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@@zakalobi80 yup, i hear you!

Woah.! Yes i have heard of folks doing that!

There’s a study of Mathias Maagaard, et al. 2024, DOI: 10.1136/rapm-2023-105098. Dexmedetomidine and Dexamethasone combined vs Dexa alone are the same in duration of analgesia. And in RAPM 2024 E. Hoerner showed more crystallization in the dexme-dexa mixture. 10.1136/rapm-2023-105229. Based on that i wouldn’t think there’s any reason in doing so.

So nice of you to say that! Thank You 🙏🏽

Thank you so much!

@@ebu_sati thank you so much- that is really kind

You gave me confident to start back doing blocks ❤️ self practice You saved me and many pts were not fit for G.A ESB SFIB THOSE blocks i was the first anesthesia doc doing it in my hospital

@@ebu_sati oh my goodness! This is so incredible to read and wonderful to hear. Keep it up and spread the knowledge. This is such an inspiring story, thank you for sharing

In theory, you could do a pecto-serratus or serratus anterior plane block from axilla with a larger volume of LA to target the nerve here, or block median antebrachial cutaneous in axilla near median nerve

@@chriswong7075 although this is not something I personally do, it is something that has been done and published

Thank you so much for your kind words 🙏🏽

@@paanmelaka thanks for watching and supporting my channel 🙏🏽🙏🏽

Thank you- please do listen to the full episode too!

You're welcome. Thanks for watching!

For posterior knee pain there are a few options: 1. Surgical Local Anaesthetic infiltration at time of surgery 2. IPACK block 3. Distal Adductor Canal block aiming for LA to follow the Path to the back of the knee. My Preference is for ipack block

@@DrAmitPawa if the pain is more over the semimembranosus/semitendinosus region, i probably should go for distal adductor canal block right?

Thank you for watching videos and supporting my channel 🙏🏽

Trying to mix it up! 😂

Is it recorded?

@@ebu_sati on any podcast provider…

Thanks So Much

Thank you so much for taking the time to watch and also feedback on the videos. It’s really great to know that they are being put to good use. Good luck for the blocks.

Paravertebral blocks have not been shown to reduce cancer recurrence, but there was a lot of excitement after one retrospective study, and a couple of small prospective studies suggested that maintaining Immune competency around the time of surgery may have an impact. The only randomised prospective large multi-centre trial that has subsequently taken place has not supported this claim.

Thank You 🙏🏽

Thank you so much for watching!

Thanks! 😃- thats very kind of you

Thank you so much 😀

There may be some utility there. Generally speaking the block will last as long as long as the duration of the drug (<24hours) - but it can be used with a nerve catheter or longer acting drugs. Pain physicians would be the best point of contact

Glad you enjoyed it

Thanks so much

Thank you so much! Please do share and enjoy the channel. Appreciate your feedback 🙏🏽

So the way to do this is by using a couple of techniques: 1. Direct your needle around the venous structures and aiming to place needle near fascia around nerves 2. Use hydrodissection to move structures out of the way /compress them by hydrostatic pressure 3. Once observed where veins are you can alter your probe pressure to compress the veins

I don’t believe that this is commercially available at this point in time sadly

So at present- I can just about do bilateral posterior QL’s with the patient supine, and a wedge under each hip one at a time. If wanting to perform Anterior QLs, could either do sitting, turning lateral twice, or do both injections from just one side

Do you mean EDRA guidance?

If it was not clear, apologies. Please do check out this video for a more precise discussion on this czcams.com/video/EJDBnzOfmms/video.htmlsi=lWsA-0FEKkRKxXzD

Thank You so much for watching ! 🙏🏽

Thank you so much 🙏🏽

Hi Paul - LFCN can of course be relevant depending on skin incision, as for the femoral branch of genitofemoral - I think it could play a role - especially for anterior approaches . This is a pretty good reference resources.wfsahq.org/atotw/evidence-for-regional-anesthesia-blocks-for-patients-with-hip-fractures-atotw-477/

Wow - thank you so much for this wonderful feedback. I really appreciate it- please do share the knowledge 🙏🏽

Really not clear evidence base for a pure a answer on this. For limited dermatomal coverage- 5cc at one level. If multiple dermatomal levels required, 5 cc per level covering the range of levels interested in - so for breast - T2/3 T3/4 T4/5 for example. There have been case reports of 20cc one level, but this does not reflect my practice

Exactly!

Thanks so much! Really appreciate it🙏🏽

Thank You!

Thank you for sharing your experiences

Thanks so much for taking the time to watch the video!

Thank you! I uploaded it as a few folks missed it at the conference. Wasn’t sure if anyone would actually watch it!

Thank You So Much!

That is so lovely to hear. Thank you for listening and for your support 🙏🏽

Dear Kate! Thanks so much!

Correct! 👍🏽

Thanks so much! That is so kind of you! Please feel free to share. Appreciate your support!

Thank You so much! Please feel free to share with your colleagues. Thanks for the positive feedback

Thank You Vicente!

Thank you so much for taking the time to watch it. I really appreciate your feedback

I am having my block on This week. They're putting me asleep though, thank God. I suffer bad anxiety. Ive had a swollen rib left side about 7th rib they say. Four years suffering after ACDF surgery went horribly wrong. It's right under my breast. Terrified but more terrified of the mental stress it's had me under. Can't keep going like this

I wish you all the best for your procedure

Thank you for sharing your experiences and for taking the time to watch the video and feedback. I really appreciate it

@@DrAmitPawa you’re very welcome! I’ve managed to come of some pretty hardcore painkillers now I’ve been having this done regularly which can only be a good thing! I still have to take painkillers, but I’ve gone from fentanyl lozenges to codiene… big difference! Xx