Interscalene Block, Piriformis Trigger Point, & Propofol in the ED?

In preparation for this weekend's: Ultrasound Pain Course for Emergency Medicine Physicians,

Dr. Rosenblum discusses two recent articles in the literature discussing Interscalene Brachial Plexus Blocks vs Propofol for anterior shoulder dislocation and Piriformis injections...

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Course Schedule- Winter 2021 Released- Join our newsletter for updates!

Upcoming Ultrasound Course Dates for Emergency Medicine Physicians, Anesthesiologists and Pain Physicians

Learn Brachial Plexus, Femoral, Sciatic, Saphenous, Genicular, IPACK, TAP, Paravertebral, Inercostal, Sacroiliac, Peripheral nerves, Iliioinguinal, Cluneal nerve blocks and more!

February 7, 2020
Ultrasound Guided Pain Procedures for Emergency Room Physicians

February 28, 2020
Ultrasound Guided Pain Procedures in the Pain Office

March 14, 2020
Ultrasound Guided Regional Anesthesia for Anesthesiologists

Podcast References:

1.  Ultrasound-guided interscalene nerve block vs procedural sedation by propofol and fentanyl for anterior shoulder dislocations. Author links open overlay panel- Esmaeil Raeyat Doost, Mohammad Mehdi Heiran, Mitra Movahedic, Amirhossein Mirafzalc

2- Ultrasound‐guided trigger point injection for piriformis syndrome in the emergency department-Victor M. Aquino‐Jose MD, Veronika Blinder MD, Jennifer Johnson BA, Tatiana Havryliuk MD

Journal of the American College of Emergency Physicians Open Volume 1, Issue 5

Dr. Rosenblum interviews Dr. Baxter on her thermo-mechanical neuro-modulatory pain relief platform.

Amy Baxter MD FAAP FACEP is a Clinical Associate Professor in Emergency Medicine at Augusta University and the founder and CEO of Pain Care Labs, the industry leader in noninvasive pain relief solutions. She is an academic, physician and research focused entrepreneur that invented a thermo-mechanical neuro-modulatory pain relief platform. Her patents include VibraCool® Vibrational Cryotherapy to treat tendinopathies and decrease opioid use, and her disruptive Buzzy® device, which has been used to control needle pain for over 37 million needle procedures. Dr. Baxter was awarded over 2.8MM in Fast-Track SBIRs by the NIH.

She also prepared and filed the FDA 510K submission for medical devices, securing the FDA expansion of the utilization to include muscle pain and cosmetic injection pain control. Dr. Baxter and Pain Care Labs were recently honored with the 2020 Tibbetts Award for Innovation for the substantial economic and social benefits the company’s pain-relieving medical devices have contributed to the United States. 

Buzzy for Healthcare, https://shop.paincarelabs.com/collections/healthcare

Buzzy for personal, https://shop.paincarelabs.com/collections/buzzy%C2%AE

VibraCool, https://shop.paincarelabs.com/collections/vibracool-r

Ultrasound Guided Interventional Pain Training

1. Krishnan S, Cascella M. Erector Spinae Plane Block. [Updated 2020 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545305/

2. EnesAydinbEmreSengunaAtifBayramogluaHaci AhmetAlicibHigh-thoracic ultrasound-guided erector spinae plane block for acute herpes zoster pain management in emergency department. The American Journal of Emergency Medicine. Volume 37, Issue 2, February 2019, Pages 375.e1-375.e3ErdalTekinaAliAhiskalioglubMuhammed 

    

Dr. Rosenblum interviews SmartAppt Creator, Albert Pilip, MD on his Doctor-Patient Friendly App that takes the Pain out of Scheduling Appointments.

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Ultrasound Course Schedule- Winter 2021 Released- Join our newsletter for updates!

• 4 Hour CME Webinar Access
• 2 Hour Hands on (in Person in NY or via Zoom)
• Tips on Safe Integration into your Practice
• Billing

Learn Brachial Plexus, Femoral, Sciatic, Saphenous, Genicular, IPACK, TAP, Paravertebral, Inercostal, Sacroiliac, Peripheral nerves, Iliioinguinal, Cluneal nerve blocks and more!

Dr. Rosenblum apologizes on behalf of the Pain Physicians for 2 overlooked topics that could help pain patients...

References

Nutritionalfacts.org

Mendonça CR, Noll M, Castro MCR, Silveira EA. Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review. Nutrients. 2020 Oct 9;12(10):3075. doi: 10.3390/nu12103075. PMID: 33050122; PMCID: PMC7601187.

Dr. Rosenblum interviews Pain Physician, Dr. Sidharth Verma on his initiative the Mumbai Pain School and discusses the next Comprehensive Interventional Pain Ultrasound Webinars:

Private 1 on 1 now available in NY

Feb 7, 2020- Emergency Room Physicians

Feb 28, 20202- Pain Physicians 

March- TBA Anesthesiologists

Is PRP Cost Effective? If So, At What Price?

Discussed in this episode:
-Talking to patients about PRP and Biologics
-Is PRP better?
-Dr. Rosenblum’s management of his own knee pain
-Ultrasound Training

Live Virtual Ultrasound CME Training Event Set for Dec. 6th, 2020

Click here to register now! https://painexam.com/events/

Podcast References:
Bendich, I, et al. What Is the Appropriate Price for Platelet-Rich Plasma Injections for Knee Osteoarthritis? A Cost-Effectiveness Analysis Based on Evidence From Level I Randomized Controlled Trial The Journal of Arthroscopic an Related Surgery. VOLUME 36, ISSUE 7, P1983-1991.E1, JULY 01, 2020

Is Local Anesthetic in Cervical Epidurals Beneficial?

In this podcast episode:
Dr. Rosenblum announces postponement of November 22 Ultrasound Course.

• Discusses RAPM article on Lidocaine in the Cervical Epidural Space
• Benefits of Ultrasound for Guiding injections to treat Cervical Radiculopathy
• Pitfalls of the Standard of Care

Private Consultation Service and Chart Review Available for Pain Patients- Inquire at DRosenblum@RMCPain.com

Live Virtual Ultrasound CME Training Event Set for Dec. 6th, 2020

Click here to register now! https://painexam.com/events/ultrasound-guided-interventional-pain-and-regional-anesthesia-virtual-training/

Podcast References:
McCormick ZL, Burnham T, Cunningham S, et al
Effect of low-dose lidocaine on objective upper extremity strength and immediate pain relief following cervical interlaminar epidural injections: a double-blinded randomized controlled trial
Regional Anesthesia & Pain Medicine Published Online First: 11 August 2020. doi: 10.1136/rapm-2020-101598

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Autism and Labor Epidurals?

Dr. Rosenblum discusses JAMA’s October 2020 article that suggests an association between Labor Epidural and the diagnosis of Autism Spectrum Disorder

• Summary of the study
• Responses from other physicians
• Statements by the The Society for Obstetric Anesthesia and Perinatology (SOAP), the American Society of Anesthesiologists (ASA), the Society for Pediatric Anesthesia (SPA), the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM)

Speaking of Labor Analgesia... Learn TAP Blocks, Ilioinguianl Block and more!

Next Ultrasound Guided Regional Anesthesia and Interventional Pain Courses..

November 22, 2020 - Live In Person Ultrasound Training-

"In-Person" Ultrasound Guided Pain Management 7 CME Credit Training Event Nov. 22nd, 2020. Limited Spaces!

Covering:
-Upper Extremity (Brachial Plexus, Axillary, Suprascapular)
-Lower Extremity (Femoral, Sciatic, Popliteal, Ankle, IPACK, Genicular)
-Soft Tissue & Joint (Shoulder, ITB, Hip, Knee, Plantar Fascia)
-Peripheral Nerve Blocks and Spine (Ilioinguinal, TAP, Intercostal, -Paravertebral, Caudal, Cervical , Cluneal and much more!)
-Live Model Scanning and Practice with Phantoms

Register Now!

https://painexam.com/events/in-person-live-ultrasound-training-november-22-nyc/

December 6, 2020-  Virtual Interventional Pain and Regional Anesthesia Training Webinar-

New Ultrasound Guided Interventional Pain Management & Regional Anesthesia 4 CME Webinar Event by PainExam, Set for Dec. 6th, 2020

Covering-

Ultrasound Guided Interventional Pain Virtual Training on Nerve Blocks, Soft Tissue Injections, Spine, etc.
-Upper extremity (Brachial Plexus, Axillary, Suprascapular, Radial, Ulna, Median)
-Lower Extremity (Femoral, Sciatic, Popliteal, Genicular, IPACK, Ankle)
-Soft Tissue and Joint (Knee & Shoulder)
-Peripheral Nerve Block (Occipital, TAP, Ilioinguinal, Intercostal Paravertebral
-Spine (Sacroiliac, Caudal, Cervical Selective Nerve Root, Medial Branch)

Register Now!
https://painexam.com/events/ultrasound-guided-interventional-pain-and-regional-anesthesia-virtual-training/

Podcast References:

https://www.asahq.org/about-asa/newsroom/news-releases/2020/10/labor-epidurals-and-autism-joint-statement

https://jamanetwork.com/journals/jamapediatrics/article-abstract/2771634

Myths in Pain Medicine: Steroid Doses, Spine Surgery, Vasectomies, etc.

Dr. Rosenblum discusses a recent email (below) from a patient suffering from Post Vasectomy Pain who reached out after hearing the recent PVPS Episode of the PainExam Podcast.

Also Discussed:
- Myth of 3 Steroid Shots Per Year
- Myth of Needing Cervical Spine Surgery to Avoid Paralysis if Rear Ended
- Myth of Downplaying Surgeries like Vasectomies (See Below)

"Dr. Rosenblum

I appreciated your recent podcast on Post Vasectomy Pain Syndrome. This is a condition I am currently suffering from. I am being treated by a pelvic floor physical therapist, which is improving muscular coordination, but not improving the pain much.

My vasectomy was in December, 2017 and I have been in pain since then. It was very distracting for about 10 months, and I had a 2 month course of Lyrica which helped reduce the pain. After about October 2018 the pain went down but it is always there. Ejacuation is not pleasurable, rather it feels like someone is squeezing my testicles unpleasantly and afterward I have a dull ache or burning sensation which persists for about 1-2 days.

I thought your reactions and impressions on reviewing the medical consequences of vasectomy to be amusing. The surgery is typically presented as being as trivial as excising a wart. This may be the experience of 90% of men, but if you end up with chronic complications, it is no exaggeration to say that it is capable of ruining your life. I am convinced that this is more common and causes far more suffering that is generally understood, affecting probably 1-2% of men who get a vasectomy. Men tend to suffer in silence. Urologists tend to resist attributing the problems to the vasectomy.

I have collected several thousand links to stories that men have posted over the last few decades, describing this unfortunate disease. I would encourage you to take a look at the ones I have posted here:

https://www.reddit.com/r/postvasectomypain/wiki/timeline

There are over 720 stories that I have posted, linked to the original source, and indexed chronologically, along with story codes. I have made it my unhealthy hobby to create the best reference possible for understanding what men go through when they end up with PVPS. I post a new story every morning and have enough to keep going for many years.

The best online forum for PVPS is www.postvasectomypain.org

Good luck with your patient"

Live "In-Person" Ultrasound Guided Injection 7 CME Training Event in NYC! Nov. 22nd, 2020

Limited Seating, Register Here! https://painexam.com/events/in-person-live-ultrasound-training-november-22-nyc/

Live "Virtual" Ultrasound Guided Pain Management Injection 4 CME Training Event- Dec. 6th, 2020

Register Here! https://painexam.com/events/ultrasound-guided-interventional-pain-and-regional-anesthesia-virtual-training/

Podcast References:
https://cdn.ymaws.com/www.spineintervention.org/resource/resmgr/factfinder/FactFinder_2019_06_Annual_Do.pdf

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Podcast Episode Sponsor-

Post Vasectomy Pain Syndrome:

Dr. Rosenblum reviews Post Vasectomy Pain Syndrome
When Urology cannot help, he ponders:

Ultrasound Guided Genito Femoral Nerve Block

• Ganglion impar
• PRP Injection
• Peripheral Nerve Stimulation
• DRG Stimulation

For Ultrasound Training online go to PainExam.com/Events
For Private in person training, email Dr. Rosenblum at DRosenblum@RMCPain.com or...

"LIVE" In-Person Ultrasound Training Event in NYC Nov. 22nd!

For more information about the Live In-Person Ultrasound CME Training Event, please visit:

https://painexam.com/events/in-person-live-ultrasound-training-november-22-nyc/

Dec. 6 "LIVE" Ultrasound Training CME Webinar Event-

For more information about the Live Ultrasound Training CME Webinar Event, please visit:

https://painexam.com/events/ultrasound-guided-interventional-pain-and-regional-anesthesia-virtual-training/

Check Out Dr. Rosenblum in the recent Clarius Webinar!

Click here to Watch Now!

Podcast References:

http://vasectomy-lib.s3.amazonaws.com/BJU%20International%202008%20Tandon.pdf

Consensus Statement on Facet Joints Reviewed!

Dr. Rosenblum Discusses the recent Consensus practice guidelines on interventions for lumbar facet joint pain from a multispecialty, international working group released earlier this year.

Also discussing:

FREE Ultrasound Webinar with Clarius on Wednesday October 28th,

https://clarius.com/webinar/bullseye-why-ultrasound-is-now-the-standard-for-guiding-injections/

NEW COMPREHENSIVE ULTRASOUND COURSE FOR PAIN MANAGEMENT AND REGIONAL ANESTHESIA, Dec. 6th.

https://www.eventbrite.com/e/126134807605

Podcast reference:

Cohen SP, Bhaskar A, Bhatia A, et al Consensus practice guidelines on interventions for lumbar facet joint pain from a multispecialty, international working group Regional Anesthesia & Pain Medicine Published Online First: 03 April 2020. doi: 10.1136/rapm-2019-101243

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COVID-19 and Pain Management

Dr Rosenblum discusses Medications and Immune Response. Considerations for pain patients at risk for COVID-19.

Dr. Rosenblum also discusses Peripheral Nerve Stimulation in a patient with a Spinal Cord Stimulator...

New Ultrasound Pain Management CME Webinar Event Hosted by PainExam, Set for October 18, 2020!

References-
Puntillo F, Giglio M, Brienza N, et al. Impact of COVID-19 pandemic on chronic pain management: Looking for the best way to deliver care. Best Pract Res Clin Anaesthesiol. 2020;34(3):529-537. doi:10.1016/j.bpa.2020.07.001

About PainExam-

Online Pain Management Board Review for the ABA, ABPM, ASIPP and WIP FIPP MOCA and primary certification in pain management. 40 CME credits available for participation
https://www.painexam.com

Dr. Rosenblum Discusses:

• Sickle Cell Disease
• Crisis
• Types of Pain associated with Sickle Cell Disease
• Opiate and non opiate management

Dr. Rosenblum ponders the value of Anecdotal Medicine and Questions the so called 'Standard of Care'

For More Educational Content and Course Go to PainExam.com/Events

References

Moffett P, Moore G. The standard of care: legal history and definitions: the bad and good news. West J Emerg Med. 2011;12(1):109-112.

Dr. Rosenblum explores the issue of Post COVID Pain Syndrome!
Is it a real thing or just secondary to prolonged inactivity, anxiety and isolation?

New Ultrasound Guided Interventional Pain Course
SUNDAY OCTOBER 18, 10-2PM!

REFERENCES

Kemp HI, Corner E, Colvin LA. Chronic pain after COVID-19: implications for rehabilitation [published online ahead of print, 2020 May 31]. Br J Anaesth. 2020;S0007-0912(20)30403-7. doi:10.1016/j.bja.2020.05.021

Dr. Rosenblum Interviews Panamanian Pain Physician In Spanish
(en Espanol)

Subtitles on the PainExam Youtube Channel or PainExam.com/news page

 Dr. Rosenblum welcomes Justin Harvey to the show to discuss financial planning and COVID preparations.

Announcement!

Dr. Rosenblum discusses a recent consensus guideline on Low Platelets in the Obstetric Patient. 

• Low Platelets and Epidurals in the OB Patient
• ASIPP Board Review Course
• Painexam Alumni Emails
• Congratulations to Graduates!
• Welcome incoming Residents and Pain Fellows!

Justin Harvey, host of the Anesthesia Success podcast interviews Dr. Rosenblum for his podcast.  Discussed in this podcast:

Business of Medicine
Industry Affiliation
Preparation for COVID
The definition of Success