RAPM Focus

In this episode of RAPM Focus, Associate Editor Ed Mariano, MD, MAS, FASA substitutes for Editor-in-Chief Brian Sites, MD, to discuss the diverse publishing landscapes in the scientific field with Executive Editor Ruth Landau, MD. Dr. Mariano is a professor at Stanford University School of Medicine. Dr. Landau is the Virginia Apgar professor and the Chief of Obstetric Anesthesiology at Columbia Un...

In this episode of RAPM Focus, Dr. Brian Sites is delighted to support the work of Dr. Ottokar Stundner, MD, and colleagues by discussing the use of liposomal bupivacaine trends following the March 2024 publication of “Crystallization of mixtures of local anesthetics with and without select adjuvants: a semiquantitative light microscopy analysis.” Dr. Studener completed his anesthesia residency in...

In this episode of RAPM Focus, Dr. Brian Sites discusses the perioperative use of hallucinogens with Trent Emerick, MD, MBA, following the February 2023 publication of Dr. Emerick’s paper, “Perioperative considerations for patients exposed to hallucinogens.” Dr. Trent Emerick is currently an associate professor in the departments of anesthesiology and perioperative medicine and bioengineering at t...

In this episode of RAPM Focus, Dr. Brian Sites sits down with Daryl Henshaw, MD, and Christopher Edwards, MD, to discuss “Evaluating residual anti-Xa levels following discontinuation of treatment-dose enoxaparin in patients presenting for elective surgery: a prospective observational trial,” first published in June 2023 . Dr. Daryl Henshaw completed his medical school residency in regional anesthe...

In this podcast episode, RAPM Editor-In-Chief Brian D. Sites discusses the massive growth opportunities in the exciting future of pain medicine. Sites highlights the importance that “anesthesiologists help define the value of medical interventions that we offer for pain management.” As RAPM begins to receive more submissions relating to costs, Dr. Sites stresses how critical it is to understand ho...

Data describing the relationship between specific traumatic injuries and opioid use is lacking, which is why RAPM is so delighted to support the work of Matthew Mauck, MD, PhD, and colleagues. In this episode of RAPM Focus, RAPM Editor-in-Chief Brian Sites, MD, discusses “Incidence of persistent opioid use following traumatic injury with Dr. Mauck, first published in June 2023 . Dr. Mauck is an as...

RAPM Editor-in-Chief Brian Sites, MD, joins Hsiangkuo Yua, MD, PhD, and Aniket Natekar, MD, two coauthors of “Real-world study of intranasal ketamine for use in patients with refractory chronic migraine,” first published in May 2023 . Dr. Hsiangkuo Yuan received his medical degree from National Yang-Ming University in Taipei, Taiwan, and a PhD in biomedical engineering at Duke University. He joine...

RAPM Editor-in-Chief Brian Sites, MD, joins Lei Xu, MD, and Ed Mariano, MD, MAS, FASA, FASRA, two coauthors of “Rate of occurrence of respiratory complications in patients who undergo shoulder arthroplasty with a continuous interscalene brachial plexus block and associated risk factors,” first published in May 2023. Dr. Xu is a clinical assistant professor in the department of anesthesiology at St...

RAPM Editor-in-Chief Brian Sites, MD, joins Daniela Bravo, MD, and Julián Aliste, MD, two co-authors of “Randomized clinical trial comparing pericapsular nerve group (PENG) block and periarticular local anesthetic infiltration for total hip artholasty,” first published in February 2023 . In this episode, they discuss the explosion of fascia PENG blocks in the past decade. Dr. Bravo is an assistant...

RAPM Editor-in-Chief Brian Sites, MD, joins Mercy A Udoji, MD, CMQ, FASA and Sudheer Potru, DO, FASA, FASAM, two coauthors of “Violence in the pain clinic: the hidden pandemic,” first published in August 2023 rapm-august 2023.pdf . Dr. Udoji is an associate professor of anesthesiology and pain medicine at Emory University School of Medicine.  Dr. Potru is a triple-board-certified anesthesiologist,...

RAPM Editor-in-Chief Brian Sites, MD, joins Anjali A. Dixi, MD, the senior author of “Hospital-level variability in regional nerve block administration by race for total knee arthroplasty,” first published in December 2022 ( https://rapm.bmj.com/content/early/2022/12/13/rapm-2022-104028 ). Dr. Dixi is from the Stanford University School of Medicine, in Stanford, CA.

The political, professional, and cultural implications of using cannabinoids remain controversial despite its increased prevalence over the last 20 years. The American Society of Regional Anesthesia and Pain Medicine established a working group in November 2020 to review the evidence and knowledge gaps around cannabis use in the perioperative period and develop clinical recommendations for the man...

The impact of the COVID-19 pandemic was especially challenging for vulnerable populations, such as those with chronic long-term health conditions, mental health conditions, and substance use disorders. Lockdowns and fear of spread led to barriers for patients whether they were accessing methadone through opioid treatment programs or being prescribed buprenorphine. A systematic review first publish...

In November of 2021, the Regional versus General Anesthesia for Promoting Independence after Hip Fracture (REGAIN) trial was published in the New England Journal of Medicine. This study was a pragmatic randomized superiority trial to evaluate spinal anesthesia as compared with general anesthesia in 1,600 patients. The authors concluded that “spinal anesthesia for hip fracture surgery in older adul...

Proponents of fascial plane blocks argue that their value can be found in opioid reduction and improvement of pain scores. On the other hand, critics argue that the effect size tends to be very small, amounting to a placebo. To address these conflicting ideas, a recent study examined the role of quadratus blocks and analgesia for laparoscopic hemicolectomy. In this month’s RAPM Focus, Editor-in-Ch...

Guidelines hold great importance in pain medicine. With many interventional procedures, there is some evidence for efficacy, but wide variation in study results due to differences in technique, interpretation, and implementation. In this month’s RAPM Focus, Executive Editor Chad Brummett, MD, joins Steven Cohen, MD, the senior author of “ Consensus practice guidelines on interventions for cervical...

For interventional procedures that involve implanting devices or ablating tissues, it is common for patients to undergo prognostic tests to determine if they are responders prior to moving on to permanent procedures. However, definitions of responders and the number of prognostic tests necessary has caused some confusion. In this month’s RAPM Focus, Editor-in-Chief Brian Sites, MD, joins David Pro...

The International Association for the Study of Pain defines pain as: “An unpleasant sensory or emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” Among many other variables, mental health conditions play a critical role in determining the emotional experience. Thus, it is very reasonable to hypothesize that baseline anxiety, for instance,...

The International Association for the Study of Pain defines pain as: “An unpleasant sensory or emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Pain is both a disease and a symptom.” The inclusion of the word emotional in the definition alludes to the fact that consciousness is part of the pain pathway. Despite the knowledge that neurocog...

Systematic reviews and meta-analyses are the main drivers of policy, evidence-based guidelines, and funding decisions, but many of them are fraught with errors, and the resources needed to peer-review them are massive. A recent systematic review examined the quality of the current published meta-analyses in order to inform the design and reporting of future studies. In this month’s RAPM Focus, Edi...

In surgical care worldwide, there has been a growing trend towards enhanced recovery with the emphasis on early mobility, avoidance of unnecessary procedures and drug-induced side effects, and faster return of normal gastrointestinal function, with the end result of shorter hospital stay. It’s natural to assume that regional anesthesiology and acute pain medicine would play a central role in enhan...

Establishing new clinical pathways and accomplishing change often takes a super-human effort in a complex health system. In terms of systemic lidocaine, the analgesic effects of systemic lidocaine are well recognized, but what is novel is the application of this therapy in an environment once thought to be inappropriate, that is, in the general inpatient units. In this month’s RAPM Focus, Editor-i...

Systematic reviews and meta-analyses are incredibly important; they drive clinical practice, policy, and reimbursement, but unfortunately, take a team of people and a significant amount of time. In this month’s RAPM Focus, Editor-in-Chief Brian Sites, MD, joins Joshua Myszewski and Kristopher Schroder, MD, to discuss their exploratory study, “Evaluation of language analysis to summarize the litera...

The impact of the type of anesthesia on perioperative outcomes has been the subject of much debate. Observational data suggests that neuraxial anesthesia may provide benefits over general anesthesia, especially in the orthopedic population; however, it remains unclear if these benefits can be materialized in all subpopulations. In this month’s RAPM Focus, Executive Editor Stavros Memtsoudis, MD, P...

Buprenorphine is an incredibly safe and effective drug as both an analgesic as well as a front-line therapy for the treatment of an opioid use disorder (OUD). However, decisions around the management of this drug in the perioperative period have generated substantial confusion and anxiety amongst patients, policymakers, and healthcare providers. In this month’s “RAPM Focus,” Editor-in-Chief Brian...