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@jeffgadsden @nehapadhi @ASRA_Society @AoraIndia @amit_pawa @BalavenkatSubr1 External oblique intercostal is a great block for upper abdomen especially outside the semilunar lines. Changed my practice overnight.

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@jeffgadsden @nehapadhi @ASRA_Society @AoraIndia @amit_pawa @BalavenkatSubr1 Completely agree that TAP blocks work for anything below the umbilicus. One exception in inguinal surgery, where it can miss the ilioinguinal and iliohypogastric nerves as they travel a varying distance in the transversalis plane , before piercing TA and entering the TAP .

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@amit_pawa Bsky seems to be the way to go. I only came on here to join the RA crowd.

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@amit_pawa @doctorevanyates Paravertebral definitely gives a more dense block, however for rib fractures patient positioning can be difficult and esp gives adequate analgesia. Awake breast surgery on the other hand ....

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@DeepakBorde4 @amit_pawa @elboghdadly @KiJinnChin @EMARIANOMD @ajrmacfarlane @CarvalB @megrosenblatt @IcostacheIoana @colinjmccartney @athmathottungal @rosie_hogg @Nadia_Hdz_MD @shaskinsMD @KalagaraHari @Ropivacaine @davejohnston24 @LloydTurbitt @bowness_james Original research is essential, however review is also important. I think it would be difficult to find a someone who has promoted the cause as well @amit_pawa @jeffgadsden @BlockIt_Hot_Pod

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@amit_pawa @BlockIt_Hot_Pod @jeffgadsden Also the ileus time is reduced - ERAS and analgesia!

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@BlockIt_Hot_Pod @jeffgadsden @amit_pawa One potential use for a lignocaine infusion is where there isn't a specific target for a block. A laparoscopic adhesiolysis as example where the combination analgesia/anti hyperalgesia/anti-inflammatory effect seems to be opioid sparing.

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@BlockIt_Hot_Pod @amit_pawa @jeffgadsden
Tequilla song update!! Tequilla, it makes me happy!
https://t.co/K3AQYH40i8

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@BlockIt_Hot_Pod @amit_pawa @jeffgadsden Is anyone using the subcostal approach to the QL block to make it spread up the abdomen as much as possible?

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@MadanNarayanan @unestezist @jeffgadsden Definitely more effective than a subcostal TAP, which in my experience is hit and miss even when the layers open beautifully.

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@MadanNarayanan @jeffgadsden Agree, its dead. EOFPB has completely replaced it for me

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@MadanNarayanan @jeffgadsden @amit_pawa @DrEAlbrecht The larger the volume in ACB, the greater the risk of a femoral/motor block. More than 15mls is not necessary.

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@EMARIANOMD @KiJinnChin @unimib @CAS_RegAnes @CAS_Regional @Ropivacaine @Bubu84csa @amit_pawa @MonicaHarbellMD @claralexlobo @athmathottungal @TorranoVito Hope this talk ends up on YT for those of us not there.👋

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@BlockIt_Hot_Pod Another eponymous anatomical name for you:-
Vloka’s sheath - the epineural sheath surrounding the common peroneal, and tibial components of the sciatic nerve around the popliteal fossa.
Thanks for the shout out last episode ❤️

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@athmathottungal @RegionalAnaesUK Never has something been so well deserved. Legend.

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@davidwhewson @RegionalAnaesUK @donal_buggy @GreeningDoc @BJAJournals @ESAIC_org @katy_skier @HughHemmings PENG and lateral cutaneous nerve of the thigh.

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@BlockIt_Hot_Pod @amit_pawa @jeffgadsden
We do single shot epidural blocks all the time!! It's a caudal.

I think there may be a gradual switch over to facial plane blocks in children (particularly QL blocks and sacral ESP/Multifidus plane blocks and rectus sheath blocks)

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@BlockIt_Hot_Pod @amit_pawa @jeffgadsden This paper explains the differences between US guided and Landmark TAP block and midaxillary and posterior TAP blocks differ. https://t.co/WJA3mWekNP
(It's how the local gets to the paravertebral space)

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@Anaes_Journal These drugs typically have long half lives, should we be withholding them for more than 24 hours?
Ramipril has a half life of around 17 hours, and perindopril is a pro-drug for perindoprilat which has a half life of 24 hours.

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@RegionalAnaesUK @Morgansb I love the use of physics for this method. It is very similar to the CAIT (compressed air injection technique) previously published in RAPM. https://t.co/dEMZEGbqKv
My main concern is that we don't have NRFit 3-way taps.