The 20 Best Acute Pain Doctors in Maryland, US

Dr. Ronen Shechter is an assistant professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. He has expertise in managing a wide variety of chronic and acute pain conditions. He believes in a multi-modal approach to pain management that utilizes physical, behavioral, interventional and pharmacologic therapies. He is also passionate about setting realistic functional goals with his patients. Dr. Shechter earned his medical degree in 1999 from the Hebrew University Hadassah Medical School in Jerusalem. He completed his training in anesthesiology and a fellowship in pain medicine at Thomas Jefferson University Hospital and subsequently remained on the faculty in the Department of Anesthesiology there. In 2012, Dr. Shechter joined the Division of Pain Medicine in the Department of Anesthesiology and Critical Care Medicine at the Johns Hopkins University School of Medicine as a research fellow and part-time faculty member. He joined the department as a full-time assistant professor in 2014. His current research investigates a novel treatment for chemotherapy-induced nerve pain. Dr. Shechter is a faculty member in the Acute Pain Medicine and Regional Anesthesia Fellowship and the Pain Medicine Fellowship programs at the Department of Anesthesiology and Critical Care Medicine. Dr. Shechter is rated as a Distinguished provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Acute Pain, Neuralgia, and Chronic Pain.

Dr. Edward G. McFarland is a professor of orthopaedic surgery at the Johns Hopkins School of Medicine. He is the Wayne H. Lewis Professor of Shoulder and Elbow Surgery and serves as director of the Division of Shoulder Surgery. He specializes in the treatment of shoulder and elbow conditions and injuries. Dr. McFarland received his B.S. in biology at Murray State University and completed his M.D. at the University of Louisville School of Medicine. He performed his residency in orthopaedic surgery at the Mayo Graduate School of Medicine, and completed a fellowship in sports medicine at the Kerlan-Jobe Orthopaedic Group in Santa Monica, California. He joined the faculty of Johns Hopkins in 1992 as an assistant professor in the Department of Orthopaedic Surgery and became a full professor in 2005. His areas of special interest include shoulder replacement surgery, especially reverse total shoulder replacement, anatomical shoulder replacement and evaluation and treatment of failed shoulder replacements. He treats patients with shoulder fractures, instability or dislocations, arthritis, rotator cuff tears and AC joint problems. He also has a special interest in sports injuries to the shoulder inclusive of all and any sports. He sees injuries to the shoulder of all ages. His research includes all of these topics including evaluation, treatment and the results of treatment. Dr. McFarland is a member of numerous professional organizations, serves on the editorial boards of three journals and is a past president of the Association of Bone and Joint Surgeons. He has authored or co-authored over 200 peer-reviewed articles, 20 book chapters and three full books, and has won several awards for his research and service. CV https://www.hopkinsmedicine.org/-/media/orthopaedic-surgery/documents/mcfarland-cv.ashx Videos Dr. Edward G. McFarland Shoulder InjuriesQ&A with Dr. Edward McFarland Reverse Shoulder ReplacementJohns Hopkins Medicine. Dr. Mcfarland is rated as an Advanced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Osteoarthritis, Axillary Nerve Dysfunction, Tendinitis, Shoulder Arthroscopy, and Tenotomy.

Dr. Joann Hunsberger is an assistant professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. Her area of clinical expertise is anesthesiology. She earned her M.D. from the Drexel University College of Medicine. She completed her residency at Johns Hopkins, where she also performed a fellowship in pediatric anesthesiology. Dr. Hunsberger is rated as an Advanced provider by MediFind in the treatment of Acute Pain. Her top areas of expertise are Acute Pain, Umbilical Hernia, Omphalocele, Osteotomy, and Bladder Reconstruction.

Eric Wang is a Pain Medicine specialist and an Anesthesiologist in Baltimore, Maryland. Dr. Wang is rated as an Advanced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Chronic Pain, Neuralgia, Acute Pain, and Complex Regional Pain Syndrome.

Hassan Rayaz is an Anesthesiologist in Baltimore, Maryland. Dr. Rayaz is rated as a Distinguished provider by MediFind in the treatment of Acute Pain. His top area of expertise is Acute Pain.

Paul Christo is a Pain Medicine specialist and an Anesthesiologist in Lutherville, Maryland. Dr. Christo is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Chronic Pain, Neuralgia, Central Pain Syndrome, Complex Regional Pain Syndrome, and Osteotomy.

Eellan Sivanesan is a Pain Medicine specialist and an Anesthesiologist in Baltimore, Maryland. Dr. Sivanesan is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Neuralgia, Chronic Pain, Complex Regional Pain Syndrome, and Shingles.

Dr. Tricia Vecchione is an assistant professor of pediatric anesthesiology at the Johns Hopkins University School of Medicine. Her areas of clinical expertise include anesthesiology, pediatric anesthesiology, and pediatric regional anesthesia and acute pain management. She earned her M.D. from SUNY Downstate Medical Center and completed her residency at Montefiore Medical Center. She completed a fellowship in pediatric anesthesiology at Texas Children’s Hospital and a fellowship in pediatric regional anesthesia at Boston Children’s Hospital. Dr. Vecchione is rated as an Experienced provider by MediFind in the treatment of Acute Pain. Her top areas of expertise are Acute Pain, Ehlers-Danlos Syndrome (EDS), and Bladder Reconstruction.

Dr. Khaled Kebaish serves as chief of the Spine Division in the Department of Orthopaedic Surgery. He is a professor of orthopaedic surgery and neurological surgery at the Johns Hopkins University School of Medicine. His areas of clinical expertise include spine deformities and scoliosis, degenerative spine disorders, spine tumors and disc arthroplasty. Dr. Kebaish earned his M.D. from Cairo University. He completed his residency at University of Toronto in Toronto, Canada, and performed a fellowship in spinal reconstructive surgery at Johns Hopkins. Dr. Kebaish's research interests include the clinical and functional outcomes of spine surgery with a special focus on adult deformity surgery. He also focuses on the biomechanical testing and evaluation of different fixation devices and techniques in the adult spine. Dr. Kebaish is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Kyphosis, Lordosis, Scoliosis, Osteotomy, and Spinal Fusion.

Fareeha Khan, M.B.B.S., M.P.H., specializes in family and geriatric medicine and has a clinical focus on improving outcomes for older patients. Dr. Khan graduated from Jinnah Sindh Medical College in Karachi, Pakistan, and has a master’s degree in public health from the Johns Hopkins Bloomberg School of Public Health. Dr. Khan completed her family medicine residency at St. Mary Mercy Hospital in Livonia, Michigan, followed by a fellowship in geriatric medicine at the University of Michigan with an advanced fellowship year at the Geriatrics Research Education and Clinical Center in the Veterans Affairs health care system in Ann Arbor, Michigan. After fellowship she joined as faculty in the department of family medicine at Atrium Health, Charlotte, North Carolina where she trained residents and geriatric medicine fellows. She worked as the geriatric medicine inpatient consultant on trauma and other services. Dr. Khan went on to establish a collaborative geriatric preoperative assessment clinic for older adults undergoing abdominal wall reconstruction surgery at Atrium Health. In 2021 Dr. Khan moved to Florida where she worked as faculty in the department of community health and family medicine at the University of Florida Health System in Jacksonville. Dr. Khan’s research interests include polypharmacy, improving surgical outcomes for older patients and advance care planning. Dr. Khan is rated as an Experienced provider by MediFind in the treatment of Acute Pain. Her top areas of expertise are Acute Pain, Delirium, Hypertension, and Hypothyroidism.

Dr. Constance L. Monitto is an assistant professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. Her clinical work focuses on intraoperative anesthetic management of pediatric patients as well as attending on the pediatric acute pain service. She serves as associate clinical director of pediatric anesthesiology at the Johns Hopkins University School of Medicine. Dr. Monitto received her undergraduate degree in physics from Princeton University and earned her medical degree from Harvard Medical School. She completed a residency in pediatrics at The Children’s Hospital, Boston, and a residency in anesthesia at Massachusetts General Hospital. She also completed a subspecialty residency in pediatric anesthesia at The Children’s Hospital of Philadelphia (CHOP). After remaining on staff at CHOP for two years, Dr. Monitto joined the Johns Hopkins faculty in 1994. Dr. Monitto's clinical research interest is pediatric pain management and her basic science research involves assessing the impact of epigenetic gene regulation on the development of resistance to chemotherapeutic agents in cancer. She is a member of the American Academy of Pediatrics, the American Society of Anesthesiologists, the Society for Pediatric Anesthesia and the International Anesthesia Research Society. Dr. Monitto is rated as an Experienced provider by MediFind in the treatment of Acute Pain. Her top area of expertise is Acute Pain.

Sonja Rasmussen, MD, MS is Professor in the Department of Genetic Medicine at Johns Hopkins School of Medicine. She joined Johns Hopkins after 4 years at the University of Florida (UF) College of Medicine and College of Public Health and Health Professions where she served as a Professor in the Departments of Pediatrics, Epidemiology, and Obstetrics and Gynecology and as the Director of UF’s Precision Health Program. Before joining University of Florida in 2018, she served for 20 years at the Centers for Disease Control and Prevention (CDC) in Atlanta, where she held several scientific leadership roles. She served in leadership roles during several CDC responses to public health emergencies, including 2009 H1N1 influenza, H7N9 influenza, Middle East Respiratory Syndrome (MERS), and Zika virus. Dr. Rasmussen is an author on >300 peer-reviewed publications and is the lead editor of The CDC Field Epidemiology Manual, released by Oxford University Press in 2019. Her research interests focus on understanding the effects of infections and medications during pregnancy, genetic and environmental risk factors for birth defects, and morbidity and mortality associated with genetic conditions. Dr. Rasmussen is rated as an Experienced provider by MediFind in the treatment of Acute Pain. Her top areas of expertise are Achalasia Microcephaly Syndrome, Microcephaly, Cortical Dysplasia, Gastroschisis, and Knee Replacement.

Dr. Greg Osgood is an assistant professor of orthopaedic surgery at the Johns Hopkins School of Medicine and Chief of Orthopaedic Trauma for the Department of Orthopaedic Surgery. His areas of expertise include orthopaedic trauma, with a special focus on fracture non-unions, pelvis and acetabular injuries, and fractures and surgical infections. Dr. Osgood’s undergraduate degree is from Harvard University. He completed medical school at Columbia University College of Physicians and Surgeons in New York. Dr. Osgood began his orthopaedic residency training with the United States Air Force and completed this training at New York Orthopaedic Hospital at the Columbia Presbyterian Medical Center. In 2005, he completed an Orthopaedic Trauma Fellowship at Harborview Medical Center in Seattle. He joined the Johns Hopkins faculty in 2010 as the organization''s first orthopaedic trauma faculty member. Dr. Osgood’s interests in orthopaedic trauma care include fracture non-unions, pelvis and acetabular injuries, routine fractures and surgical infections. Dr. Osgood is a former major in the United States Air Force. He completed several combat deployments, providing orthopaedic trauma care to our military. Dr. Osgood is actively involved in numerous professional organizations, including being the associate editor of the Journal of Orthopaedic Trauma, a member of the AO North America Teaching Faculty, a member of the Education Committee of the Osteosynthesis and Trauma Care Foundation, Orthopaedic Trauma Association Military Committee, and the director of the Humanitarian Program of the Osteosynthesis and Trauma Care Foundation. Videos Dr. Greg OsgoodOrthopaedic Trauma Surgeon An Innovative Approach to Nerve Repair ‚Äî Santi‚Äôs Story. Dr. Osgood is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Acute Pain, Infectious Arthritis, Compartment Syndrome, Hip Replacement, and Vertebroplasty.

"Harpal ""Paul"" Khanuja, M.D., is an associate professor of orthopaedic surgery at The Johns Hopkins University School of Medicine. Dr. Khanuja serves as the director of the Department of Orthopaedic Surgery at Johns Hopkins Bayview and the director of adult reconstruction, hip and knee replacement surgery for The Johns Hopkins University School of Medicine. Dr. Khanuja sees and treats adults with disorders of the hip and knee. He specializes in joint replacement surgery, including total hip replacement and total knee replacement. He also offers minimally invasive hip and knee replacement, including anterior hip replacement. He coordinates the integration of best practices for joint replacement. His clinical focus is on improved post-operative recovery and decreased pain. Dr. Khanuja also specializes in complex surgeries, joint replacement revisions and outpatient joint replacement. Dr. Khanuja holds research interests in cartilage repair, osteonecrosis, computer-assisted surgery patient safety and new technologies in joint replacement. Dr. Khanuja is past president of the Maryland Orthopaedic Association and a member of the American Academy of Orthopaedic Surgeons and the Association of Hip and Knee Surgeons. He co-founded Operation Walk Maryland, a volunteer medical service organization that provides free surgical treatment for patients in developing countries and in the United States. Videos Dr. Paul Khanuja 2017 Clinical Collaboration and Teamwork Award - Harpal Khanuja, M.D. & Total Joint Rep. Team, JHBMC Outpatient Hip and Knee ReplacementQ&A with Dr. Harpal (Paul) Khanuja Recent News Articles and Media Coverage Forty-Seven Patients Benefit From Free Joint Replacement Surgery in a Guyana HospitalNews Source Guyana (October 2018) Advances in joint replacement surgery allow same-day discharge.Johns Hopkins Bayview News (February 2016) Operation Walk MarylandDome (April 2016) Webinar: the Causes and Cures of Joint PaintJohns Hopkins Medicine (October 2014) Making Knees New AgainJohns Hopkins Medicine (June 2014) A Systematic Approach to Joint ReplacementsJohns Hopkins Orthopaedic Surgery (February 2014)". Dr. Khanuja is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Osteonecrosis, Osteoarthritis, Knock Knees, Knee Replacement, and Hip Replacement.

Dr. Babar Shafiq is an orthopaedic surgeon fellowship trained in traumatology who performs surgery for acute trauma and adult reconstruction. As an Associate Professor of Orthopaedic Surgery at the Johns Hopkins University School of Medicine, the Johns Hopkins Hospital and Johns Hopkins Howard County Medical Center. Dr. Shafiq is very active clinically caring for patients with a broad range of orthopaedic injuries and conditions. An abbreviated list incudes: Poorly healing Fractures called Non-unions/Malunions Limb Deformity/Limb Length Hip Replacements Fractures: Lower Extremity: Hip, Pelvis, Acetabulum, Femur, Tibia, Tibia plateau, Ankle, Foot Upper Extremity: Shoulder, Clavicle, Humerus, Scapula, Elbow, Forearm, Distal Radius Fractures around hip and knee replacements Dr. Shafiq completed his orthopaedic trauma fellowship in Minnesota at the renowned Regions Hospital/University of Minnesota - Twin Cities Orthopaedic Trauma Fellowship. He has practiced orthopaedic traumatology at the Johns Hopkins Hospital since 2013 after spending 2 years serving as the Director of Orthopaedic Trauma at Howard University Hospital where he also completed his medical and residency training. In addition, Dr. Shafiq formerly practiced Physical Therapy after completing a master's degree prior to attending medical school. His knowledge of biomechanics, rehabilitation, and surgery make him uniquely qualified to guide patients from injury through rehab and on to optimal recovery. Current academic and administrative appointments: Director: Johns Hopkins Orthopaedic Bone Health Center (where he partners with Andra Love, PA-C to identify and manage the care of patients with fragility fractures and osteoporosis related fracture risk) Associate Program Director: Johns Hopkins Orthopaedic Residency training program Dr. Shafiq is very active in teaching and research. He gives lectures and teaches medical students, residents and fellows on a daily basis both at Johns Hopkins and at regional, national and international courses. Dr. Shafiq has authored or co-authored over 70 peer-reviewed publications and book chapters (See PUBMED for a detailed list) Outside of the hospital Dr. Shafiq spends time with his wife, 3 children and his dog. He is active in cycling, running and swimming. Dr. Shafiq is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Compartment Syndrome, Infectious Arthritis, Axillary Nerve Dysfunction, Fasciotomy, and Hip Replacement.

Vishal Hegde, M.D., is an orthopaedic surgeon specializing in hip and knee replacement surgery, serving patients in the Baltimore area. His expertise is in minimally invasive hip and knee surgery, including anterior total hip replacement, partial and total knee replacement, complex hip and knee replacement and revision surgery after a failed previous joint replacement. Dr. Hegde is committed to providing the best possible care for his patients. He strives to create a personalized approach to each patient. He does this through customized treatment plans tailored to each patient’s unique lifestyle as well as through the application of new technologies such as precision computer navigation. Dr. Hegde is an assistant professor in the Johns Hopkins Department of Orthopaedic Surgery. He graduated cum laude from Columbia University and received his medical degree from Weill Cornell Medical College. Dr. Hegde did his orthopaedic surgery residency at the University of California Los Angeles. He then completed an advanced clinical fellowship in adult reconstructive surgery at Colorado Joint Replacement in Denver, Colorado. He is a candidate member of the American Academy of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons. Dr. Hegde is committed to moving the field of joint replacement forward and has published many research articles and orthopaedic surgery textbook chapters. His research interests include developing innovative new techniques and technologies to prevent implant infection and improve outcomes after hip and knee replacement surgery. He has won numerous awards for his research from organizations including the American Academy of Orthopaedic Surgeons, the Musculoskeletal Infection Society and the Western Orthopaedic Association. Dr. Hegde is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Osteoarthritis, Chondroblastoma, Acute Pain, Knee Replacement, and Hip Replacement.

Savyasachi “Savya” Thakkar, M.D., is a hip and knee reconstructive surgeon serving patients in the Baltimore, Maryland, and Washington, D.C., metro areas. His expertise is in minimally invasive hip and knee surgery, including partial and total hip and knee replacement, outpatient joint replacement and complex revisions after previous joint replacement. Dr. Thakkar uses computer and robotic-assisted techniques for these procedures to provide cutting-edge care to patients with hip and knee arthritis. Currently an Assistant Professor of Orthopaedic Surgery at Johns Hopkins, Dr. Thakkar completed his medical degree at the Johns Hopkins University School of Medicine and stayed for his residency with the Johns Hopkins Department of Orthopaedic Surgery. He was the first recipient of the Ronald P. Byank leadership award as a chief resident. He continued his training as a knee arthritis and traumatology fellow in Switzerland, followed by an adult reconstruction fellowship in New York. He then pursued the prestigious European Knee Society traveling fellowship focusing on advanced surgical techniques in the management of arthritis. Dr. Thakkar’s research interests include technological advances in the treatment of arthritis, post-traumatic arthritis, the economic impact of arthritis and the optimization of hospital protocols for arthritis management. He is also interested in exploring same-day joint replacement surgery to help patients minimize time in the hospital and maximize return to function. Dr. Thakkar is the chair of Orthopaedic Surgery at Johns Hopkins Howard County Medical Center. Dr. Thakkar is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Osteonecrosis, Osteoarthritis, Osteoporosis, Knee Replacement, and Hip Replacement.

Dr. Peju Adekoya is an Interventional Pain Physician at The Johns Hopkins Hospital, Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine. He completed an Interventional Pain Medicine fellowship at Harvard University's Massachusetts General Hospital, Boston. He completed his Anesthesiology training here at Johns Hopkins Hospital, the Department of Anesthesiology and Critical Care Medicine in Baltimore. During this very fulfilling time, he received several prestigious awards such as the Merel Harmel MD outstanding resident award, resident achievement award for test performance excellence, resident of the year award and an award for clinical excellence at Johns Hopkins, along with the award for clinical excellence at the Hospital for Special Surgery, New York. Prior to this, he obtained his undergraduate and medical degree at Howard University, Washington, D.C. His areas of clinical expertise includes Anesthesiology, comprehensive and interventional pain medicine that includes the spine, joints (upper and lower extremities), muscles/myofascial tissue, abdomen, pelvis, headaches, cancer-related and several other pain syndromes using image-guided techniques (fluoroscopy and/or ultrasound) along with adjunct therapies as indicated. Furthermore, he also utilizes advanced neuromodulation techniques to treat a range of persistent chronic pain conditions using modalities of spinal cord and dorsal root ganglion stimulation with an implantable pulse generator. Dr. Peju Adekoya has been active in published works in outcomes-based research for chronic pain conditions. He is primarily seeing patients at the National Capital Region, Bethesda, MD. Including from both Johns Hopkins Suburban Hospital and Sibley Memorial Hospital. Appointment Information for Dr. Peju Adekoya: Call 410-955-7246. Dr. Adekoya is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Chronic Pain, Facet Joint Syndrome, Neuralgia, and Acute Pain.

Amiethab Aiyer, M.D., is an orthopaedic surgeon specializing in treating patients with foot and ankle conditions, such as fractures, deformities, and ligament and tendon tears. He is skilled in minimally invasive bunion correction, Achilles tendon rupture repair, as well as ankle reconstruction and replacement. Dr. Aiyer is the division chief of foot and ankle surgery in the Johns Hopkins Department of Orthopaedic Surgery. He completed his medical training at Drexel University College of Medicine in Philadelphia. During his fourth year of medical school, Dr. Aiyer completed a research fellowship at the Rothman Orthopaedic Institute, also in Philadelphia. He then completed an orthopaedic surgery residency at the Penn State Health Milton S. Hershey Medical Center in Hershey, Pennsylvania. During the residency, Dr. Aiyer received multiple awards, including the Alan Levine Orthopaedic Graduate Medical Education Scholarship from the American Academy of Orthopaedic Surgeons (AAOS). He has also been selected to present at the Orthopaedic Research and Education Foundation Resident Research Symposium and as an American Orthopaedic Association (AOA) Emerging Leader. In his final year of residency, he received the Gold Humanism Resident Teacher Award. Dr. Aiyer went on to complete a research and clinical fellowship at the Institute for Foot and Ankle Reconstruction at Mercy Medical Center in Baltimore. As a researcher, he is currently investigating diagnosis, surgical treatments and patient outcomes for bunions, Achilles tendon ruptures, ankle arthritis, ankle trauma and other conditions affecting the foot and ankle. His research encompasses clinical, basic science and biomechanical studies. He has presented his research at numerous conferences held by the American Orthopaedic Foot & Ankle Society, AAOS and other professional organizations of which he is a member. He is a fellow of the AAOS and AOA, and a member of the Alpha Omega Alpha Honor Medical Society. Along with special interests in clinical practice and multiple facets of orthopaedic foot and ankle research, he is passionate about teaching residents and medical students; he has been mentoring medical students for several years. Dr. Aiyer has been recognized for his commitment to education with multiple teaching and faculty educator awards, and he is working with other orthopaedic surgeons to develop a nationwide push for medical student mentorship. Using social media platforms, he co-founded the @orthomentor Instagram account to provide students with easy access to mentorship and advising. Dr. Aiyer is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Achilles Tendon Rupture, Metatarsus Adductus, Flat Feet, Tendinitis, and Osteotomy.

Hardin Pantle, M.D., FACEP, FAAP, FAAEM, is an Assistant Professor of Medicine at The Johns Hopkins University School of Medicine and former Assistant Director of the Emergency Department at Johns Hopkins Bayview Medical Center. Dr. Pantle earned a medical degree at Columbia University College of Physicians and Surgeons in 1998 and completed residencies in pediatrics (2001) and emergency medicine (2004) at The Johns Hopkins University. He has worked in the Emergency Department at Johns Hopkins Bayview Medical Center since 2004. Dr. Pantle is rated as an Experienced provider by MediFind in the treatment of Acute Pain. His top areas of expertise are Multisystem Inflammatory Syndrome in Children (MIS-C), Schizoaffective Disorder, Gastrointestinal Bleeding, Acute Pain, and Gastrostomy.