the Study of Pain
Neuromodulation Society of the UK & Ireland
Publications:
  • Author for chapter on “Perioperative pain” in the “Perioperative Complications in Neurosurgical Anesthesia and Critical Care Medicine Handbook”, Springer, 2012
  • Techniques to reduce lead migration during SCS trial, Pain Medicine news, vol 07; Jul 2009
  • Addressing pain in burn injury, Current Anaesthesia and Critical Care, Z Hanafiah, O Potparic, Tacson Fernandez, C&WH, 2008
  • Recent developments in management of acute severe Asthma, Graeme P Currie, T Fernandez et al, BMJ 2005; 330: 585-589

Presentations:

  • Author for chapter on “Perioperative pain” in the “Perioperative Complications in Neurosurgical Anesthesia and Critical Care Medicine Handbook”, Springer, 2012
  • Techniques to reduce lead migration during SCS trial, Pain Medicine news, vol 07; Jul 2009
  • Addressing pain in burn injury, Current Anaesthesia and Critical Care, Z Hanafiah, O Potparic, Tacson Fernandez, C&WH, 2008
  • Recent developments in management of acute severe Asthma, Graeme P Currie, T Fernandez et al, BMJ 2005; 330: 585-589
Courses offered to GPs
  • Management of neuropathic pain - multimodal approaches
  • Cognitive strategies in pain management
  • Interventional strategies in Chronic pain management
  • Understanding of the role of Neuromodulation in Chronic pain management
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