NYSORA - Continuing Medical Education

NYSORA - Continuing Medical Education Leading educational organization in the fields of Anesthesiology, Critical Care, Pain and Perioperative Medicine
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Trusted by 5 million readers annually, NYSORA is the #1 provider of free educational content and proprietary illustrations in the fields of Anesthesiology, Ultrasound, MSK, and Pain Medicine. In addition to hardcover textbooks and manuals, we published several apps with 11K+ users, organized 500+ live conferences, workshops, and retreats featuring lectures by world-renown industry experts around the globe, and self-funded philanthropic educational anesthesia programs in the developing world, substantially contributing to the development of regional anesthesia and pain management in Asia, Africa, South America, and the Balkans.

You know regional blocks are powerful. But assessing effectiveness can be a challenge.AI-powered NOL (Nociception Level ...
09/25/2025

You know regional blocks are powerful. But assessing effectiveness can be a challenge.

AI-powered NOL (Nociception Level Index) monitoring allows you to:
- Objectively monitor the physiological response to pain
- Assess block effectiveness

"As one of the first users of this technology in the US, I see a real clinical need for nociception monitoring - and would want my family monitored with it if they were undergoing surgery." - Dan Katz, MD, Professor and Vice Chair of Education, Dept. of Anesthesiology, Pain & Perioperative Medicine, Mount Sinai Hospital, NYC

Nociception monitoring can transform your regional anesthesia practice. Learn more at the Lunchtime Symposium at NYSORA

Saturday, Sept 27 at 1:15 PM. Speaker: Pascal Lafferriere-Langlois, MD, MSc, Hôpital Maisonneuve-Rosemont, Montreal, Canada.

Medasense Biometrics LTD

09/24/2025

Struggling with rolling veins? Watch how proper preparation turns a difficult IV into a smooth success!

- Double tourniquets
- Low-angle entry
- Patience = easy access

Find more practical tips in the NYSORA IV Access App. Designed to support you in mastering difficult IV access, step by step.

https://community.nysora.com/IV-Access-App-IG

“Grateful for the opportunity to share with the NYSORA community our perspective on treating persons with pain and funct...
09/22/2025

“Grateful for the opportunity to share with the NYSORA community our perspective on treating persons with pain and functional problems related to spasticity.” - Jose Pereira, MD

“What stood out was the focus on the bedrock of our field: radiofrequency ablation, orthobiologics, ultrasound guidance, neuromodulation. Progress in pain medicine comes not only from new technologies but from learning from each other.” - Scott Pritzlaff, MD

The Pain Summit in Leuven reminded us why we come together: not just for techniques, but for conversation, collaboration, and building the future of pain medicine as a community.

To everyone who joined us - thank you for bringing your insight and energy.
To those following along - this is just the beginning.

The next Pain Summit is where you need to be. Because progress happens when we do it together!

New target for refractory craniofacial cancer painA 2025 multicenter study (33 pts, 11 hospitals, China) shows intrathec...
09/22/2025

New target for refractory craniofacial cancer pain

A 2025 multicenter study (33 pts, 11 hospitals, China) shows intrathecal morphine delivery to the prepontine cistern can cut pain scores from 8.0 → 1.0 in 30 days, with >90% pain reduction and minimal side effects.

Why it works:

- Direct action on cranial nerve roots (incl. trigeminal)
- Ultra-low morphine dose → fewer systemic effects
- Minimally invasive via lumbar puncture + fluoroscopy

Impact:

- 96.7% achieved >50% relief by day 30
- Systemic opioids were reduced to near-zero
- No major complications

Would you consider prepontine-targeted ITDD for patients with intractable craniofacial cancer pain when standard therapies fail? Let us know in the comments!

To get more updates on the latest impactful research in pain medicine, download NYSORA’s Pain Medicine Assistant!

https://www.nysora.com/pain-medicine-assistant-app/

Reference: Long D et al. Anesthesia & Analgesia. 2025;141(2)

A young woman arrives in the ICU with sudden, severe liver failure. In fulminant hepatic failure (FHF), rapid deteriorat...
09/19/2025

A young woman arrives in the ICU with sudden, severe liver failure. In fulminant hepatic failure (FHF), rapid deterioration can lead to brain swelling, multi-organ failure, and death within days. Anesthesiologists play a critical role in supporting these patients during emergency surgery or transplantation.

Key points from the review by Vertrugno et al., 2025:

- Cerebral protection – careful control of ICP, sodium, and ventilation to prevent herniation.
- Hemodynamic stability – managing vasodilation, high cardiac output, and coagulopathy.
- Perioperative strategy – tailored anesthetic drugs and vigilant monitoring during liver transplant.
- Cause matters – acetaminophen overdose, viral hepatitis, and autoimmune disease require targeted therapy.

Early recognition, meticulous critical care, and rapid transplant referral can be lifesaving.

Read more about hepatic failure in our Anesthesiology Manual: Best Practices & Case Management. https://www.nysora.com/books/anesthesiology-manual/

Vetrugno L, Alessandri F, Toscano A, Voza A, Deana C. 'Fulminant hepatic failure' anesthesiologic considerations. Curr Opin Anaesthesiol. 2025 Aug 1;38(4):503-512.

09/17/2025

SUPRACLAVICULAR Brachial Plexus Block: 1-2-3 approach Targeting the brachial plexus above the clavicle? Here's how with the help of the NYSORA Nerve Blocks App

A 47-year-old patient is scheduled for ORIF of a midshaft humerus fracture—time for a supraclavicular brachial plexus block.

- Place a linear transducer transversely just above the clavicle to identify the brachial plexus lateral and superior to the subclavian artery.
- Insert the needle in-plane, from lateral-to-medial, and perform two injections:
1. 10 mL in the corner pocket (between the first rib and lower trunk).
2. 10 mL between the upper and middle trunk divisions.
- Watch the local anesthetic spread around the brachial plexus trunks.

Learn or teach the step-by-step technique with the NYSORA Nerve Blocks App: https://community.nysora.com/nerve-blocks-app-OSM

When to Transfuse? A Guide to Perioperative RBC TransfusionOptimizing transfusion decisions begins with a stepwise appro...
09/15/2025

When to Transfuse? A Guide to Perioperative RBC Transfusion

Optimizing transfusion decisions begins with a stepwise approach that considers hemoglobin levels, bleeding severity, and patient stability.

Key Decision Points:

- Hb 8 g/dL → Avoid unless severe symptoms
- Massive bleeding? Transfuse
- Minor/moderate bleeding? Try conservation
- Unstable or hypoxic? Consider transfusion

Pair clinical judgment with Patient Blood Management (PBM) strategies to improve outcomes and reduce unnecessary transfusions.

Stay ahead with the NYSORA Assistant App, featuring the latest Anesthesia Updates and MAIA, NYSORA’s powerful AI Assistant. Instantly search clinical questions, simulate anesthetic plans, and stay ahead with expert-verified guidance at your fingertips.

https://community.nysora.com/anesthesia-assistant-app-O-SM

Reference: Morris FJD et al. Br J Anaesth. 2023;131:1002-1013.

09/12/2025

A 52-year-old patient presents with burning, tingling pain and allodynia of the chin and lower lip, consistent with mental neuralgia.

An ultrasound-guided mental nerve block is performed to relieve pain and confirm the diagnosis. Dr. Sadiq Bhayani demonstrates how to perform this intervention.

Key steps:

- Position: Supine, mouth slightly open, jaw relaxed
- Scanning: Transducer ~3 cm lateral to midline, 1 cm above lower mandibular border (between first & second premolars)
- Identify the mental artery & nerve with Doppler
- Insert the needle in-plane or out-of-plane, and target the nerve just outside the foramenInject 1–2 mL local anesthetic ± steroid

For a practical guide to ultrasound-guided mental nerve block, check out NYSORA’s Ultrasound-Guided Interventional Pain Procedures Manual.

https://community.nysora.com/Ultrasound-Guided-Interventional-Pain-Procedures-Manual-OSM

A failed spinal block doesn’t end in the OR—the follow-up is just as important. Postoperative review ensures patients un...
09/10/2025

A failed spinal block doesn’t end in the OR—the follow-up is just as important. Postoperative review ensures patients understand what happened, and records guide safer plans for the future.

Key steps:

- Explain events clearly to the patient and document in detail.
- Assess for rare neurological causes; recurrent failures may need an MRI.
- Consider, though rare, faulty local anesthetics—hyperbaric bupivacaine is most often reported.
- Verify the chemical stability of amide anesthetics; test efficacy if needed.

A thorough investigation turns a setback into valuable knowledge for better patient outcomes.

Read more about the management of failed spinal anesthesia in NYSORA's Regional Anesthesia Module on NYSORA360! https://nysoralms.com/courses/regional-anesthesia/

09/09/2025

Median nerve block at the level of the wrist: Inside out

NYSORA’s Reverse Ultrasound Anatomy (RUA) Animations make every step visible, transforming anatomy and technique into an intuitive learning experience.

In this focused animation of the median nerve block at the wrist level, RUA shows:

- The precise needle path through the subcutaneous tissue
- Key anatomical relationships to avoid nearby tendons and vessels
- How local anesthetic spreads around the median nerve for an effective block

By turning a textbook concept into a real-time, 3D experience, NYSORA’s RUA improves understanding and helps refine clinical accuracy.

Access the full library of RUA animations inside the NYSORA Nerve Blocks App.

Download now: https://community.nysora.com/nerve-blocks-app-OSM

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NYSORA is world-wide renowned educational organization with focus in anesthesiology, peri-operative medicine and ultrasound. Incorporated in 2,000 in NYC, NYSORA has substantially contributed to education and advancement in science and practice of anesthesiology. Through its research and educational programs, NYSORA contributed the development of loco-regional anesthesia and acute pain practice worldwide. NYSORA's website is visited by 4,000,000 unique visitors annually; its readership comprises 50,000 health care providers. NYSORA donated supplies and conducted many philanthropic educational programs in developing countries in Latin America, Asia, Africa and Eastern Europe. Its acronym stands for “New York School of Regional Anesthesia”.