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🩺 LOW-DOSE REMIFENTANIL: GOODBYE TO HYPERALGESIA? New analysis of 402 same-day surgery patients shows low-dose remifentanil doesn’t meaningfully increase postoperative pain or opioid use. 🔗 doi.org/10.1136/rapm-2… Harsha Shanthanna Maram Khaled MBBCh, PhD《مرام》

🩺 Is Spinal LIDOCAINE Safe for Outpatient Joint Arthroplasty? • 🦵 TNS incidence: 0.2% (1,011 patients) • 📉 Multimodal protocols slash risk compared to historical rates >20% 🔗 doi.org/10.1136/rapm-2… Authors: Sara Amaral, MD, EDRA, DESAIC @THEsae253616 Joshua Dooley Jeff Gadsden #RAPM

🔬 Spin Wizardry to Regenerative Alchemy How do PRP spins, stem-cell sources & philosophical blind spots shape regenerative outcomes? A new Daring Discourse calls for unified standards and warns against “spin wizards.” 🔗 doi.org/10.1136/rapm-2… Guilherme ("Gui") Ferreira Dos Santos

APS for Rib Fractures: Promising but not enough ❗️Slight upticks in blocks & APS consults, but no big gains in pain, delirium, or respiratory outcomes. 🧠 We need smarter targeting & system-level change. CLICK HERE -> doi.org/10.1136/rapm-2… Sarah Tierney

Hearts & Nerves: Preventing Chronic Pain in Cardiac Surgery ✅ Bilateral ESP block after cardiac surgery reduces acute pain & opioid use ❌ Doesn’t impact chronic postsurgical pain at 3 or 6 months doi.org/10.1136/rapm-2… Burhan DOST, MD esra turunc Alessandro De Cassai Hesham| BTCBULL_Token Team

🖼️ Healing Emotional Wounds brings RAPM clinician voices to life through art. A call to destigmatize distress, embrace peer support, and make emotional first aid visible. 🎨 Art by Morgan Granzow Courtney J. Burns, Elliott Higgins, MD 👨‍🎤 on Bluesky 🔗 doi.org/10.1136/rapm-2…

🚨 Buprenorphine: Underused & Overdue Despite safety benefits, buprenorphine is rarely used for acute pain—<25% of anesthesiologists surveyed reported using it. Notably, fentanyl & hydromorphone use remains high. Education & uptake needed. 🔗 doi.org/10.1136/rapm-2… Hickeytr

Healing isn’t just for our patients—it’s for us, too. 💬💙 In the latest RAPM Focus, Courtney J. Burns, Elliott Higgins, MD 👨‍🎤 on Bluesky & Alopi Patel, M.D., FASA explore well-being & reflection in anesthesiology—featuring Healing Emotional Wounds by Morgan Granzow. 🎧👇 🔗 bit.ly/4kCMjEx

🧒💉 Less pain, less opioid? Yes, please. New RCT in RAPM shows kids getting paravertebral blocks after thoracotomy used 50% less sufentanil & had lower pain scores vs. wound infiltration. Same recovery, better comfort. 📖 doi.org/10.1136/rapm-2…

🦵💉 Less is more! Optimizing TKA pain relief New RAPM trial finds 10 mL of 0.15% bupivacaine works just as well as 20 mL of 0.25% for knee surgery pain relief. Same comfort, less drug—smart for safer, tailored anesthesia. 📖 doi.org/10.1136/rapm-2…

🚀 Next-Level Spine Surgery Pain Management is Here! Meet BR-003: an implantable hydrogel delivering local anesthetic for 3+ days around pedicle screws in spine surgery. Early trials show: safe drug levels no serious side effects no impact on implants. doi.org/10.1136/rapm-2…

🧵 Is Proximal Intercostal Block a safer alternative in arrhythmia care?? Key findings: ✅100% of successful blocks reached the cervicothoracic chain ❌PVB/epidural spread inconsistent 💡Suggests direct fascial spread as main mechanism 🔗 doi.org/10.1136/rapm-2…

This month, we highlight Otto Stundner, MD, MBA, MPH, ESAIC, a member of the Editorial Board at RAPM. 🎯 Dr. Stundner shares valuable advice for submitting authors. 🔗 Click here to read all his tips and learn more: bit.ly/3ZiPDMp Otto Stundner #RAPM

🧵 Can Cervical Medial Branch Blocks do more than diagnose? Key findings: ✅ 62.2% had ≥30% pain reduction at 2 weeks 📉 Only 22.7% still had relief at 12 weeks 🧠 Emotional/physical functioning also improved 🔗 Learn more about it: doi.org/10.1136/rapm-2…

🧵Who’s at risk for unplanned admission after outpatient arthroscopy? Key findings from 1.18M+ cases: ✅ 3.1% had unanticipated admissions 📈 Risks: older age, shoulder surgery, ASA ≥3, COPD, CHF, diabetes 🚑 Top causes: pulmonary, cardiac, infection 🔗 doi.org/10.1136/rapm-2…

💥 Ganglion Impar Block - Relief for Tailbone Pain? Meta-analysis: 📊 11 studies, 625 pts ⬇️Decreased pain throughout study ✅ No serious side effects 🔗 doi.org/10.1136/rapm-2…

🎮 Can VR help in the OR? A new RCT in RAPM found that VR didn’t lower pain during regional anesthesia for hand surgery—but it did reduce anxiety during surgery. 😌 Satisfaction with VR? ➡️ 9/10 🔗Read more about this RCT here: doi.org/10.1136/rapm-2…

🧠 Should Sedation During Nerve Blocks Be Personalized? 🔥 High pain catastrophizing = less pain with sedation 😊 Low pain catastrophizing = more satisfaction with reassurance 💡 Tailor care to mindset. 🔗 Read more about this study here: doi.org/10.1136/rapm-2…

📄 Your science deserves speed. RAPM moves fast: ⏱️ First decision in 11 days* 🎯 Acceptance in 50 days* ✅ Rapid. Rigorous. Respected. Visit RAPM's homepage: bit.ly/3FSlqNE *Mean times from 2024

💡 Is general anesthesia (GA) needed for shoulder arthroscopy? New RAPM study finds regional anesthesia (RA) alone provided better outcomes than GA+RA: 📉 Hypotension: 13% vs 57% ⏱️ PACU: 22 vs 52 min 🏠 Discharge: 96% vs 75% 🔗 Read more here: doi.org/10.1136/rapm-2…