RAPM Focus

BMJ Group

RAPM Focus is devoted to exploring the provocative and impactful aspects of the research published in Regional Anesthesia & Pain Medicine (RAPM) - rapm.bmj.com. Authors are joined by Editor-in-Chief, Dr. Brian Sites, and other members of the RAPM Editorial Board to discuss and debate the findings that matter most for clinicians, patients, and policy makers. Topical coverage includes all aspects of acute, perioperative, transitional, and chronic pain medicine.

At RAPM, we believe well-done pain medicine improves health and well-being. Thanks for joining us.

@RAPM_Online Podcast and music produced by Dan Langa.

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October 15 · 37 min
Episode 56:  National patterns and variation in regional anesthesia use for shoulder, hip, knee, and ankle arthroplasty
Although regional anesthesia (RA) has been associated with improved pain control, reduced opioid consumption, and faster recovery following arthroplasty, disparities in its utilization have been identified, with limited data available for shoulder and ankle procedures. In this episode of RAPM Focus, Associate Editor Nabil Elkassabany, MD, guest hosts a discussion with authors Monica Harbell, MD, and Meredith Anderson, MD, about their June 2026 original research article, “National patterns and variation in regional anesthesia use for shoulder, hip, knee, and ankle arthroplasty.” The conversation examines national trends in RA utilization, variations across patient populations and hospital settings, and opportunities to improve access to RA. Dr. Monica Harbell is an associate professor of anesthesiology in the Department of Anesthesiology and Perioperative Medicine at Mayo Clinic Arizona. She completed her anesthesiology residency and regional anesthesia fellowship at the University of California, San Francisco. She serves as Associate Chair of Education and Program Director for the anesthesiology residency at Mayo Clinic Arizona. She is a member of the ASA Patient Safety Editorial Board and the ASA Committee on Practice Parameters. Dr. Meredith Anderson is a first-year anesthesiology resident in the Department of Anesthesiology and Perioperative Medicine at Mayo Clinic Arizona. She earned her medical degree from Mayo Clinic Alix School of Medicine. Her academic interests include regional anesthesia, patient safety, quality improvement, and medical education. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online. 
September 15 · 35 min
Episode 55: Regional Anesthesia for Distal Radius Fracture Repair: A Multicenter Retrospective Cohort Study of Perioperative Outcomes and Postoperative Healthcare Utilization
Editor-in-Chief Brian Sites, MD, explores the use of regional anesthesia for distal radius fracture repair with Edward Yap, MD, and David Zeltser, MD, based on the results of their multicenter retrospective cohort study. Their discussion follows the June 2026 publication of their original research paper, “Regional Anesthesia for Distal Radius Fracture Repair: A Multicenter Retrospective Cohort Study of Perioperative Outcomes and Postoperative Healthcare Utilization.” Dr. Yap is an anesthesiologist at Kaiser Permanente Northern California and a physician researcher in the TPMG DARE Program, with a joint appointment as associate clinical professor at University of California, San Francisco. His research spans perioperative outcomes, population health, comparative effectiveness, and implementation science across surgical populations. Dr. Zeltser is a board-certified orthopedic hand and wrist surgeon at Kaiser Permanente Washington, where he also serves as Interim Associate Medical Director of Orthopedic Surgery. Over a decade of practice, he has developed a keen interest in perioperative pain control shaped by direct patient feedback, coordinating closely with anesthesia colleagues on nerve block utilization for outpatient upper extremity surgery. His research, conducted through the Kaiser Permanente National Implant Registries and KPNC clinical databases, spans elbow arthroplasty outcomes, distal radius fractures, and healthcare utilization in integrated health systems. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
August 14 · 18 min
Episode 54: Glucagon-like peptide 1 receptor agonist use and risk of arthroplasty for knee osteoarthritis: retrospective database analysis
Knee osteoarthritis is a leading cause of chronic pain and disability, with limited disease modifying therapies—yet glucagon-like peptide 1 receptor agonists may reduce progression to total knee arthroplasty. In this episode of RAPM Focus, Executive Editor Anahi Perlas, MD, FRCPC, explores whether or not GLP-1 receptor agonists may reduce the risk of arthroplasty for total knee osteoarthritis with Ryan D’Souza, MD, and Jay Karri, MD. Their conversation follows the April 2026 publication of their original research paper, “Glucagon-like peptide 1 receptor agonist use and risk of arthroplasty for knee osteoarthritis: retrospective database analysis.” Dr. Anahi Perlas is a professor of anesthesiology and pain medicine at the University of Toronto. She is the Director of Research and the Director of the Perioperative POCUS Fellowship at Toronto Western Hospital. Additionally, Dr. Perlas is an Executive Editor of Regional Anesthesia and Pain Medicine, and a founding and current member of the American Society of Anesthesiologists Editorial Board on point-of-care ultrasound, overseeing the ASA Certificate of Completion in POCUS. Dr. Ryan D'Souza is a pain physician and professor of anesthesiology at Mayo Clinic. His major focus lies in neuromodulation, guideline development, and evidence appraisal. He serves on the Board of Directors of NANS and has authored over 200 publications. He is a section editor for Neuromodulation journal and Journal of Pain Research, and also serves on the editorial board for RAPM. Dr. Jay Karri is an assistant professor of physiatry and pain medicine at the University of Maryland School of Medicine in Baltimore, Maryland. His clinical and research interests include musculoskeletal ultrasound, neuromodulation, and technical considerations in pain interventions. He serves on the ASRA Pain Medicine Guidelines and Regulatory Advocacy Committee, and is an Associate Editor at the Regional Anesthesiology and Pain Medicine journal. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
July 15 · 33 min
Episode 53: Analgesic efficacy of the ultrasound-guided pericapsular nerve group (PENG) block for ambulatory hip arthroscopy: a randomized controlled double-blind trial
In this episode of RAPM Focus, Editor-in-Chief Brian Sites, MD, discusses the optimal analgesic approach for reducing postoperative pain following ambulatory hip arthroscopy with Laura Girón Arango, MD, Joanne Tan, MBBS (Hons), FRACP, and Sinéad Campbell, MB, BCh, BAO, FCAI. Their conversation follows the March 2026 publication of their original research paper, “Analgesic efficacy of the ultrasound-guided pericapsular nerve group (PENG) block for ambulatory hip arthroscopy: a randomized controlled double-blind trial.” Hip arthroscopy is an increasingly common outpatient surgical procedure where postoperative pain can be severe. Peripheral nerve blocks have been evaluated for analgesia following hip arthroscopy; however, there is no consensus on an optimal technique that provides effective local anesthetic-based postoperative analgesia without motor blockade. In this study, the investigators hypothesized that the pericapsular nerve group (PENG) block would provide effective motor-sparing analgesia following ambulatory hip arthroscopy, randomizing 94 patients undergoing outpatient hip arthroscopy to receive either a preoperative pain block with 20ml of 0.5% ropivacaine or a sham procedure. Dr. Laura Girón Arango is a staff anesthesiologist at Toronto Western Hospital and Women’s College Hospital, and an assistant professor at the University of Toronto. Her clinical and academic work focuses on regional anesthesia and point of care ultrasound. Her research has centered on motor-sparing regional anesthesia techniques for hip and knee surgery, including the PENG, iPACK, and adductor canal blocks. Additional areas of interest include perioperative diaphragm ultrasound assessment and the use of gastric ultrasound to evaluate aspiration risk, particularly in patients receiving GLP-1 receptor agonists. Through this work, she aims to advance perioperative safety, improve individualized pain management, and promote the integration of ultrasound into routine anesthetic practice. Dr. Joanne Tan is a consultant anesthetist, regional anesthesia lead, and regional anesthesia fellowship supervisor at the Royal Adelaide Hospital in Adelaide, Australia, and a clinical lecturer at the Adelaide University. She completed a regional anesthesia fellowship at the Toronto Western Hospital and University of Toronto, and neuroanesthesia and upper GI fellowships at the Royal Adelaide hospital. Her interests include regional anesthesia, POCUS, neuroanesthesia, quality improvement, medical education, and making memes. Dr. Sinéad Campbell is a staff anesthesiologist at Toronto Western and Women’s College Hospital in Toronto, and an assistant professor at the University of Toronto. Her clinical practice focuses on regional anesthesia and neuroanesthesia. Her research interests include regional anesthesia and perioperative cognitive impairment. She is actively involved in clinical education, with a focus on teaching ultrasound-guided regional anesthesia and practical perioperative decision-making to trainees. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
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June 15 · 43 min
Episode 52: Impact of removing liposomal bupivacaine from a health system formulary on length of stay: an observational study in video-assisted thoracoscopic wedge resection
In this episode of RAPM Focus, Raj Gupta, MD, FASRA, hosts a critical conversation with RAPM Editor-in-Chief Brian Sites, MD, on the intersection of patient care and surgical recovery in healthcare economics, following the December 2025 publication of Dr. Sites’s research letter, “Impact of removing liposomal bupivacaine from a health system formulary on length of stay: an observational study in video-assisted thoracoscopic wedge resection.” Dr. Raj Gupta is a professor of anesthesiology at Vanderbilt University in Nashville, Tennessee. He is the medical director of Vanderbilt Health Belle Meade Surgery Center. Dr. Gupta previously served on the ASRA Pain Medicine Board of Directors. Dr. Brian Sites is a professor of anesthesiology and orthopedic surgery at the Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center. He is the medical director of the acute pain medicine service. Dr. Sites’s clinical passion and research centers around the role of image guidance for regional anesthesiology. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
May 15 · 24 min
Episode 51: Utilization and opioid outcomes of a transitional pain service in high-risk surgical veterans: a cohort study
In this episode of RAPM Focus, RAPM’s Social Media Editor, Alopi Patel, MD, engages with author and RAPM Associate Editor Dr. Sesh Mudumbai, MD, MS, and Oluwatobi Hunter, DNP, RN-BC, AGACNP-BC, following the December 2025 publication of their original research paper, “Utilization and opioid outcomes of a transitional pain service in high-risk surgical veterans: a cohort study.” Dr. Sesh Mudumbai is an associate professor of anesthesiology at Stanford University School of Medicine and director for clinical informatics systems and perioperative analytics at the VA Palo Alto Health Care System. His research focuses on understanding pain trajectories, opioid outcomes, and healthcare utilization patterns in surgical populations, with particular emphasis on developing data-driven and informatics-related approaches to improve perioperative care for high-risk veterans. He leads a research program at the intersection of clinical anesthesiology, pain medicine, and health services research. Dr. Oluwatobi “Tobi” Hunter is the lead nurse practitioner for perioperative pain management and co-director of the transitional pain service at the Veterans Affairs Palo Alto Health Care System. Her clinical interests include perioperative pain management, contingency management for substance use disorders, buprenorphine initiation, auricular acupuncture, and building collaborative multidisciplinary teams. She engages in scholarship through peer-reviewed publications, webcasts, and speaking engagements. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
April 15 · 36 min
Episode 50: Pro–con debate on perioperative gabapentinoids: a nuanced approach is the best one
In this episode of RAPM Focus, Editor in Chief Brian Sites, MD, discusses the pros and cons of perioperative gabapentinoids with author and RAPM Executive Editor Eric Schwenk, MD, and Kishor Gandhi, MD, following the November 2025 publication of his brief technical report, “Pro-con debate on perioperative gabapentinoids: a nuanced approach is the best one.” Dr. Eric Schwenk is a professor of anesthesiology and perioperative medicine at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, PA and is the vice chair of faculty affairs and professional development. His clinical and research interests are outcomes after orthopedic surgery, chronic postsurgical pain, and ketamine in migraine. He serves on the ASRA Pain Medicine Guidelines and Regulatory Advocacy Committee. Dr. Kishor Gandhi is a clinical associate professor and associate residency director at Virtua College of Medicine and Life Sciences at Rowan University in New Jersey. His clinical interests include regional anesthesia and acute pain. Dr. Gandhi has been in clinical practice for 20 years. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
March 16 · 15 min
Episode 49: SPACE-Postpartum: a multidomain biopsychosocial framework for predicting chronic pain and impaired recovery after cesarean delivery – proof-of-concept report
This episode of RAPM Focus challenges physicians to think differently about pain after cesarean delivery by showcasing a new approach for patient care after cesarean delivery. RAPM Executive Editor Eric Schwenk, MD, explores the SPACE-postpartum model with Sarah Ciechanowicz, BMBCh, FRCA, following the October 2025 publication of her brief technical report, “SPACE-Postpartum: a multidomain biopsychosocial framework for predicting chronic pain and impaired recovery after cesarean delivery – proof-of-concept report.” The SPACE-postpartum model is essentially a multidomain symptom system for understanding recovery after cesarean delivery. This biopsychosocial framework brings together five interconnected symptom areas—sleep, pain, affect, cognition, and energy—for early risk assessment after surgery, offering a comprehensive approach to the entire recovery process after cesarean delivery. Early recovery is not just about pain scores, but about a pattern of symptoms that tend to cluster and shape a patients’ long-term trajectory. By assessing that pattern early on, we could potentially identify a modifiable risk profile for chronic pain and impaired recovery. Dr. Sarah Ciechanowicz (“Chye-kha-no-vich”) is a consultant anesthetist at University College London Hospitals, researcher at Imperial College London, and former visiting fellow in obstetric anesthesia research at Stanford University. Her work focuses on improving postpartum recovery and pain prediction after caesarean delivery. She developed the SPACE-Postpartum framework—a multidomain biopsychosocial model designed to identify women at risk of chronic pain and inform intervention in the early postpartum period. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
February 12 · 25 min
Episode 48: Long-term outcomes of amputation in patients with complex regional pain syndrome (CRPS): a mixed-methods study
The management of complex regional pain syndrome (CRPS) continues to challenge clinicians—especially when conservative and interventional strategies fall short. This episode of RAPM Focus, hosted by RAPM Editor and Social Media Editor Ryan D’Souza, MD, explores these challenges in managing CRPS with Daniël van der Spek, MD, and Frank Huygen, MD, PhD, FIPP, FFPMCAI, following the August 2025 publication of their original research paper, “Long-term outcomes of amputation in patients with complex regional pain syndrome (CRPS): a mixed-methods study.” In rare and severe cases, amputation has been proposed as a last resort intervention, but the topic remains completely controversial. How does one weigh the potential relief of unrelenting pain against the risk of further complications and disability from an amputation? This episode explores a fascinating, mixed-method study into the long-term outcomes of patients with CPRS undergoing limb amputation in hopes of pain relief, despite risks of residual pain or phantom limb pain. Dr. Daniël van der Spek is a medical doctor and PhD candidate at the Erasmus University Medical Center under the supervision of Professor Huygen his research focus is on CPRS with a particular emphasis on interventional pain management. Dr. Frank Huygen is an anesthesiologist and pain physician serving as the head of the Department of Pain Medicine at Erasmus University Medical Center, and has been a full professor since 2009. His expertise focuses on CPRS and neuromodulation. He leads multiple national and international research projects, and maintains close collaborations with CRPS patient organizations, in both the Netherlands and 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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
January 16 · 32 min
Episode 47: Outpatient continuous adductor canal block (CACB) for total knee arthroplasty: a double-blinded randomized placebo-controlled trial
Kick off 2026 with the January episode of RAPM Focus, where RAPM Social Media Editor Alopi Patel, MD, converses with Josh Gleicher, MD, MSc, FRCPC, and Hermann dos Santos Fernandes, MD, PhD, following the September 2025 publication of their original research paper, “Outpatient continuous adductor canal block (CACB) for total knee arthroplasty: a double-blinded randomized placebo-controlled trial.” Dr. Gleicher is a staff anesthesiologist and regional anesthesia expert at Mount Sinai Hospital in Toronto, Canada. He completed his anesthesiology training and fellowship in regional anesthesia at the University of Toronto and holds a master’s degree in quality improvement and patient safety. Dr. Gleicher has extensive experience leading clinical trials in acute postoperative pain, with multiple funded studies and recognized expertise in anesthesia research. He is also a co-developer of the ISAFE technique for adductor canal catheter placement. In his spare time, he enjoys skiing and spending time with his wife and three kids. Dr. dos Santos Fernandes is a specialist in anesthesiology and pain management, trained at University of São Paulo, where he also achieved his PhD and completed a post-doctorate program. He has fellowship training in regional anesthesia and medical education at Mount Sinai Hospital, University of Toronto, and holds multiple certifications, including the superior title in anesthesiology and European diploma in anesthesiology and intensive care. Currently, he is an assistant professor at the University of Toronto and a staff anesthesiologist at Mount Sinai Hospital, with research and clinical focus on regional anesthesia. A retired basketball player and aspiring tennis player, he likes to travel with the family in his free time. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
Dec 19, 2025 · 24 min
Episode 46: Postsurgical opioid prescribing among veterans using community care for orthopedic surgery at non-VA hospitals compared to a VA hospital with a transitional pain service
The 2025 year draws to a close with the December episode of RAPM Focus, where RAPM Social Media Editor Alopi Patel, MD, converses with Benjamin S. Brooke, MD, PhD, and Michael “Jay” Buys, MD, following the April 2024 publication of their original research paper, “Postsurgical opioid prescribing among veterans using community care for orthopedic surgery at non-VA hospitals compared to a VA hospital with a transitional pain service: a retrospective cohort study | Regional Anesthesia & Pain Medicine.” The research study looked at opioid prescriptions after orthopedic surgery for veterans, comparing veterans who underwent surgery at the Salt Lake City VA Hospital to those in the community. Dr. Brooke is a Professor of Surgery, Biomedical Informatics (adjunct), Population Health Sciences (adjunct), and Chief of the Division of Vascular Surgery at the University of Utah. He grew up in Salt Lake City, receiving his Doctor of Medicine from the University of Utah before heading east to complete his internship and residency in General Surgery at the Johns Hopkins Hospital. During his surgical residency, Dr. Brooke received his PhD in Clinical Investigation at the Johns Hopkins Bloomberg School of Public Health. He then completed a fellowship in Vascular Surgery at the Dartmouth-Hitchcock Medical Center. Dr. Buys is an Associate Professor (Clinical) of Anesthesiology at the University of Utah and Chief of the Acute/Transitional Pain Section at the Salt Lake City VA Medical Center. He completed his medical degree at the University of Iowa and residency in anesthesiology at the University of New Mexico, after which he served as an active duty anesthesiologist in the US Air Force at Wilford Hall Medical Center in San Antonio and at Craig Joint Theater Hospital in Afghanistan. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
Nov 17, 2025 · 30 min
Episode 45: Post-Surgical Medication, Awareness, Recovery, and Tracking Using a Phone-Based App
In the November 2025 episode of RAPM Focus, ASRA Pain Medicine Past-President and RAPM Editor David Provenzano, MD, converses with Megan Rolfzen, MD, and Karsten Bartels, MD, PhD, MBA, following the July 2025 publication of their original research article, “Post-Surgical Medication, Awareness, Recovery, and Tracking Using a Phone-Based App (SMART-APP): A Randomized Controlled Trial.” In their clinical trial, Drs. Rolfzen, Bartels, et. al., tested the hypothesis that a patient-facing educational smartphone app would permit surgical patients to effectively manage their pain while using fewer opioids after discharge. Dr. Rolfzen is an assistant professor of anesthesiology at the University of Michigan and a scholar in the NIH T90 HEAL PAIN program. Dr. Bartels is a professor of anesthesiology, psychiatry, and learning health sciences at the University of Michigan and leads a research program focused on perioperative pain and mental health. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
Oct 15, 2025 · 46 min
Episode 44: Regional Anesthesiology Fellowships & Their Significance
In this unique episode of RAPM Focus, Editor in Chief Dr. Brian Sites’s fellow, Dr. Meredith Peck, discusses regional anesthesia fellowships with Dr. Giselle Maquoit. Fellowship applications have seen an obvious decline over the past several years due to an extremely lucrative job market. However, regional anesthesia fellowships still offer invaluable experiences for regional anesthesiologists. Meredith Peck, DO, is a current regional anesthesia and pain medicine fellow at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. Gisselle Maquoit, MD, is a current anesthesiologist at Kennebec Anesthesia Associates, a private practice serving Maine General Hospital. She completed a regional fellowship at Duke University. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
Sep 29, 2025 · 21 min
Episode 43: Developing a method for ultrasound estimation of gastric volume in patients with previous gastric sleeve
Gastric ultrasound can be so important in assessing aspiration risk in any number of patients preoperatively, and POCUS can be an incredibly valuable tool in this circumstance. In this episode of RAPM Focus, RAPM social media editor, Alopi Patel, MD, converses with Jacob Wrobel, MD, and Alexander Doyal, MD, MPH, FASA, following the June 2025 publication of “Developing a method for ultrasound estimation of gastric volume in patients with previous gastric sleeve.” Dr. Jacob Wrobel is a recent graduate of the University of North Carolina School of Medicine and is preparing to begin his anesthesiology residency at the University of Pittsburgh Medical Center. He has a special interest in the applications for point-of-care ultrasound in the perioperative setting and plans to continue to pursue research in this area in his career as an anesthesiologist. Dr. Alexander Doyal is an associate professor in the department of anesthesiology within the transplant and vascular anesthesia division at the University of North Carolina. He has a keen interest in POCUS, research, and education. He serves as the POCUS course director in the School of Medicine. He also leads workshops for residents, and teaches and mentors faculty at regional and national meetings. His research interests are varied, and included novel POCUS clinical applications. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
Aug 21, 2025 · 31 min
Episode 42: Mepivacaine versus bupivacaine spinal anesthesia for return of motor function following total knee arthroplasty: a randomized controlled trial
In the era of fast-tracked surgery and same-day discharge, anesthesiologists are looking for strategies to optimize recovery without compromising safety or pain control. A long-standing debate centers around whether low-dose bupivacaine or mepivacaine is the better spinal agent to promote early ambulation after total knee arthroplasty. In this episode of RAPM Focus, RAPM Editor-in-Chief, Brian Sites, MD, explores this debate with Clinton Pillow, MD, following the May 2025 publication of “Mepivacaine versus bupivacaine spinal anesthesia for return of motor function following total knee arthroplasty: a randomized controlled trial.” This episode explores a topic faced by every anesthesiologist that manages joint replacements, especially total knee arthroplasty, has grappled with—what is the ideal spinal anesthetic when time is money and same-day discharge is the goal? Dr. Pillow is an assistant professor in the department of anesthesiology and perioperative medicine at the Medical University of South Carolina. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
Jul 28, 2025 · 42 min
Episode 41: Buprenorphine versus full agonist opioids for acute postoperative pain management: a systematic review and meta-analysis of randomized controlled trials
In this episode of RAPM Focus, Editor-in-Chief Brian Sites, MD, discusses the use of buprenorphine for acute pain management with Thomas Hickey, MD, MS, following the February 2025 publication of “Buprenorphine versus full agonist opioids for acute postoperative pain management: a systematic review and meta-analysis of randomized controlled trials.” Dr. Hickey is full-time staff at the West Haven VA where he is medical director of preoperative evaluation and the PACU, and site director for the anesthesiology residency. Within the VA, he is chairman of the VA New England Healthcare System committee on preoperative evaluation and ERAS, co-chair of the VA’s national pain/opioid consortium for research workgroup on perioperative management of medications for opioid use disorder, and a member of the National Anesthesia Program Acute Pain Management Committee. He is board certified in both anesthesiology and addiction medicine. His research interests focus on the overlap between addiction medicine and acute pain management, particularly on the use of buprenorphine for acute pain management. He and his wife are kept busy by their three kids and all their activities. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
Jun 30, 2025 · 36 min
Episode 40: Hidden Influence? Unmasking Conflicts of Interest from Randomized Clinical Trials on Spinal Cord Stimulation for Chronic Pain
In this episode of RAPM Focus, Editor-in-Chief Brian Sites, MD, speaks with RAPM Editor Ryan D’Souza, MD, and Nasir Hussain, MD, following the October 2024 publication of “Hidden Influence? Unmasking Conflicts of Interest from Randomized Clinical Trials on Spinal Cord Stimulation for Chronic Pain.” Let’s set the stage first. Spinal cord stimulation, or SCS, is a therapy that involves implanting a device that sends electrical signals to the spinal cord, aiming to disrupt pain signals before they reach the brain. It’s a rapidly evolving field with a lot of promise, but it also attracts substantial investment from medical device companies. Now, when we talk about conflicts of interest, or COIs, we’re referring to situations where a researcher’s personal interests, particularly financial ones, have the potential to cloud their professional judgment and influence the outcomes of their research. Think of it this way: if a researcher is financially tied to a company that makes a specific SCS device, might they be more inclined to see their research results in a favorable light? That’s the concern. Dr. Ryan D’Souza is an associate professor and pain medicine physician at Mayo Clinic. He is the Director of Neuromodulation, and Director of the Inpatient Pain Service. He serves on the Board of Directors of the North American Neuromodulation Society and also serves in leadership roles for ASRA Pain Medicine. Dr. D’Souza has authored over 150 peer-reviewed publications and serves on several editorial boards. Dr. Nasir Hussain is a pain medicine physician and anesthesiologist at the Ohio State University. He is an assistant professor, associate program director for the anesthesiology residency, and assistant program director of the chronic pain fellowship. Dr. Hussain has authored over 110 peer-reviewed publications in leading journals in the field, and has presented his work nationally at several conferences. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
May 23, 2025 · 27 min
Episode 39: Beyond the block: a canvas for well-being and conversation in anesthesiology and pain medicine
In this episode of RAPM Focus, Alopi Patel, MD, speaks with K. Elliott Higgins III, MD, and Courtney Burns, MD, about their powerful pain palette essay, “Beyond the block: a canvas for well-being and conversation in anesthesiology and pain medicine.” This essay accompanies Healing Emotional Wounds—a community-engaged art piece by medical and scientific illustrator Morgan Granzow. Dr. Higgins is the director of health and well-being for UCLA’s department of anesthesiology and perioperative medicine, a physician health officer for UCLA Health, and a practicing anesthesiologist with subspecialty expertise in regional anesthesia and acute pain medicine. His research focuses on measuring and understanding health care professional well-being through a systems lens. As founding leader of the Well-Being Influencers Survey for Healthcare (WISH) research consortium, he led the development of WISH, a validated tool designed to assess perceptions of organizational conditions that shape well-being rather than individual states like burnout. He also co-chairs the American Society of Anesthesiologists’ well-being research working group and serves as both a member and change maker coach for the National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience. Dr. Burns is an anesthesiology resident physician at Vanderbilt University Medical Center and member of the BH Robbins Scholars Physician-Scientist Development Program. Her research interests include clinician well-being among the anesthesiology workforce, psychological sequelae of adverse clinical events, and the association of clinician occupational well-being challenges with health care quality and patient outcomes. She is experienced in the medical humanities and has leveraged both visual art and narrative medicine in promoting well-being among students and clinicians. She also serves as a member of the American Society of Anesthesiologists’ Committee on Physician Well-Being and the Society for Education in Anesthesia’s Committee on Well-Being. Inviting reflection and dialogue within the RAPM community and beyond, this artwork isn’t just visual—it’s a conversation starter. By incorporating language that emerged from guided reflection, it aims to create safer, more compassionate clinical environments. Whether displayed in break rooms, pain clinics, or perioperative spaces, it offers clinicians a moment to pause, see themselves in others’ words, and feel less alone. This discussion explores how this project seeks to destigmatize emotional struggles in medicine, promote well-being, and serve as a catalyst for further research—whether through focus groups, interviews, or broader institutional efforts. Most importantly, this piece reminds us that healing isn’t just for our patients—it’s for us, too. View more of Morgan Granzow’s medical and scientific illustrations here.
Apr 24, 2025 · 35 min
Episode 38: Current state of the pain medicine match: perspective and an eye to the future
In this episode of RAPM Focus, executive editor Steven Cohen, MD, discusses the September 2024 publication of “Current state of the pain medicine match: perspective and an eye to the future,” with Meredith Barad, MD, Anuj Aggarwal, MD, and Lynn Kohan, MD. This letter explores the rationale behind reassessing the NRMP’s utility for pain medicine, examining historical and current trends, and considering the implications of withdrawing from the match. Despite a recent decline in applicants and an increase in unfilled positions, the APPD advocates for continued participation in the match. The match ensures equitable and stable recruitment, preventing the chaotic pre-match environment of competitive, early offers. Data from similar specialties highlight the pitfalls of non-match systems, such as increased applicant pressure and reduced program visibility. The APPD supports maintaining the NRMP match while implementing reforms like preference signaling to address evolving challenges. The APPD aims to preserve the match’s benefits and ensure a stable future for pain medicine fellowship recruitment. Dr. Barad is a clinical associate professor in anesthesiology (pain) and neurology at Stanford. She is the co-director of the Stanford Facial Pain Program and focuses on headache and facial pain. She completed her undergraduate work at the University of Texas at Austin and graduated from Stanford University Medical School in 2003. After her internship at Santa Clara Valley Medical Center in San Jose, CA, she went on to a neurology residency and pain fellowship at Stanford. She is board certified in neurology, headache, and pain. She is the associate division chief of education and program director for the pain fellowship. She is the current president of the American Pain Program Directors. She serves as the chair of the headache and facial pain special interest group for the American Academy of Pain Medicine and is on the editorial board of Pain Medicine. Dr. Aggarwal is a clinical assistant professor of anesthesiology and the associate program director of the pain medicine fellowship at Stanford University, where he specializes in headache and orofacial pain. In addition to his work in pain medicine, he helps lead the teaching of medical students serving as director of pharmacology and as associate director for the Science of Medicine. Dr. Kohan is a professor of anesthesiology and pain medicine at the University of Virginia. She is the division chief and the chronic pain program director. She serves on the board of directors for national pain societies including ASRA Pain Medicine. *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, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.
Mar 20, 2025 · 11 min
Episode 37: Single-bolus Injection of Local Anesthetic, With or Without Continuous Infusion, for Interscalene Brachial Plexus Block in the Setting of Multimodal Analgesia
This AI-generated episode of RAPM Focus discusses the May 2024 publication of “Single-bolus Injection of Local Anesthetic, With or Without Continuous Infusion, for Interscalene Brachial Plexus Block in the Setting of Multimodal Analgesia: A Randomized Controlled Unblinded Trial” by Dr. Patrick Rhyner et al.” For anyone facing shoulder surgery, pain management after the procedure is crucial. In this paper, Rhyner et al. question whether or not a continuous infusion of pain medication through a catheter is better than giving a patient a single injection after having shoulder surgery. The paper discusses a multimodal approach of pain management—dethamexazone, magnesium, acetaminophen, and ketorolac. In this study, patients undergoing two common shoulder surgeries—shoulder arthroplasty or arthroscopic rotator cuff repair—were divided into two groups, in which one group received a continuous infusion of medication via catheters, or a single dose of pain relief. Results were measured by how much morphine patients needed through a patient-controlled analgesia pump during the first 24 hours after surgery. *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, LinkedIn @ Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

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