Episode 163: Thoracic Wall Blocks with Barbara Versyck

In this 163rd episode I welcome Dr. Barbara Versyck to the show to discuss thoracic wall blocks. We discuss the types of blocks, what they are used for, and what the evidence is for their efficacy.

References:

Videos: 

Pecs II: https://www.youtube.com/watch?v=YFWneF4pwOA

Serratus Anterior block: https://www.youtube.com/watch?v=K2w46jjMgfMErector

Spinae plane block: https://www.youtube.com/watch?v=EVowRjEFUfk

Literature: 

Chin, Ki Jinn. “Thoracic wall blocks: from paravertebral to retrolaminar to serratus to erector spinae and back again–a review of the evidence.” Best Practice & Research Clinical Anaesthesiology (2019).

Versyck, B., G‐J. van Geffen, and K‐J. Chin. “Analgesic efficacy of the Pecs II block: a systematic review and meta‐analysis.” Anaesthesia 74.5 (2019): 663-673.

Poster: 

https://www.bbraun.com/content/dam/catalog/bbraun/bbraunProductCatalog/S/AEM2015/en-01/b9/thoracic-wall-blocks-forbreastcancersurgery.pdf.bb-.98924081/thoracic-wall-blocks-forbreastcancersurgery.pdf

Episode 155: Opioid-Free Anesthesia with Michael Manning

In this 155th episode I welcome Dr. Michael Manning to the show to discuss opioid-reduced and opioid-free anesthesia. We discuss the downsides of opioid usage and what we can do to reduce our use in our patients or even eliminate it completely.

References:

1. Koepke EJ, Manning EL, Miller TE et al. The rising tide of opioid use and abuse: the role of the anesthesiologist. Perioper Med (Lond) 2018;7:16.

2. Brummett CM, Waljee JF, Goesling J et al. New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults. JAMA Surg 2017;152:–e170504.

3. Manchikanti L, Helm SI, Fellows B et al. Opioid Epidemic in the United States. Pain Physician 2012;15:ES9–ES38.

4. Gan TJ, Habib AS, Miller TE et al. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin 2014;30:149–60.

The Road Less Stupid: https://www.amazon.com/Road-Less-Stupid-Keith-Cunningham/dp/0984659269

Armchair Expert Interview with Ira Glass: https://armchairexpertpod.com/pods/ira-glass

Episode 138: Lower Extremity Blocks Part 1: Ankle and Sciatic

In this 138th episode I welcome Drs. Segna and Rayaz back to the show to discuss lower extremity nerve blocks. We cover the ankle block and sciatic nerve block approaches today and will cover the anterior leg in a later episode.

The Medium Article: https://medium.com/@admiralcloudberg/the-near-crash-of-air-canada-flight-759-c61094867d45

Episode 127: Upper Extremity Blocks with Drs. Segna and Rayaz

In this 127th episode I welcome Drs. Segna and Rayaz to the show to discuss upper extremity nerve blocks. We discuss how they’re done, what they’re done for, and some high yield board style questions that may come up based on them.

References:

Hadzic, Admir. Hadzic’s textbook of regional anesthesia and acute pain management. McGraw Hill Professional, 2017.

Hall, Brian A., and Robert C. Chantigian. Anesthesia: A Comprehensive Review E-Book. Elsevier Health Sciences, 2014.

Horlocker, Terese T., Erik Vandermeuelen, Sandra L. Kopp, Wiebke Gogarten, Lisa R. Leffert, and Honorio T. Benzon. “Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines.” Regional anesthesia and pain medicine43, no. 3 (2018): 263-309.

Interscalene:

Supraclavicular:

Infraclavicular:

Axillary:

https://www.nysora.com/techniques/upper-extremity/

Episode 109: Non-Opioid Adjuncts with Drs. Grant and Bicket part 2

In this 109th episode we pick up where we left off in episode 108 and discuss the intraoperative use of non-opioid adjuncts.

References:

Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697.

Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing Role in Routine Anesthesia Care. Regional Anesthesia and Pain Medicine. 2018:43(8):815-818.

Grant MC, Ouanes JP, Joshi BL. Perioperative Esmolol and Opioids: Is More Really Less? Regional Anesthesia and Pain Medicine. 2018:43(8):813-814.

IV Lidocaine: https://academic.oup.com/bjaed/article/16/9/292/1743710

Ketamine: https://www.ncbi.nlm.nih.gov/pubmed/29870457

Dextramethorphan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755866

Episode 108: Non-opioid adjuncts with Drs. Grant and Bicket Part 1

In this 108th episode I welcome Dr. Mike Grant and Dr. Mark Bicket to the show to discuss various non-opioid adjuncts such as esmolol, ketamine, dexmedetomidine, lidocaine, and magnesium, and the role they may play in multimodal anesthesia. In this episode, part 1, we discuss pre and post-op use. Intraop use will be discussed in episode 109.

References:

Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697.

Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing Role in Routine Anesthesia Care. Regional Anesthesia and Pain Medicine. 2018:43(8):815-818.

Grant MC, Ouanes JP, Joshi BL. Perioperative Esmolol and Opioids: Is More Really Less? Regional Anesthesia and Pain Medicine. 2018:43(8):813-814.

IV Lidocaine: https://academic.oup.com/bjaed/article/16/9/292/1743710

Ketamine: https://www.ncbi.nlm.nih.gov/pubmed/29870457

Dextramethorphan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755866/ R

Episode 74: Opioid Crisis Engagement with Chad Brummett

In this episode, episode 74, I welcome Dr. Chad Brummett to the show.  Chad is the co-director of the Opioid Prescribing Engagement Network (OPEN) in Michigan and leads some fantastic and extremely effective initiatives to combat the opioid crisis.  His website has more details and materials for anyone interested in starting similar initiatives elsewhere.  Check it out at Michigan-open.org.

Outline by Brian Park: Opioid Crisis Engagement outline

Episode 61: The Opioid Crisis with Shravani Durbhakula

In this episode, episode 61, I welcome Dr. Shravani Durbhakula, one of our chronic pain doctors, to the show.  We discuss the opioid crisis in American from the perspective of a chronic pain physician including what it is, how it came about, how it impacts our patients, and what we can do about it.

References are here: References

Outline by Brian Park: Episode Outline