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Regional Anesthesia & Pain Medicine

RAPM is your authoritative medical source for regional anesthesia and pain knowledge – from pediatric

11/20/2024

🔬 Optimal Pain Relief: The Case for Double Parasternal Injections

A new RAPM study shows double injections for superficial parasternal blocks provide better sensory coverage (T2–T6 dermatomes: 81% vs. 51% success) after cardiac surgery.

✅ More reliable results without added complications!

Link to the article can be found HERE -> https://bit.ly/3OaKuzI

11/18/2024

🔒 Unlocking the Obturator: A Deeper Look into Ultrasound-Guided Nerve Blocks

Excited to share new research in *RAPM* exploring an anatomical study on ultrasound-guided obturator nerve blocks!

Key Findings:
📍Consistent staining of the nerve’s common trunk & anterior branch (100%).
📍Posterior branch staining in 80% of cases.
📍Intrapelvic diffusion in 65% of samples.

✨Using landmarks like the **iliopubic ramus** and **obturator membrane** could enhance precision and outcomes in regional anesthesia.

✨ More studies are needed to confirm safety and efficacy, but this is a promising step forward!

Link to the article can be found HERE -> https://bit.ly/4hKwz0W

11/15/2024

🔹 Clarity on Radiofrequency for Back Pain Relief? Here’s What Works Best!
🔹

📃 A RAPM study highlights endoscopic neurotomy as the most effective treatment for lumbar facet joint syndrome (a common cause of chronic low back pain).

💉 This modality seems to offer better pain relief and function than other treatments, including injections and conservative care.

More research is needed, but this is promising news for those managing chronic back pain!

📖 Discover the full study here: https://bit.ly/4fnBL9E

11/11/2024

🔍 Blocks and Burns: continuous peripheral nerve blocks for burn management.

A recent study in RAPM shows that continuous peripheral nerve blocks (CPNB) offer safe, effective pain relief for acute burn injuries. Over 5 years, 281 patients received CPNB with a low infection rate (1.2%) and no major complications. 🏥

✨ Highlights:
- 1/3 of patients had enough pain relief to skip the OR for bedside debridement
- Most catheters were infraclavicular or popliteal sciatic, used for a median of 6 days

These findings could shape the future of burn care! 💪

📖 Discover the full study here: https://bit.ly/4fljwkT

11/10/2024

This month we highlight Axel Maurice Szamberski, MD, PhD, a member of the Editorial Board on RAPM.

📚 Dr. Axel Maurice Szamberski s an Associate Professor at CHU in Nice, France.

🎯 Here are some precious tips Dr. Szanberski has for submitting authors:

"My advice is to be straightforward and direct. It is crucial to present findings clearly, regardless of whether they are positive or negative. Negative results are as valuable as positive ones because they enhance our understanding of what works, what doesn’t, and why."

🔗 If you'd like to know more about Dr. Szamberski, read more here: https://bit.ly/3ULYYK6

11/08/2024

🔍 "MRI Genicular Nerve Mapping: A New Approach to Knee Pain Relief"

Chronic knee pain, including post-surgery pain, is a major challenge for patients and clinicians. Our latest study in RAPM used MRI to map the genicular nerves, crucial targets for radiofrequency ablation (RFA) in knee pain treatment.

Key Insights:

➡️ Genicular nerves are located further back than traditional rhizotomy targets, which may limit RFA effectiveness.
➡️ MRI-based mapping improves precision by identifying the exact anterior-posterior location of these nerves.
➡️ This approach could refine RFA techniques and enhance outcomes for chronic knee pain patients.

💡 Implication: Updated targeting guidelines for genicular nerves using MRI data may lead to better knee pain management.

📖 Discover the full study in RAPM! https://bit.ly/4f0dOVF

11/06/2024

🔍 "Axillary Nerve: what YOU should know"

Our latest article in RAPM delves into the complex anatomy of the axillary nerve and its essential role in shoulder pain management.

This educational piece highlights key sonographic targets and anatomical insights for more effective interventions in both perioperative and chronic shoulder pain cases.

📄 Key Points:
1️⃣ The axillary nerve plays a central role in shoulder innervation, critical for targeted pain relief.
2️⃣ Detailed sonoanatomy and optimal intervention points are explored to improve clinical outcomes.

📖 Discover more in the full article! https://bit.ly/3UopusZ

11/04/2024

BMJ has a long-standing interest in publishing content independent of commercial influence. Learn how our to***co research policy has recently been updated and extended across the portfolio. ➡️ https://bit.ly/4e98Zs9

10/30/2024

🔍 "Social Media Users’ Perspectives on Spinal Cord Stimulation"

Our latest study in RAPM analyzed Reddit discussions on spinal cord stimulation (SCS) for chronic back pain, uncovering key patient perspectives, expectations, and concerns.

📄 Highlights:

🙃 Many users shared mixed feelings on SCS effectiveness, with some reporting less pain relief than expected.

😐 Common concerns: lead migration, infection risk, and device-related discomfort.
Users offered advice on device choice, MRI compatibility, and managing post-op pain.

💡 This study highlights the potential of social media to better understand patient needs and improve healthcare communication.

📖 Read more in RAPM! https://bit.ly/4fg9vFa

10/28/2024

🔍 "Proximal vs. Distal ICBN Block: Which Is More Effective for Upper Arm Surgery?"

This article compared two ultrasound-guided approaches for intercostobrachial nerve (ICBN) block in upper arm arteriovenous access surgery.

📊 Key Findings:
🔹 The proximal block was more effective in the axillary region (96.7% vs. 73.3%)
🔹 Both approaches achieved effective surgical anesthesia (93.3%).

💡 Conclusion:
Both blocks are effective, with the proximal approach preferred for axillary interventions.

📖 Read the full study in RAPM for more insights! https://bit.ly/4f37xZo

10/25/2024

🚨 Game-Changing Insights Into Superficial Parasternal Intercostal Plane Blocks🚨

This cadaveric study by Harbell et al. titled ‘Anatomical Evaluation of the Superficial Parasternal Intercostal Plane (SPIP) Block’ compared the dye spread of single and double injection techniques of ultrasound-guided SPIP blocks!

🔬 Educational Insights:
▪️ SPIP Block Basics: This technique targets the plane between the pectoralis major and internal intercostal muscles to anesthetize the intercostal nerves supplying the anterior chest wall.

🔬 Key Findings:
▪️ Single injections showed consistent mediolateral spread from the sternum to the mid-clavicular line but limited craniocaudal coverage.
▪️ Double injections achieved a broader craniocaudal spread across more intercostal spaces and nerves, suggesting better coverage in anterior thoracic procedures.

🔬 Take Away:
▪️ This work highlights the potential need for multiple SPIP injections to optimize efficacy for anterior thoracic procedures.

Pushing the boundaries of regional anesthesia! 🙌

Link ⬇️ :
https://bit.ly/3AOo1Fc

10/23/2024

🎧 New Episode of RAPM Focus! 🎧

Brian Sites MD, our Editor-in-Chief, discusses with Alexander Abess MD, and Jonathan W**d MD, how research in health care is increasingly vital yet often hindered by escalating costs and time constraints.

🔊 Listen to it here: https://bit.ly/3C6SX48

10/18/2024

📢 Closing the Loop: Surgeon Feedback to Cut Post-Surgery Opioid Overprescribing

This study explored the feasibility of nudging surgeons with data on their patients' opioid use post-surgery.

📝 Key findings:
-100% of surgeons found the nudges acceptable.
- While prescription sizes didn't change, personalized feedback shows promise for improving prescribing practices.

🔗 Read more by clicking here -> https://bit.ly/3YcdxYC

10/15/2024

Watch an overview of some of the latest BMJ initiatives to preserve research integrity and maximise value. 👉 https://bit.ly/4e98Zs9

10/14/2024

🔍 Conflicts of Interest in Clinical Trials: A Call for Transparency 🔍

A recent study in the RAPM journal highlights a crucial issue: conflicts of interest (COIs) in randomized clinical trials (RCTs). Here are some key findings:

78.9% of analyzed RCTs reported COIs.
35.6% of authors per trial had at least one COI, averaging $41,157.83 in monetary value.
76.3% had undisclosed COIs, raising concerns about research integrity.
These findings stress the need for stronger COI disclosure guidelines and promoting non-industry funding.

🔗 To read more about it, click here: https://bit.ly/408ybLP

10/13/2024

🔍 Conflicts of Interest in Spinal Cord Stimulation Trials 🔍

A recent study in the RAPM Journal reveals concerning levels of conflicts of interest (COIs) in RCTs on spinal cord stimulation for chronic pain. Of the 38 trials analyzed (2013-2023):

• 78.9% reported COIs
• 76.3% had undisclosed COIs

These findings highlight the need for stronger COI policies and greater transparency to maintain integrity in neuromodulation research.

🔗 If you'd like to read more, click here: https://bit.ly/3A91nYd

10/09/2024

👩🏻‍🏫 RAPM is launching a Senior Mentorship Program!

👀 We're seeking experienced clinicians/researchers with a strong publication record to mentor new researchers in manuscript writing during the revision phase.

Interested?

📥 Email [email protected] to sign up!

10/07/2024

This month we highlight A. Sassan Sabouri, MD, a member of the Editorial Board on RAPM.

📚 Dr. Sabouri is an Assistant Professor of Anesthesia at the Massachusetts General Hospital/ Harvard Medical School, Boston.

🎯 Here are some precious tips Dr. Sabouri has for submitting authors:

"Clarity and conciseness are paramount in scientific writing. It’s crucial to be clear in detailing your methodology and results. Lastly, transparent reporting of findings is highly desirable."

🔗 If you'd like to know more about Dr. Sabouri, read more here: https://bit.ly/3Y6oGv6

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Videos

BMJ has a long-standing interest in publishing content independent of commercial influence. Learn how our tobacco research policy has recently been updated and extended across the portfolio. #ContentIntegrity ➡️ https://bit.ly/4e98Zs9

Patients’ threads on social media can provide insightful information, as expectations and real life-experiences not always match. Read more about this original study on spinal cord stimulation in RAPMs webpage!

Watch an overview of some of the latest BMJ initiatives to preserve research integrity and maximise value. #ContentIntegrity 👉 https://bit.ly/4e98Zs9

Learn how our Equality, Diversity and Inclusion policy supports our mission to create a stronger evidence base and improve the diversity of research content. #ContentIntegrity 👉 https://rapm.bmj.com/pages/authors?utm_id=BMJ031&utm_campaign=usage&utm_source=facebook&utm_medium=organic&utm_content=author_support

Love a good podcast? 🎧 BMJ has 20 different podcasts covering a wide range of topics. We produce over 150 episodes, with over 2 million downloads, each year. The RAPM Focus podcast should be the one for you. Find out more and subscribe today 👉 https://rapmfocusbmj.podbean.com/

📢 New Reel Alert! New study demonstrates association between adipose tissue and widespread pain! @Ryan_S_DSouzaMD

📢 New Reel Alert! New study demonstrates association between adipose tissue and widespread pain!

Ever wondered about the use of methadone during surgery? 🏥✨ Researchers surveyed 169 U.S. anesthesiology residency programs to find out how often intraoperative methadone is used for managing pain and what obstacles might be in play. Here’s the scoop: out of 49 responding institutions, methadone use was quite rare. For inpatient surgeries, only 12% of hospitals reported using it, and the numbers were even lower for outpatient procedures. 🚫💉 For more details, check out the full study in Regional Anesthesia & Pain Medicine. https://bit.ly/3ZtN6zN

Learn how BMJ is adapting to the use of Generative AI to continue its mission of maintaining and improving content integrity. #ContentIntegrity ➡️ https://bit.ly/4e98Zs9

📣 New RAPM Focus Episode is out!!! 🎙️ In this new podcast episode, Dr. Sites and Dr. Barrington discuss best practice advisories and policies with systematic reviews! 📰 🔉 Hear all about it here: https://bit.ly/3MtUUtu