Regional Anesthesia & Pain Medicine

RAPM is your authoritative medical source for regional anesthesia and pain knowledge – from pediatric to geriatric. The official journal of ASRA. @ASRA_society

[Regional Anesthesia & Pain Medicine @RAPMOnline]

Good news for IG lovers!!! 🤩
Now you can also find us there at rapm_online

Just click and follow:
🔗 https://t.co/L4Otkv95MN

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🧠 Can spinal cord stimulation reduce opioid use?

🔎 This meta-analysis of 43 studies found:
↓ 32% opioid consumption
↓ 18 MME/day at 12 months
↓ 53% odds of continued opioid use after SCS implantation

🔗 https://t.co/3eu6ZzPr1K

@Ryan_S_DSouzaMD

#Neuromodulation #RAPM

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🚨 Subperception DRG stimulation vs sham stimulation in established responders

An RCT found subperception DRG stimulation reduced pain vs sham in established responders, with no serious device-related adverse events.

LINK -> https://t.co/UWXLwnjt8b

#RAPM #DRG #PainMedicine

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🚨 Preoperative vitamin D deficiency was linked to higher postoperative pain and increased opioid use after breast cancer surgery.

💡 This study highlights preoperative nutritional optimization.

READ HERE -> https://t.co/x37XZ27IMG

#RAPM #PainMedicine #VitaminD #BreastCancer

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🎙️ New RAPM Focus Episode 51:

Alopi Patel, MD, speaks with Sesh Mudumbai, MD, MS, and Oluwatobi “Tobi” Hunter, DNP, on transitional pain services, opioid outcomes, and high-risk surgical veterans.

🎧 Listen here -> https://t.co/IKFzJ5o9Wp

#RAPM #ChronicPain

[Regional Anesthesia & Pain Medicine @RAPMOnline]

📊 Can early pain predict recovery after knee replacement?

In a study of 17,200 patients, two trajectories emerged: low vs high pain.
High pain was linked to more opioid use and consultations.

⚠️ Pain in the first 12–24 hours predicted later outcomes.

🔗https://t.co/u1AuD93ARI

[Regional Anesthesia & Pain Medicine @RAPMOnline]

⚡️From electrical dose to neural dose: redefining SCS

In rat pain models:
• Only suprathreshold spinal cord stimulation worked
• 1.2–1.3×evoked compound action potential threshold gave the best analgesia
• Higher doses added no benefit

🔗 https://t.co/sW29D9QSOo

#RAPM

[Regional Anesthesia & Pain Medicine @RAPMOnline]

💉 New approach for axillary nerve block?

📊 Results
• 100% nerve identification
• Staining of anterior & posterior branches in all specimens
• Mean target 0.96 cm from branch bifurcation

May offer a simpler alternative to posterior ANB.

🔗 https://t.co/avW9LZMsGq

#RAPM

[Regional Anesthesia & Pain Medicine @RAPMOnline]

💉 New trans-quadrangular space approach for axillary nerve block?

📊 Results
• 100% main trunk staining
• 83% anterior division
• 90% posterior division
• No musculocutaneous/posterior cord spread

💡 Promising phrenic-sparing strategy

🔗 https://t.co/HLp1O1fpcx

#RAPM

[Regional Anesthesia & Pain Medicine @RAPMOnline]

Facial pain—especially trigeminal neuralgia—is often misdiagnosed.

An ASRA RAPM paper debunks common myths: MRI isn’t routine, and neurovascular compression ≠ diagnosis.

Bottom line: facial pain is a clinical diagnosis—don’t let imaging lead the way

🔗 https://t.co/LUMePZQGiE

[Regional Anesthesia & Pain Medicine @RAPMOnline]

💡 Plain vs hyperbaric bupivacaine for spinal TKA—does it matter?

A recent RCT says no: both had the same ~33% MAP drop, similar nadir BP, and no difference in vasopressors or side effects

Bottom line: baricity didn’t change early hemodynamics

🔗 https://t.co/3ZMm2YIs1S

#RAPM

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🫀 Regional anesthesia in pediatric cardiac surgery—does it help?

👶 RAPM meta-analysis (31 RCTs) shows ↓ opioids, faster extubation, and shorter ICU stay. But evidence is low quality with high variability.

🔗 https://t.co/vHsoA3PnUn

#RAPM #PediatricPain #RegionalAnesthesia

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🔍 PENG block for hip arthroscopy—game changer or not?

📚 A RAPM RCT shows ↓ PACU opioids & shorter stays, but no benefit in 24h opioids, pain, or recovery.

💡 Takeaway: modest early gains, no overall impact. Not ready for routine use.

🔗 https://t.co/bbfGUoiLfE

#RAPM

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🎙️ New RAPM Focus Podcast 50!

💊 Brian Sites, MD, Eric Schwenk, MD, and Kishor Gandhi, MD, discuss the pros and cons of perioperative gabapentinoids and why a nuanced, patient-specific approach matters.

🔗 https://t.co/ZHW32hJzhw

#RAPM #Anesthesiology #PainMedicine

[Regional Anesthesia & Pain Medicine @RAPMOnline]

Dr. Sites will be at our booth this Friday from 3-4pm at #ASRASPRING26. Come by to connect, ask questions, and get insights on publishing in RAPM!

[Regional Anesthesia & Pain Medicine @RAPMOnline]

We’ll be exhibiting at #ASRASPRING26! Dr. Sites will be hosting 'Meet the Editor' sessions at the exhibit hall and membership booths…come by and say hello!
@ASRA_Society

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🚨 Suprascapular Nerve Blocks: Anatomy Matters—Down to the Fascicles

💉 New anatomy study in RAPM reveals that the suprascapular nerve fascicles vary—monofascicular proximally and multifascicular distally.

💡This may impact approach & safety.

🔗 https://t.co/igoylXTMHV

#RAPM

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🚨 Clear Solutions? Crystallization in Local Anesthetic Cocktails

🧪 A new study in RAPM shows that LA+adjuvant mixes can crystallize. Lidocaine combos showed no crystals; most mepivacaine/ropivacaine mixes did—worst was ropivacaine+bicarb.

🔗 https://t.co/DHtKxzHLFR

#RAPM

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🚨 Can Liposomal Bupivacaine Upgrade VATS Recovery?

🫁 This new RCT studied TPVB with liposomal bupivacaine in patients undergoing VATS procedures. Results showed prolonged analgesia 1160 vs 743 min vs bupi+dex, with better POD1 pain.

🔗 https://t.co/UnCuQhrlQe

#RAPM

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🚨 Does Anesthesia Shape Recurrence?

📚 This RCT highlights that spinal anesthesia lowered 2-yr recurrence vs general (~27% vs ~40%) in non-invasive bladder cancer.

🔗 https://t.co/uoVf50ex0k

#RAPM #Anesthesia #PerioperativeMedicine

[Regional Anesthesia & Pain Medicine @RAPMOnline]

🎙️ New RAPM Focus

SPACE-Postpartum reframes C-section recovery beyond pain scores—tracking Sleep, Pain, Affect, Cognition & Energy to spot early risk for chronic pain.

Should postpartum care assess symptom patterns, not just pain?

🔗https://t.co/mZlwqXFSOr

#RAPM #WomensHealth