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 Salzburg, Austria, as well as a research fellowship in regional anesthesia and perioperative outcomes at the Hospital for Special Surgery in New York. After his training, he joined the faculty at Innsbruck Medical University, also in Austria, where he currently is co -chair of pediatric anesthesia. He holds an MBA in Master of Public Health degrees. from the Imperial College of London and is an editorial fellow at the BJA.

With its high expense and questionable benefit over conventional forms of local analgesia, it is possible that the use of liposomal bupivacaine is declining—especially in the United States.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

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 the University of Pittsburgh Medical Center and School of Medicine. He was a fellowship director for the chronic pain fellowship, and associate chief in the medical director of the UPMC chronic pain division. He is also the designated pain specialist for the NLF Pittsburgh Steelers.

Medicine is always changing, providing a career steeped in creativity. Hallucinogen use in the general population is growing, becoming more and more common. There is a renewed interest in the therapeutic benefits of drugs commonly classified as hallucinogens. These drugs are complicated and alter the sensorium. Psychedelics, a type of hallucinogen, are mediated by serotonin to a receptor and can help to soothe pain.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on Twitter @RAPMOnline.

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 anesthesia and acute pain fellowship training at Wake Forest. He is the associate vice chair of clinical operations at Atrium Health Wake Forest Baptist, the section head of regional anesthesia and acute pain management, and the medical director of acute pain services.

Dr. Christopher Edwards is a graduate of Louisiana State University Health Sciences at Wake Forest for both anesthesia and fellowship training in RAPM. He is the medical director for regional anesthesia and acute pain.

Dr. Henshaw and colleagues performed a prospective observational trial, where they asked the question if current guidelines to hold full anti-coagulation dose of Lovenox for 24 hours before surgery resulted in adequate anti-Xa level activity to support the performance of neuraxial or deep anesthetic type nerve block procedures. Consenting patients on treatment-dose enoxaparin were randomized to either a 24-hour group (last dose at 07:00 the day prior to surgery) or a 36-hour group (last dose at 19:00 2 days prior to surgery). On arrival for surgery, blood samples were obtained to assess residual anti-Xa level activity and renal function. The primary outcome was residual anti-Xa level activity following the last treatment dose of enoxaparin. Incorporating all patients, linear regression modeling was performed to predict the timepoint at which the level of anti-Xa activity reliably fell below 0.2 IU/mL.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on Twitter @RAPMOnline.