#HIPAC - Twitter Hashtag

8 months ago

Thank you to the organizing committee for the fantastic opportunity to speak at the conference! 🙏 I truly enjoyed sharing insights and connecting with everyone. 💪 #IGCC2025 #Gastroenterology #HIPAC #PIPAC #Oncology #Innovation #MedicalConference #GICommunity @ealjahdli

DrG_Jamjoum's tweet photo. Thank you to the organizing committee for the fantastic opportunity to speak at the conference! 🙏 I truly enjoyed sharing insights and connecting with everyone. 💪 #IGCC2025 #Gastroenterology #HIPAC #PIPAC #Oncology #Innovation #MedicalConference #GICommunity
@ealjahdli https://t.co/FrQVVT3mko

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Dr.Kartik Sonawane

@KartikBSonawane

11 months ago

🎯 🚀 Forward Flow Forward: Mastering the Popliteal Pathway via Smart ACB Strategies 🛠 #RegionalAnesthesia #NerveBlocks #UltrasoundGuided #PeripheralNerveBlock #AnesthesiaEducation #AdductorCanalBlock #PoplitealPlexus #AnteriorApproach #DSB #HiPAC #4in1Block #KneeAnalgesia #MotorSparing #TipOfTheDay #MyRATips Tip of the Day: 🧠The Adductor Canal: Nature’s Passageway to the Popliteal Fossa 👉The AC is a musculoaponeurotic tunnel, bounded by two muscles (VMM & ALM/AMM) and one aponeurosis (VAM). 👉It naturally connects the anterior thigh to the posterior thigh through the adductor hiatus. 👉 Using this anatomical passageway, local anesthetic can be directed from an anterior approach to reach posterior targets like the popliteal plexus and even sciatic nerve branches. 📢Volume Dynamics & Direction in ACB-Based Techniques 🔍 When performing ACBs for knee or below-knee surgeries, understanding how LA moves and how we can guide that movement is critical for: 🦵Targeting the popliteal plexus (for knee analgesia), 🦵Or reaching the sciatic nerve trunks (for foot/ankle surgery). 💡 Popliteal Plexus = Enough for Knee Surgery ✨LA spread to posterior capsule & intra-articular branches (tibial & obturator articular twigs) is usually sufficient for TKA and arthroscopy. ✨Achievable with 15–20 mL when injected in the PURPLE perivascular zone at the proximal AC (just distal to FT apex). 💡 Sciatic Trunk Coverage = Needed for Below-Knee Surgery ✨Full coverage of the TN & CPN requires: High-volume LA (30–40 mL) in the AC. ✨The drug follows the femoral artery through the adductor hiatus into the popliteal fossa and around the sciatic nerve. 📢📚 What Did Dye Studies Show? 📝Multiple dye and contrast studies have confirmed spread to the popliteal plexus when large volumes (20–30 mL) are injected perivascularly in the distal AC. 📝In the landmark Gautier et al. series, 20 mL of contrast injected into the AC showed dye around the sciatic nerve in all cases, with limited sensory or motor impact. 📝Similarly, Runge et al. and Goffin et al. (cadaveric work) demonstrated consistent spread into the popliteal fossa, especially when dye was injected 1–2 cm above the adductor hiatus. 📝Most importantly, Johnston et al. confirmed that dye injected into the distal AC could spread to the popliteal plexus, while distal FT injections did not. 📝Hi-PAC and 4-in-1 innovated further by extending the anterior spread to the sciatic trunk. 📝The only contradictory claim (RAPM, 2023) lacks dissection and underreports its own positive data. 💉 Where to Inject? The “Purple Zone” 🎯 Optimal target = deep to sartorius, lateral to femoral artery, and under the VAM. 🟣 This is the perivascular PURPLE zone, a conduit that sends LA through the adductor hiatus → popliteal fossa. 📏 How Much? Volume Matters 📍<10 mL: Often insufficient to reach the popliteal plexus or include major articular branches. 📍15-20 mL: Ideal for proximal AC – to achieve popliteal spread without sciatic involvement. 📍≥20 mL: Increases likelihood of sciatic spread, especially if injected distally in the AC. ⚙️ DSB Technique = Dual Injection for Strategic Spread 🔑Volume Efficiency + Direction Control 🔹 1st injection: 10-20 mL in distal FT pre-fills the proximal tract, restricting retrograde spread of the second injection. 🔹 2nd injection: 10–20 mL in AC moves distally, pushing the drug toward the popliteal plexus ✅ Key Advantage: DSB achieves popliteal plexus involvement with less total volume than needed in a single-shot ACB alone. 🧠 Concept: Blocking the Backdoor, Opening the Front - By “sealing off” the proximal path with the first bolus, DSB converts the second bolus into a distally driven column, minimizing leakage and maximizing effect. 🛑Why the RAPM (Smulders et al.) Study Missed the Mark? 🧟Cadaveric study, but no dissection❌. 🕓CT after 30 min - not real-time, no vascular flow, potential underestimation. 🧪Used 2 mL groups (!), only 30 mL showed popliteal spread in 3 cases - yet still concluded “no sciatic spread.” ❌ No comparison with prior positive studies ❌ Ignored key findings in 30 mL group 📛Titled with a strong claim despite contradictory findings: misleading, non-neutral, and goal-directed bias. 📉Contrast in CT can resemble soft tissue = interpretation bias. 🔄 Why Modify ACB Instead of Adding Blocks? 🚫 You don’t always need iPACK or posterior sciatic blocks. ✅ A single smart ACB (or DSB) can: 🔳Cover posterior capsule of the knee 🔳Reach articular sciatic branches 🔳Sometimes even spread to sciatic trunk (if needed, with higher volume) 🙌 Minimizes motor block, preserves function, reduces number of injections. 🟥Achieve foot analgesia from the front in below-knee surgeries when using Hi-PAC or 4-in-1. 🏠🔑 Final Take-Home Message ✅ Site trumps name: Where and how you inject matters more than the block label ✅ 15–20 mL in the purple zone = safe & effective posterior knee coverage ✅ DSB enhances forward flow, limiting volume while boosting effectiveness ✅ 30–40 mL directed distally (Hi-PAC/4-in-1) can reach sciatic trunk from anterior thigh ✅ One modified ACB can replace multiple blocks -if you respect anatomy and guide your volume! ✅Popliteal-plexus spread rarely weakens ankle; Hi-PAC/4-in-1 almost certainly will factor this into rehab plans. So, always use diluted LA for selective sensory blockade. ✅Document your plan - write “Popliteal-plexus target (20 mL)” or “Hi-PAC (35 mL) for below-knee surgery” so PACU and physio teams know what to expect. 🚀 One clever anterior injection can replace multiple blocks - if you know what you're doing.💡

KartikBSonawane's tweet photo. 🎯 🚀 Forward Flow Forward: Mastering the Popliteal Pathway via Smart ACB Strategies 🛠

#RegionalAnesthesia #NerveBlocks #UltrasoundGuided #PeripheralNerveBlock #AnesthesiaEducation #AdductorCanalBlock #PoplitealPlexus #AnteriorApproach #DSB #HiPAC #4in1Block #KneeAnalgesia #MotorSparing #TipOfTheDay #MyRATips

Tip of the Day:

🧠The Adductor Canal: Nature’s Passageway to the Popliteal Fossa

👉The AC is a musculoaponeurotic tunnel, bounded by two muscles (VMM & ALM/AMM) and one aponeurosis (VAM).
👉It naturally connects the anterior thigh to the posterior thigh through the adductor hiatus.
👉 Using this anatomical passageway, local anesthetic can be directed from an anterior approach to reach posterior targets like the popliteal plexus and even sciatic nerve branches.

📢Volume Dynamics & Direction in ACB-Based Techniques

🔍 When performing ACBs for knee or below-knee surgeries, understanding how LA moves and how we can guide that movement is critical for:
🦵Targeting the popliteal plexus (for knee analgesia),
🦵Or reaching the sciatic nerve trunks (for foot/ankle surgery).

💡 Popliteal Plexus = Enough for Knee Surgery

✨LA spread to posterior capsule & intra-articular branches (tibial & obturator articular twigs) is usually sufficient for TKA and arthroscopy.
✨Achievable with 15–20 mL when injected in the PURPLE perivascular zone at the proximal AC (just distal to FT apex).

💡 Sciatic Trunk Coverage = Needed for Below-Knee Surgery

✨Full coverage of the TN & CPN requires: High-volume LA (30–40 mL) in the AC.
✨The drug follows the femoral artery through the adductor hiatus into the popliteal fossa and around the sciatic nerve.

📢📚 What Did Dye Studies Show?

📝Multiple dye and contrast studies have confirmed spread to the popliteal plexus when large volumes (20–30 mL) are injected perivascularly in the distal AC.
📝In the landmark Gautier et al. series, 20 mL of contrast injected into the AC showed dye around the sciatic nerve in all cases, with limited sensory or motor impact.
📝Similarly, Runge et al. and Goffin et al. (cadaveric work) demonstrated consistent spread into the popliteal fossa, especially when dye was injected 1–2 cm above the adductor hiatus.
📝Most importantly, Johnston et al. confirmed that dye injected into the distal AC could spread to the popliteal plexus, while distal FT injections did not.
📝Hi-PAC and 4-in-1 innovated further by extending the anterior spread to the sciatic trunk.
📝The only contradictory claim (RAPM, 2023) lacks dissection and underreports its own positive data.

💉 Where to Inject? The “Purple Zone”

🎯 Optimal target = deep to sartorius, lateral to femoral artery, and under the VAM.
🟣 This is the perivascular PURPLE zone, a conduit that sends LA through the adductor hiatus → popliteal fossa.

📏 How Much? Volume Matters

📍<10 mL: Often insufficient to reach the popliteal plexus or include major articular branches.
📍15-20 mL: Ideal for proximal AC – to achieve popliteal spread without sciatic involvement.
📍≥20 mL: Increases likelihood of sciatic spread, especially if injected distally in the AC.

⚙️ DSB Technique = Dual Injection for Strategic Spread

🔑Volume Efficiency + Direction Control
🔹 1st injection: 10-20 mL in distal FT pre-fills the proximal tract, restricting retrograde spread of the second injection.
🔹 2nd injection: 10–20 mL in AC moves distally, pushing the drug toward the popliteal plexus
✅ Key Advantage: DSB achieves popliteal plexus involvement with less total volume than needed in a single-shot ACB alone.
🧠 Concept: Blocking the Backdoor, Opening the Front - By “sealing off” the proximal path with the first bolus, DSB converts the second bolus into a distally driven column, minimizing leakage and maximizing effect.

🛑Why the RAPM (Smulders et al.) Study Missed the Mark?

🧟Cadaveric study, but no dissection❌.
🕓CT after 30 min - not real-time, no vascular flow, potential underestimation.
🧪Used 2 mL groups (!), only 30 mL showed popliteal spread in 3 cases - yet still concluded “no sciatic spread.”
❌ No comparison with prior positive studies
❌ Ignored key findings in 30 mL group
📛Titled with a strong claim despite contradictory findings: misleading, non-neutral, and goal-directed bias.
📉Contrast in CT can resemble soft tissue = interpretation bias.

🔄 Why Modify ACB Instead of Adding Blocks?

🚫 You don’t always need iPACK or posterior sciatic blocks.
✅ A single smart ACB (or DSB) can:
🔳Cover posterior capsule of the knee
🔳Reach articular sciatic branches
🔳Sometimes even spread to sciatic trunk (if needed, with higher volume)
🙌 Minimizes motor block, preserves function, reduces number of injections.
🟥Achieve foot analgesia from the front in below-knee surgeries when using Hi-PAC or 4-in-1.

🏠🔑 Final Take-Home Message

✅ Site trumps name: Where and how you inject matters more than the block label
✅ 15–20 mL in the purple zone = safe & effective posterior knee coverage
✅ DSB enhances forward flow, limiting volume while boosting effectiveness
✅ 30–40 mL directed distally (Hi-PAC/4-in-1) can reach sciatic trunk from anterior thigh
✅ One modified ACB can replace multiple blocks -if you respect anatomy and guide your volume!
✅Popliteal-plexus spread rarely weakens ankle; Hi-PAC/4-in-1 almost certainly will factor this into rehab plans. So, always use diluted LA for selective sensory blockade.
✅Document your plan - write “Popliteal-plexus target (20 mL)” or “Hi-PAC (35 mL) for below-knee surgery” so PACU and physio teams know what to expect.

🚀 One clever anterior injection can replace multiple blocks - if you know what you're doing.💡

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Bean & Sprout's Mom @beansprouts_mom

almost 3 years ago

Now this, 👇. This is how you get value from paying for a bluecheck. Full exposé below 🔥 (h/t @LazarusLong13) #HIPAC #CovidIsAirborne #StopHICPAC @OSHA_DOL @WorkSafeBC @OHCOWclinics @GovCanHealth

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Oriol Borrás-Gené #YoSoyURJC 🏳️‍🌈 @oriolTIC

about 3 years ago

📢Herramientas interactivas de participación para el aprendizaje colaborativo #HIPAC 👉PID de la @unicomplutense 🎓@inasiyu @dcaraban y yo ⚙️Aprende a usar y aplicar en tus clases: @wooclap @Mentimeter #PPTLIVE @VevoxApp @padlet #Forms y @Kahoot 🔗https://t.co/C0VDvDcNsP

oriolTIC's tweet photo. 📢Herramientas interactivas de participación para el aprendizaje colaborativo #HIPAC

👉PID de la @unicomplutense

🎓@inasiyu @dcaraban y yo

⚙️Aprende a usar y aplicar en tus clases:
@wooclap @Mentimeter #PPTLIVE
@VevoxApp @padlet #Forms y @Kahoot

🔗https://t.co/C0VDvDcNsP https://t.co/EFCJb6D5HD

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J. Ignacio Pichardo @inasiyu

about 3 years ago

Curso gratuito "Herramientas interactivas de participación para el aprendizaje colaborativo #HIPAC" para PDI de @unicomplutense: aprender haciendo #learnignbydoing @wooclap @Mentimeter @MicrosoftES PPT @VevoxApp @padlet @GoogleForEdu #Forms y @Kahoot. Info https://t.co/sDA6jqW3iU

inasiyu's tweet photo. Curso gratuito "Herramientas interactivas de participación para el aprendizaje colaborativo #HIPAC" para PDI de @unicomplutense: aprender haciendo #learnignbydoing @wooclap @Mentimeter @MicrosoftES PPT @VevoxApp @padlet @GoogleForEdu #Forms y @Kahoot. Info
https://t.co/sDA6jqW3iU https://t.co/eRoieag7hx

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Método HIPAC @hipac4u

over 3 years ago

🎉NUEVA EDICIÓN del curso #HIPAC Hoy volvemos @inasiyu @dcaraban y @oriolTIC con otra edición del curso de formación del profesorado de la @unicomplutense “Herramientas interactivas para el aprendizaje colaborativo” 🛠️@Mentimeter @WooclapES @powerpoint @VevoxApp #GoogleForms

hipac4u's tweet photo. 🎉NUEVA EDICIÓN del curso #HIPAC

Hoy volvemos @inasiyu @dcaraban y @oriolTIC con otra edición del curso de formación del profesorado de la @unicomplutense “Herramientas interactivas para el aprendizaje colaborativo”

🛠️@Mentimeter @WooclapES @powerpoint @VevoxApp #GoogleForms https://t.co/55l653zUqX

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Oriol Borrás-Gené #YoSoyURJC 🏳️‍🌈 @oriolTIC

about 4 years ago

🏅Herramientas Interactivas de Participación para el Aprendizaje Colaborativo #HIPAC🏅 Comenzamos en 5 minutos con el curso para el #PDI @unicomplutense junto a @inasiyu @dcaraban y en el #HiperAula @hipac4u

oriolTIC's tweet photo. 🏅Herramientas Interactivas de Participación para el Aprendizaje Colaborativo #HIPAC🏅

Comenzamos en 5 minutos con el curso para el #PDI @unicomplutense junto a @inasiyu @dcaraban y en el #HiperAula @hipac4u https://t.co/KV19WZkkPD

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Método HIPAC @hipac4u

about 4 years ago

🔥Comenzamos 🔥 Hoy a las 9:30 dará comienzo la primera edición del curso de la @unicomplutense “Herramientas interactivas para la participación y el aprendizaje colaborativo”, dentro del método #HIPAC 🎓@inasiyu @dcaraban y @oriolTIC

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Manoj Pandey @manojpandey66

about 6 years ago

Current status and advances in total #paritonectomy and #HIPAC Presenter Dr. Mainak Moderator: Dr. Tarun #SurgicalOncology, Department of Surgical Oncology IMS, BHU For joining in, inbox your email address to receive link

manojpandey66's tweet photo. Current status and advances in total #paritonectomy and #HIPAC
Presenter Dr. Mainak
Moderator: Dr. Tarun
#SurgicalOncology,
Department of Surgical Oncology
IMS, BHU
For joining in, inbox your email address to receive link https://t.co/x6yVO9qZnF

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Abdiqafar Hosh @Abdiqafarshire

over 6 years ago · Somalia

A historic achievement for all Somalis. Thanks to Prez @M_Farmaajo and PM @HassanAKhaire to this critical milestone toward building a successful and prosperous Somalia. #DebtRelief #HIPAC #Somalia

IMF

@IMFNews

over 6 years ago

IMF and World Bank consider #Somalia eligible for debt relief on initial assessment. This is an important milestone toward writing-off most of Somalia’s $5.3 billion debt. https://t.co/BU6M4zya0G

IMFNews's tweet photo. IMF and World Bank consider #Somalia eligible for debt relief on initial assessment. This is an important milestone toward writing-off most of Somalia’s $5.3 billion debt. https://t.co/BU6M4zya0G https://t.co/I10cuTuH15

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Ben Gregory @bengregz

over 7 years ago

Awesome competition down at @LboroSport #Hipac , @Scott_Simpson_ & I on the decks and MCing the meet. Man of the Match 3PBs for @ewalshpv great jumping dude! #polevault

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PR Council AC NJ @PRCouncil_ACY

over 7 years ago

RT @haydaycoffee Thanks for featuring #AtlanticCity, @AAAMidAtlantic! Come visit Hayday for coffee, along with the rest of #hipAC on @visitorangeloop. https://t.co/sb71GEw2vG #seemyHayday #landontheOL #thisisAC #doAC

PRCouncil_ACY's tweet photo. RT @haydaycoffee Thanks for featuring #AtlanticCity, @AAAMidAtlantic! Come visit Hayday for coffee, along with the rest of #hipAC on @visitorangeloop. https://t.co/sb71GEw2vG #seemyHayday #landontheOL #thisisAC #doAC https://t.co/71uVGZfJEw

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Hayday Coffee @haydaycoffee

over 7 years ago

Thanks for featuring #AtlanticCity, @AAAMidAtlantic! Come visit Hayday for coffee, along with the rest of #hipAC on @visitorangeloop. https://t.co/vsH3gvFCsS #seemyHayday #landontheOL #thisisAC #doAC

haydaycoffee's tweet photo. Thanks for featuring #AtlanticCity, @AAAMidAtlantic! Come visit Hayday for coffee, along with the rest of #hipAC on @visitorangeloop. https://t.co/vsH3gvFCsS #seemyHayday #landontheOL #thisisAC #doAC https://t.co/fVMIAmp9JA

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Chris Watts @spearcoach

over 7 years ago · Loughborough

Hello... #Hipac #loughboroughuniversity #javelin #coaching #purple #track @thomasroehler #inthehouse #pilgrimage @ Loughborough University - Throws Training Camps https://t.co/nA96weaQlk

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Jess Excell @JessExcell

almost 8 years ago

We’ve got @CNPNewton at the #Athletics too 🥇#2018SG @_SchoolGames #HIPAC @LboroSport

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_jdxpc🦋 @JholinaDv26

about 8 years ago

#INCWalkToFightPoverty #HIPAC

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Rio Woolf @BladeBoyRio

over 8 years ago · Loughborough

Great to bump into our friend @ParalympicsGB Star @RunJumpStefReid @LboroSport @lborouniversity #HiPAC when we were there for Rio’s very special #athletics #training session @BritAthletics #LoughboroughSport #StefReid #Paralympics #Legend #Inspirational #ThisGirlCan #ThisGirlDoes

BladeBoyRio's tweet photo. Great to bump into our friend @ParalympicsGB Star @RunJumpStefReid @LboroSport @lborouniversity #HiPAC when we were there for Rio’s very special #athletics #training session @BritAthletics #LoughboroughSport #StefReid #Paralympics #Legend #Inspirational #ThisGirlCan #ThisGirlDoes https://t.co/wn3VTLD0wU

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Rio Woolf @BladeBoyRio

over 8 years ago · Loughborough

BIG THX to the lovely staff @LboroSport @lborouniversity #HiPAC for the warm welcome back & for all their help in setting up a very special #athletics #training session for #BladeBoyRio! Watch out for the #BigReveal in 2 wks!🤐🤫😉 @BritAthletics @ParalympicsGB #LoughboroughSport

BladeBoyRio's tweet photo. BIG THX to the lovely staff @LboroSport @lborouniversity #HiPAC for the warm welcome back & for all their help in setting up a very special #athletics #training session for #BladeBoyRio! Watch out for the #BigReveal in 2 wks!🤐🤫😉 @BritAthletics @ParalympicsGB #LoughboroughSport https://t.co/aJcI7toL70

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Rio Woolf @BladeBoyRio

over 8 years ago · Loughborough

BIG THX to the lovely staff @LboroSport @lborouniversity #HiPAC for giving us such a warm welcome back and for all your help in making Rio’s visit so special! 🙌🏻 More pics/vids to follow 20/2/18!🤫😉🤐#LoughboroughUniversity @BritAthletics @ParalympicsGB #Athletics #Training