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Reposted by Chris Prabhakar

𝐑𝐚𝐥𝐩𝐡 𝐌𝐨𝐡𝐭𝐲 𝐌𝐃 𝐌𝐏𝐇 @rmohty.bsky.social · Dec 19

Happy Holidays from one of the incredible sonographers who created this masterpiece

☃️❄️🌲🎄

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Reposted by Chris Prabhakar

Julia Haber, MD @drjuliahaber.bsky.social · Nov 15

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Ali Christy, MD, PhD @oligoclonalband.medsky.social · Dec 17

Elizabeth Garrett Anderson (1836-1917), 1st female dean of a British med school, and 1st female mayor in Britain, pretended to be rich during med school (in Paris, 1870) so admin would think she'd be able to sue if they suddenly said women couldn't be doctors 1/10

An oil painting of Elizabeth Garrett Anderson in the 1860s

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Robbie Erskine @drrobbieerskine.bsky.social · Dec 16

Here’s one of my essentials for a Femoral Triangle Block…and it never gets stolen by anyone else !!!

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Katie Wiskar @katiewiskar.bsky.social · Dec 16

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Time for another #POCUS pitfalls thread: the infamous IVC 🤩

I have MANY thoughts on the IVC 💭

When I first started teaching POCUS, I actually disliked the IVC because it was often poorly done or incorrectly interpreted ❌

I have now come to love the IVC, BUT you have to do it right!

#emimcc

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Chris Prabhakar @chrisprabhakar.bsky.social · Dec 13

Interesting, Jon! If I read this correctly, ESP is no better than control. SAPB has the unenviable position of being likely worse than the control group!

ICBs, PVBs, and TEAs for the win!

The authors seem to go silent in the discussion and conclusions re: ESP, not sure why.

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Jon Bailey 🇨🇦🏄‍♂️🌊 @son-of-caine.bsky.social · Dec 13

VATS procedures:

TEA, PVB, ESP, and SAPB ⬇️ CPSP at 2-3 and 6 months vs control
No differences TEA, PVB, and ESP but SAPB less reduction of CPSP

pubmed.ncbi.nlm.nih.gov/39240480/

@garrettsbarry.bsky.social
@chrisprabhakar.bsky.social
@ropivacaine.bsky.social
@dr-amit-pawa.bsky.social

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Anaesthesia @anaesjournal.bsky.social · Dec 13

This is a heatmap of topics identified in 6 research prioritisation studies relevant to regional anaesthesia.

Important themes were on the role of RA in:
• ⬇️ chronic postsurgical pain
• improving postop recovery
• benefit in specific patient groups

#RASky #AnSky #MedSky

https://buff.ly/49zVeBD

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Amit Pawa @dr-amit-pawa.bsky.social · Dec 12

When I teach Axillary Brachial plexus blocks I often talk about the relatively common variation where the musculocutaneous nerve has “Late take off”.

Here is a post-block example where you see median, ulnar, radial, MCN & MABCN

#RAsky #AnSky #POCUSky

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Robbie Erskine @drrobbieerskine.bsky.social · Dec 10

Anaesthetists: Is it just me or does everyone think is a little strange that anaesthetists have to take significant amount of time snapping open glass ampoules, needling vials etc and drawing up the contents, risk/time/tasks. Maybe more drugs should be readily available in prefilled syringes??

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Journal of Clinical Anesthesia @j-clin-anesth.bsky.social · Dec 10

In this new randomized trial of 126 patients having laparoscopic cholecystectomy, intravenous lidocaine provided a non-inferior quality of recovery compared to erector spinae plane block. Either approach was superior to placebo.

#RegionalAnesthesia #AnSky

🔗 doi.org/10.1016/j.jclinane.2024.111528

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Chris Prabhakar @chrisprabhakar.bsky.social · Dec 10

No blocks yet over here. Steve Coppens' study on anterior QL for laparoscopic colorectal surgery showed no benefit over placebo, despite sensory blockade.

pubmed.ncbi.nlm.nih.gov/37970976/

The effect of anterior quadratus lumborum block on morphine consumption in minimally invasive colorectal surgery: a multicentre, double-blind, prospective randomised placebo-controlled trial - PubMed

We investigated the efficacy and safety of a bilateral anterior quadratus lumborum block in patients undergoing minimally invasive colorectal surgery. This was a two-centre, double-blind, prospective,...

pubmed.ncbi.nlm.nih.gov

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Amit Pawa @dr-amit-pawa.bsky.social · Dec 10

For Laparoscopic Abdominal surgery- are you performing blocks? If so which?

This study in RAPM compared TAP to Lateral QLB and noted a difference in dermatomal loss of sensation, but not analgesia.

I’d love to see an arm with Anterior QLB.

Thoughts?
#RAsky #AnSky

rapm.bmj.com/content/rapm...

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doctimcook.bsky.social @doctimcook.bsky.social · Dec 4

Delighted that Ben Dallyn from @RUHBath won the 1st prize for oral presentation @dasairway

He presented A MANIKIN STUDY OF STYLETS & BOUGIES (static & dynamic)…..

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Jon Bailey 🇨🇦🏄‍♂️🌊 @son-of-caine.bsky.social · Dec 4

Finally a case I can talk about in detail... my own!

I got a ACL reconstruction with patellar bone-tendon-bone graft, microfractures, and intraarticular hydrogel.

Single shot adductor and superolateral geniculate blocks.
Worked great and lasted 16 hours!

www.youtube.com/watch?v=DGv0...

Ultrasound Guided Genicular Blocks (2024 update!)

YouTube video by Regional Anesthesiology and Acute Pain Medicine

www.youtube.com

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Greg Bryson @glbryson.bsky.social · Nov 28

IV lidocaine given intraop and for 6-12h postop failed to influence gut motility, analgesia, quality of recovery, or time to discharge following laparoscopic colectomy.

JAMA @jama.com · Nov 28

RCT: Perioperative intravenous lidocaine infusion did not improve the return of gut function after elective minimally invasive colonic resection.

ja.ma/4eNDNi7

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Chris Prabhakar @chrisprabhakar.bsky.social · Dec 4

Duration may be a factor. 24 hr minimum for IV lidocaine, at least for colorectal surgery.

journals.lww.com/anesthesia-a....

Appropriate Duration of Perioperative Intravenous... : Anesthesia & Analgesia

tion of lidocaine infusion in patients undergoing colorectal surgery. METHODS: We searched the PubMed, EMBASE, Web of Science, and Cochrane Library databases to identify articles published before D...

journals.lww.com

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Chris Prabhakar @chrisprabhakar.bsky.social · Dec 4

If only mine always unzippered like that! For me, it's more like expanding the deeper muscle, then the superficial one, then losing the plane entirely in various pockets of local!

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Amit Pawa @dr-amit-pawa.bsky.social · Dec 4

That feeling when you see “unzippering” like this!

#SIFI #IYKYK
#RAsky #AnSky

with patient consent

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doctimcook.bsky.social @doctimcook.bsky.social · Dec 3

t’s interesting how people define anaesthesia

I ask every new resident what anaesthesia is.
When they offer me a triad of

-Unconsciousness
-Muscle relaxation
-Analgesia

I give them 1 out of 3

Why is that?
Am I right?

a close up of a man 's face with a jacket that says ' a ' on it

ALT: a close up of a man 's face with a jacket that says ' a ' on it

media.tenor.com

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Chris Prabhakar @chrisprabhakar.bsky.social · Dec 4

I thought anesthesia was simply the induction of a state of insensibility (to surgical stimulus). This would fit for all forms of anesthesia. While Wendell Holmes, in his letter to Morton, was describing ether general anesthesia, it fits nicely for local-regional as well.

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Katie Wiskar @katiewiskar.bsky.social · Dec 3

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I love love LOVE scanning the heart 😍, but when it comes to bang for your buck for ultrasound novices, lung ultrasound is such a winner 🏆

It's time for another #POCUS basics #skeetorial 🧵

Let's talk about common pitfalls in #LungUltrasound and how to correct these ✔️

#emimcc