Good morning!! It’s the first day of #Blocktober24 ! Looking forward to a fun month of sharing and learning with everyone! Dr Amit Pawa💉🎙️ Tanya Ed Mariano, MD, MAS, FASA, FASRA 🇺🇸🇵🇭 @fuzzymittens Jonny Wilkinson Duke Anesthesiology Sethina Watson Anesthesiology News ASRA Pain Medicine RA-UK ESRA | European Society of Regional Anaesthesia

Duke Anesthesiology Dr Amit Pawa💉🎙️ Ed Mariano, MD, MAS, FASA, FASRA 🇺🇸🇵🇭 Tanya Sam Ghali, M.D. Orlando R. Pérez-Nieto @fuzzymittens Association of Anaesthetists EAST Dr Kevin Fong Jonny Wilkinson Royal College of Anaesthetists ASRA Pain Medicine ESRA | European Society of Regional Anaesthesia Orthopedic and Trauma Institute Kate Prior Dr Aidan Baron D r. S u e ñ o Miguel Díaz Sethina Watson bob funnekotter Mary-Ann Fox cassandrews 🇦🇺🏡 RA-UK Sociedad Española del Dolor bane circuit Zedu Ultrasound Training @[email protected] Curro Miralles Madhav Swaminathan Emily Sharpe, MD, FASA Melissa Byrne DO MPH FASA Dr. Naveen Eipe, MD 🩺 Hari (హరి 🇮🇳) Kalagara One of my two faves is Suprainguinal Fascia Iliaca (SIFI). It’s elegant, is a true “3-in-1” block and works very well for hip/thigh/knee. Downside? IMO sometimes the fascia is mushy and you don’t get that beautiful unzippering seen here: #Blocktober24 Raj Gupta, MD, FASRA Chad M Brummett

Duke Anesthesiology Dr Amit Pawa💉🎙️ Ed Mariano, MD, MAS, FASA, FASRA 🇺🇸🇵🇭 @fuzzymittens Sam Ghali, M.D. Association of Anaesthetists ASRA Pain Medicine ESRA | European Society of Regional Anaesthesia Difficult Airway Society (DAS) @dastrainees Jonny Wilkinson Rosie Hogg Lloyd Turbitt Royal College of Anaesthetists Dr. Ron George 🇨🇦 #Anesthesiologist Sethina Watson Madhav Swaminathan Curro Miralles Emily Sharpe, MD, FASA Melissa Byrne DO MPH FASA Clara Lobo 🇵🇹🇺🇦🇪🇺🇦🇪 bob funnekotter Simon Ash Steve Coppens Alan Macfarlane RA-UK Sara Amaral, MD, EDRA, DESAIC Nadia Hernandez, MD, FASA Melody Anderson (Herman), MD Jan Boublik Imran Ahmad Kellie Jaremko kylie baker Canadian Anesthesiologists' Society Dr. Guy Weinberg A/Prof Suzi Nou @snouzin.bsky.social AORA India I like to do needle blocks (yeah, I know, shocker) for the airway. Check out this video to understand the rationale and to see it done step by step. Make sure to watch until the end…#Blocktober24 Tim Cook Tom Lawson Hans Huitink youtu.be/1yaD2APv14Y

Duke Anesthesiology Dr Amit Pawa💉🎙️ Ed Mariano, MD, MAS, FASA, FASRA 🇺🇸🇵🇭 ASRA Pain Medicine ESRA | European Society of Regional Anaesthesia Orlando R. Pérez-Nieto MiMi Association of Anaesthetists Jonny Wilkinson Chris Yap Tanya Royal College of Anaesthetists AORA India Josh Luftig Arun Nagdev Murali Thondebhavi Dr. Ron George 🇨🇦 #Anesthesiologist Sethina Watson Kwesi Kwofie Dr. Vishal Uppal MBBS, FRCA 🇨🇦🇮🇳🏴󠁧󠁢󠁳󠁣󠁴󠁿 Jon Bailey MD MSc FRCPC EDRA 🇨🇦🧗🏄‍♂️ RLJohnson Nabil Elkassabany MD MBA MSCE James K. Kim Clara Lobo 🇵🇹🇺🇦🇪🇺🇦🇪 Steve Coppens Alan Macfarlane Raj Gupta, MD, FASRA Regional Anesthesia & Pain Medicine Kariem Deepak Sharma Simon Ash Nadia Hernandez, MD, FASA Melody Anderson (Herman), MD A/Prof Suzi Nou @snouzin.bsky.social Stephen Haskins Dr.Kartik Sonawane Dr Prit Anand Singh Ashwani Gupta Jennifer Noerenberg Jennythatcanblock michael kerr cassandrews 🇦🇺🏡 Elliott Higgins, MD 👨‍🎤 on Bluesky Mark Leonard Stuart Grant Matt Oldman Dr Damon Kamming BSc MBChB FRCA Executive MBA Morné Wolmarans Mary-Ann Fox My hard-learned RAPTIR tips : 1) rotate the probe slightly (see full vid near end) to allow needle to start slightly more medially...less bony contact 2) deliberately calculate the depth and insert needle far enough posteriorly -- usually in trapezius -- to ensure flat trajectory

Jeff Gadsden Duke Anesthesiology Dr Amit Pawa💉🎙️ Tanya Ed Mariano, MD, MAS, FASA, FASRA 🇺🇸🇵🇭 bob funnekotter Orlando R. Pérez-Nieto Sam Ghali, M.D. MiMi Association of Anaesthetists ASRA Pain Medicine ESRA | European Society of Regional Anaesthesia AORA India LASRA Internacional Jesse Ehrenfeld MD MPH Jonny Wilkinson Jens Børglum Dr Robbie Erskine Sethina Watson Alan Macfarlane Jennifer Noerenberg Jennythatcanblock Dr Helgi Morné Wolmarans Anesthesiology News Sociedad Española del Dolor Sara Amaral, MD, EDRA, DESAIC RA-UK Ben Lovell Mary-Ann Fox cassandrews 🇦🇺🏡 Leigh White Dr. Diego Midino💊 D r. S u e ñ o AnaestheticEducation bane circuit Bojan Korda Zedu Ultrasound Training @[email protected] Amy Pearson, MD, FASA Nadia Hernandez, MD, FASA Melody Anderson (Herman), MD James K. Kim Matt Oldman Madhav Swaminathan I think the answer is that it isn't, and never was! Femoral = saph, nvi, nvl, nvm, cuties. Adductor = saph, often nvm, maybe one cutie. The equianalgesia folly... spinal = epidural = femoral + sciatic = femoral = adductor = LIA...

Kavita Houthoff Khemlani Duke Anesthesiology Dr Amit Pawa💉🎙️ Tanya Ed Mariano, MD, MAS, FASA, FASRA 🇺🇸🇵🇭 D r. S u e ñ o Mary-Ann Fox Sam Ghali, M.D. Royal College of Emergency Medicine Orlando R. Pérez-Nieto MiMi Dr Aidan Baron Association of Anaesthetists ASRA Pain Medicine ESRA | European Society of Regional Anaesthesia RA-UK Paul Wischmeyer MD Jonny Wilkinson 💉𝔇𝔯 𝔪𝔞غ𝔦𝔞 Royal College of Anaesthetists Sethina Watson Anesthesiology News bane circuit Zedu Ultrasound Training @[email protected] Amy Pearson, MD, FASA Steve Coppens Madhav Swaminathan Dave Price Curro Miralles Emily Sharpe, MD, FASA 🩺 Hari (హరి 🇮🇳) Kalagara Raj Gupta, MD, FASRA Clara Lobo 🇵🇹🇺🇦🇪🇺🇦🇪 Ana Patrícia Pereira Samer Narouze,MD,PhD,MMM Sally El-Ghazali Chad M Brummett Harriet Hopf James K. Kim Manolito _ educAnestesia Barbara Versyck Eleni Moka Murali Thondebhavi Shane Power Henry Jason Jon Bailey MD MSc FRCPC EDRA 🇨🇦🧗🏄‍♂️ Amanda Kumar michael kerr Leigh White cassandrews 🇦🇺🏡 I once had a breast surgeon say “mastectomy patients don’t hurt afterwards because we cut the nerves.” I…don’t….even….*shakes head* Anyway, I like these for simple mastectomy. They’re not QUITE enough IMHO as surgical block, but with prop TIVA & LMA, it’s fab! Easy & safe. 🙌

Duke Anesthesiology Dr Amit Pawa💉🎙️ Tanya Ashwani Gupta MiMi Ed Mariano, MD, MAS, FASA, FASRA 🇺🇸🇵🇭 Sam Ghali, M.D. Orlando R. Pérez-Nieto ASRA Pain Medicine ESRA | European Society of Regional Anaesthesia ESRA Trainees Journal of Trauma and Acute Care Surgery Association of Anaesthetists AORA India Murali Thondebhavi Jonny Wilkinson Nadia Hernandez, MD, FASA Melody Anderson (Herman), MD Royal College of Anaesthetists Dr. Ron George 🇨🇦 #Anesthesiologist Dr. Diego Midino💊 Miguel Díaz D r. S u e ñ o Sethina Watson RA-UK Madhav Swaminathan Dave Price PedsAnesthesia.Net 😷 Canadian Anesthesiologists' Society Curro Miralles Paul Wischmeyer MD Paul H. Ting Samer Narouze,MD,PhD,MMM Emily Sharpe, MD, FASA James K. Kim Alan Macfarlane Dr. Alana Flexman Nabil Elkassabany MD MBA MSCE bob funnekotter Simon Ash Dr. Ruthi Landau Tom Jelic Dr Nav Sidhu A/Prof Suzi Nou @snouzin.bsky.social michael kerr Leigh White cassandrews 🇦🇺🏡 Nuala Lucas UCSF Anesthesia and Perioperative Care Stanford RAAPM The other way I failed early on is by placing my needle in the TA plane, injecting all the local in one spot, and walking away, high-fiving my colleagues. We began to realize we were seeing unusual patterns of sensory loss and getting failures, like in this study: #Blocktober24

ESRA Italian Chapter Annual Meeting (Cesena) What a wonderful congress! Congratulations to Domenico Santonastaso, Andrea Tognu and Vanni Agnoletti. Thanks to Eleni Moka and Vicente Roques for their valuable contribution

Get ready for the 2nd World Day of Regional Anaesthesia & Pain Medicine on 25 January 2025! #WDRAPM 🌍 +185 cities across all continents 🤝 Closing the World Week during which physicians around the globe will connect together

Thank you all! Alone we go fast, together we go far! #WDRAPM2025

From San Giovanni Rotondo (Puglia) 🇮🇹we will celebrate the second world day of regional anesthesia and pain medicine: lots of enthusiastic people, excellent speakers, workshops and the awaited ESCAPE GAME! #WDRAPM2025 “Joining Hands for a Pain Free Future Worldwide”

🫶 Thank You for Making #WDRAPM2025 Incredible! 🌍 A huge thank you to all the participants, organizers, speakers and partners who made it a Global Success! 🥳Let’s keep the momentum going and continue making an impact together! #RegionalAnaesthesia #PainMedicine #GlobalUnity

Join the ESRA professional community and take your career to the next level! 🔹 Why Join? 🔹 👩‍🔬 ESRA members are the pioneers in Regional Anaesthesia and Pain Management, united by expertise and passion. Together, we drive excellence ⭐

TOP TIPS for TAP block! 😊

Nick Suarez Dr Amit Pawa💉🎙️ Jeff Gadsden 1/ Hi Nick Glad you enjoyed it! Hanging drop is a good way of confirming one’s arrival in the epidural space..particularly when you’re a long way in, it kinda feels ok(lig flavum) but you need an extra little bit of reassurance . You can then control your advance into the CSF

Many hospitals still lack an ACUTE PAIN SERVICE. This isn’t about money. It’s about priorities. Patients suffer. This must change. Important words from Regional Anesthesia & Pain Medicine Editor-in-Chief Brian D. Sites, M.D., M.S.

Abstracts are the most prevalent way to showcase your scientific research... (submit yours by 11 May 💡) ... but we also value alternative means of communication such as educational videos! Watch last year's winning video: Parasternal Blocks, by Burhan DOST & Elif S OZEL ⬇️

SankarK Dr Amit Pawa💉🎙️ Siva Arumugam, MD, FASA Dr.Kartik Sonawane Dr Nav Bahal PIB is the way to go! We cut consumption to 1/3 of what it was before with chest wall catheters and rectus sheath. If we infused 10ml/hr, we could give PIB 10ml/3hrs with same effect!

SankarK Dr Amit Pawa💉🎙️ Dr.Kartik Sonawane Dr Nav Bahal Disclaimer: we don’t do infusions any more but my two cents - Depends: ✅Fascial plane block (like PEC/SA/TAP) intermittent bolus makes sense as they are volume dependent for spread. Background may help spread with each bolus ✅Plexus or periph N cath prolly either wud work

Dr Huw DARA-ESRA Dr Amit Pawa💉🎙️ Dr Robbie Erskine Ed Mariano, MD, MAS, FASA, FASRA 🇺🇸🇵🇭 Block It Like It’s Hot Podcast Kwesi Kwofie Kristopher Schroeder ASRA Pain Medicine ESRA | European Society of Regional Anaesthesia Belgian Association of Regional Anesthesia BARA CAS Residents CAS Regional & Acute Pain Section RA-UK Kerlijne Vandenbulcke Laura Ellen Brereton GE HealthCare Vscan Family Jerry Jones James K. Kim Alan Macfarlane Nadia Hernandez, MD, FASA Jon Bailey MD MSc FRCPC EDRA 🇨🇦🧗🏄‍♂️ Steve Coppens Jonny Wilkinson Amy Pearson, MD, FASA Curro Miralles Melody Anderson (Herman), MD Haha no, it’s all just poking a little fun. I still do them. But it DOES happen to be my least fave BPB for 3 reasons: 1) the plexus is often quite spread out (and sometimes on the medial side of the artery too!), leading to… 2) you often need 2-3 separate injxns around the