Tim Jen MD MHSc FRCPC

🇨🇦 Regional Anesthesiologist. Clinical Researcher.
St. Paul's Hospital at the University of British Columbia, Vancouver.

[Tim Jen MD MHSc FRCPC @DrTimJen]

New video: Navigating the Difficult Spinal Anesthesia.
https://t.co/CahJtCjeMj

#CASAM2026 #Regional #Anesthesia #Spinal

[🩺 Hari (హరి 🇮🇳) Kalagara @KalagaraHari]

#ASRAFALL26
Congratulations to Dr Samer Narouze @NarouzeMD for the most prestigious 2026 @ASRA_Society John Joseph Bonica Award🥇
Great Mentor, Pioneer, Expert & Leader in Pain Medicine ! 🙏 @ESRA_Society @AoraIndia @AFSRA10 @Ropivacaine @EMARIANOMD @DProvenzanoMD @dr_rajgupta

[Tim Jen MD MHSc FRCPC @DrTimJen]

@KalagaraHari Haha I would never have thought of that

[Tim Jen MD MHSc FRCPC @DrTimJen]

ESP spread remains controversial, but this 2025 in-vivo study is compelling:

https://t.co/e1pHCsb4Xu

Live human, not cadavers.
Ropivacaine and contrast, not dye.
Actual ESPB, not some variation of intertransverse process block.

96.5% of blocks spread to PVB space.

[CJA - Canadian Journal of Anesthesia @CJA_Journal]

Pneumothorax rates following cardiac surgery with versus without continuous serratus anterior plane catheters: a secondary analysis of trial data with propensity score matching to a historic cohort - Canadian Journal of Anesthesia
Access - https://t.co/bFZUejvO2A
@CASUpdate

[Tim Jen MD MHSc FRCPC @DrTimJen]

Fine I admit it, I've never heard of them either (until today)

[Tim Jen MD MHSc FRCPC @DrTimJen]

A few rebound pain-related, mechanistic studies that you've never heard of

https://t.co/YArABolNGO
https://t.co/rPNVgNL7vC
https://t.co/FQH3sISvEu
https://t.co/0f8pz8V6Y5
https://t.co/KbUBa1xsEb

[Tom Quick @TJQPNI]

Here are the links to my examinations for #Ulnar #Median & #Radial nerves with @OrthohubXYZ

https://t.co/ITkulbM8Hk

https://t.co/MxIOZ4yfOV

https://t.co/eZyGmZOBDS

[Tim Jen MD MHSc FRCPC @DrTimJen]

@KalagaraHari @jeffgadsden @ashwani_doc @michyaries888 @DrRobbieErskine @DrJeniMD @deepak_neuro @amit_pawa @EMARIANOMD @RegionalAnaesUK @DaraEsra @ESRA_trainees @ESRA_Society @Steve_Coppens @DrTuhinM @curromir @dr_rajgupta @nelkassabany @ajrmacfarlane @claralexlobo @saraamaralMD @ruthi_landau @Nadia_Hdz_MD @Duke_Anesthesia @SretroPMD @rakesh6282 @davejohnston24 @Ropivacaine @NarouzeMD @HouthoffKavita @MKwesiKwofie @ChrisPrabhakar @jon_bailey_anes @athmathottungal @NYSORA @Jerryblocksthat @KartikBSonawane @AmandaKumarMD @MonikaNandaMD @anesthesiadocmd @DrDiveshArora @DrRiteshRoy1 @shilpabhat04 @viralparek @tsmurali I completely agree

[🩺 Hari (హరి 🇮🇳) Kalagara @KalagaraHari]

@ashwani_doc @michyaries888 @jeffgadsden @DrRobbieErskine @DrJeniMD @deepak_neuro @amit_pawa @EMARIANOMD @RegionalAnaesUK @DaraEsra @ESRA_trainees @ESRA_Society @Steve_Coppens @DrTuhinM @curromir @dr_rajgupta @nelkassabany @ajrmacfarlane @claralexlobo @saraamaralMD @ruthi_landau @Nadia_Hdz_MD @Duke_Anesthesia @SretroPMD @rakesh6282 @davejohnston24 @Ropivacaine @NarouzeMD @HouthoffKavita @MKwesiKwofie @DrTimJen @ChrisPrabhakar @jon_bailey_anes @athmathottungal My strong advocacy for Nerve Stimulator even in the era of ultrasound is when “the eyes cannot see what the mind does not know" ! & when 👀 cannot see at all !
PNS is a great tool box in #regionalanethesia
@NYSORA advocates most often ! @Jerryblocksthat
For me it’s a MUST !

[Korean Journal of Anesthesiology (KJA) @Korean_J_Anesth]

Editor’s Recommendation✏️
Propensity scores can balance measured covariates—but they do not establish causality.
New #KJA Statistical Round: how to align estimands (ATE/ATT), covariate selection, overlap, and unmeasured confounding for sound causal interpretation.
PS matching ≠ causality.

https://t.co/n3C5NDGdfB

#Anesthesiology #Causality #ConfoundingFactors #ObservationalStudy #PropensityScore #TreatmentOutcome #SCIE #MEDLINE #KJA

[Tim Jen MD MHSc FRCPC @DrTimJen]

@mfettiplace May that day not come, esp for cardiac sx pts! But noteworthy:

1) Excessive sedation: doi: 10.1016/j.bjao.2024.100279
2) Involuntary twitch: doi: 10.1136/rapm-2025-107162
3) Rising serum LA levels over 48h infusion:
PMID: 38680128, 38537393, 27977439, 22266899

[Tim Jen MD MHSc FRCPC @DrTimJen]

Is it a surprise that there are so many concerns with LAST with continuous SPIP blockade?

Fig 1.
Blue dot: ribs
Large white dot: major arterial perforators

Fig 2.
Black dot = ITA perforators

Fig 3.
Coronal section

Br J Plast Surg. 1986; 39: 287-99

[Tim Jen MD MHSc FRCPC @DrTimJen]

To learn the innervation of the costal, diaphragmatic, and mediastinal parietal pleura --> Use a wire to scratch around in awake humans.

Costal pleura: Intercostal nerves
Diaphragmatic pleura: Outer rim intercostal nerves
Inner rim phrenic nerves.

Capps, J. Arch Intern Med 1911

[Tim Jen MD MHSc FRCPC @DrTimJen]

Our entire understanding of visceral innervation of pleura, pericardium, lung parenchyma, heart, and coronaries are based on few wild studies 100 years ago.

Lewis T. Pain. New York: MacMillan 1942.

[Tim Jen MD MHSc FRCPC @DrTimJen]

Any centres in this world other than Montreal doing pleural drain bupivacaine inj after cardiac surgery?

https://t.co/UJ7LxzdbYu

Seems appealing and clinically effective

[Tim Jen MD MHSc FRCPC @DrTimJen]

Yes I learned my lesson

[Tim Jen MD MHSc FRCPC @DrTimJen]

Reviewed for this open-access journal.
Recommended Reject.
Editor decided to accept without revision, "based partly on my recommendation".

Ok.

[Tim Jen MD MHSc FRCPC @DrTimJen]

@mobav0 Mo, soon you’ll also get that meat smoker and play pickleball. 👍🏼

[Tim Jen MD MHSc FRCPC @DrTimJen]

Accurate, except more like 12 hours, and one citation.

[Tim Jen MD MHSc FRCPC @DrTimJen]

I just love this figure that differentiates between association vs causation in observational studies.

From Causal Inference: What if? (Miguel Hernan)