Claim OwnershipBlock It Like It’s Hot: Regional Anesthesia, Pain Medicine & POCUS
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Your hosts Amit ”I Got The” Pawa and Jeff “Tha Notorious JCG” Gadsden discuss current issues in regional anesthesia, ultrasound-guided nerve blocks, pain medicine and POCUS, while dropping some tips on how to make your regional anesthesia workflow a blocker’s delight. Each episode dives into clinical pearls, emerging research, and practical POCUS tips (along with a lot of banter and dad jokes). Ideal for anesthesiologists, pain physicians, CRNAs, and trainees—subscribe and level up your perioperative or ICU practice.
40 Episodes
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Greetings from Norway!! 🇳🇴 Amit and Jeff once again return to the GE Healthcare Block Box, this time at the ESRA25 meeting in Oslo! In this episode, we chat with Athmaja Thottungal about her motivation behind a career change, the value of healthcare coaches for preventative health, and some practical tips to chill out and engage in a "digital detox". Following that, we talk with John McDonnell and hear his thoughts on blocks new aaaaand not-so-new (and he teases us with some yet-to-be-published hints about a knee block he's working on...). Two incredibly insightful guests, two adequate hosts. Enjoy!
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Links:
🔗 International Board of Lifestyle Medicine: https://iblm.org/
🔗 Institute of Integrative Nutrition (Where Athma got her coaching certification from): https://www.integrativenutrition.com/
🔗 The article on psoas sheath block that John and team published: https://pubmed.ncbi.nlm.nih.gov/40386030/
In this fascinating episode, Amit and Jeff interview Dr. Jordana Garbati, an “emoji-ologist” 😎 who has researched and lectured internationally about the use of emoji as language. For something we use every day, we sure had a lot of questions: are we using these correctly? Are there ways to be misinterpreted? Is it ok to emoji your boss? What emoji are useful in communicating with colleagues or patients? If you’ve ever wondered how emoji get chosen to be on your phone, or if you wanna understand how luxury brands and birdwatchers are using emoji, then stay tuned. 🧠💉🧊🔥🎙️🤓🧀🤦♂️
Dr. Garbati's University of Toronto profile: https://www.utm.utoronto.ca/isup/people/jordana-garbati
Dr. Garbati's lab website: http://thescrl.com/
Dr. Garbati's LinkedIn page: https://ca.linkedin.com/in/jordana-garbati
Dr. Garbati's X/Twitter: @DrGarbati
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Our two hosts sit down for a stimulating (yes, intended) conversation with Kwesi Kwofie from Dalhousie University in Halifax, Canada, who gets down and dirty about needle nerve contact and nerve injury. Where exactly should we put the needle when performing a supraclavicular brachial plexus block? Or...is the supraclav dead?!! Why is periplexus preferred over intraplexus when doing interscalene brachial plexus blocks? Oh, and Kwesi might just win the joke contest. But wait, not to outdone, we follow up with Kristopher Schroeder from the University of Wisconsin, who educates us about raaaaaanch dressing, cheese curds, and gets us thinking about artificial intelligence and anesthesiology--is it ok to use generative AI to write a reference letter for a colleague? What is 'sentiment analysis' and do we have to read the whole paper anymore? Can AI help in decision-making surrounding transfusion practices? For all this and much much more, tune in to this fascinating episode.
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Are you an ESP lover or hater? In this episode, Amit and Jeff discuss all things erector spinae plane block and manage to touch on mechanisms, the controversy about ventral spread, which surgical procedures it works best for, and most importantly, share some tips and tricks to make sure that it DOES work for you in your practice.
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, patient safety and perioperative care!
1In our inaugural episode, Amit and Jeff learn a little bit about each other's backgrounds (amongst other things such as movies, Disney and fave Xmas foods) and discuss what we can expect from the podcast going forward.
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, patient safety and perioperative care!
Got pain that last for a looooong time? YOU, my friend, need a continuous catheter! Join Amit and Jeff as they discuss all things catheter-related: What is the best way to place them? How do keep them from falling out? What are the differences in catheter and pump designs? Is a programmed intermittent bolus enough? Or do we need a background rate too? What is a 'green gizmo'? Why does Jeff keep attempting accents? So many questions--and SO MANY answers! Stay tuned for all this and much more as we pump it up in this fun and enlightening episode.
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Links:
🔗 Article on force required to remove catheters with and without tunneling: https://pubmed.ncbi.nlm.nih.gov/24447324/
🔗 Article on best method for securing catheters to skin in volunteers: https://pubmed.ncbi.nlm.nih.gov/33406276/
🔗 Article on short vs. long axis placement of popliteal catheters: https://pubmed.ncbi.nlm.nih.gov/27440634/
🔗 Article on the first documented continuous catheter using a cork, needle and tape: https://pubmed.ncbi.nlm.nih.gov/20983091/
In this toe-tally fascinating episode, Amit and Jeff talk ankle blocks, digital blocks, Mayo blocks, popliteal sciatic blocks, and much more. Who knew there were so many ways to block the five little piggies??!
Join us every episode for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Links from the episode:
🔗 Robards et al article about needing an intra-sheath needle tip position to elicit a motor response for popliteal sciatic nerve block: https://pubmed.ncbi.nlm.nih.gov/19608846/
🔗 Lopez article about the sensory distribution of the saphenous nerve: https://pubmed.ncbi.nlm.nih.gov/22854395/
🔗 Wahal/Bullock article on the Femoral Arterial Block (FAB): https://pubmed.ncbi.nlm.nih.gov/33431616/
🔗 Mythbusters video on the use of epinephrine in digital blocks: https://youtu.be/Lh8dp8csNHU?si=mczxCGDWoEGuUmoQ
Two amazing interviewees in one deee-licious episode! The uber-impressive Ki Jinn Chin from the University of Toronto shares his ASRA "origin story", his thoughts on how regional anesthesia really does incorporate elements of artistry, creativity and improvisation, how long a YouTube video SHOULD be, and what he's doing with spinals these days. Following that, the always inspiring and engaging Amanda Kumar joins us from Duke University where she shares her experience with high-fidelity simulation, the use of cognitive aids, how to practice ultrasound-guided needling at home, and why she loves cat memes.
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Amit and Jeff continue their fascinating dive into the mind and life of Admir Hadzic, author, innovator, founder of NYSORA, brewer of fine beer, bassist and sports car nut. In this episode we discuss standardization in regional anesthesia, the future of textbooks in medicine, how sedated DO patients really want to be for nerve blocks, what it's like to drive a Ferrari to your next gig, and (because we don't shy away from cont-rah-versy, Admir's passionate thoughts and feelings on why there IS a difference between spinal and general for hip fracture and where some of the recent data may be more harmful than helpful for patients.
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Amit and Jeff are still (!) sweating it out in the block box, and have the good fortune to be joined by three wonderful guests: Stuart Grant from the University of North Carolina, Steve Coppens from the Catholic University of Leuven, and Gary Schwartz from Maimonides Medical Center in NYC. We cover such topics as peripheral nerve stimulation for looooong term pain control, the value of the ESP (and where it might just be hype--I'm talking to you, bunionectomy), the struggle of teaching residents AND fellows in the same institution, and cryoanalgesia of the cuties and intercostal nerves and what that means for patients both before their operations and after. Oh, and maybe why you shouldn't let your colleagues (or your trainees) stick needles in your back...
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
He's the founder of NYSORA, a rock-blues bassist, and a lover of fine beer and finer automobiles. We had a ton of fun chatting with Admir Hadzic about the his origin story, how he has been able to reinvent himself and his focus, and how to NOT live your life in "thirds". Over three decades, Admir has built a global educational brand while running a highly efficient regional anesthesia service in New York and now Belgium, and he shares his secrets on how he's been able to build a team, create value, and not get bogged down in things that aren't moving the mission forward. Cheers!
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Our star-studded guest list continues live from the GE Healthcare Block Box at ASRA Spring 25! In this episode we interview Ed Mariano, Eleni Moka, and Michael Bullock, and get their answers to such questions as: What platforms work best for social media? How do we bring RA education to under-resourced parts of the globe? What is the mechanism of tourniquet hypertension and what's a clever trick to obviate that? Why is Jeff so $&*# at accents? And more! No cuts, no edits, no bleeps -- just hard-hitting investigative journalism and--oh, wait, I'm being told that's not what we do. Either way, enjoy!
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Wine, flamingos, and a glass box…this is NOT your typical BILIH episode...Amit and Jeff join you from the ASRA Spring Annual Meeting 2025 in Orlando, Florida, where they recorded live interviews with over a dozen influential thinkers in regional anesthesiology. Join us as we chat and laugh with James Kim, Sandy Kopp and Nadia Hernandez over discussions of POCUS, probe covers, catheters, the NEW anticoagulation guidelines, and much much more!
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Clear!!! In the exciting conclusion to our two-parter on blocks in emergency medicine, things get real as the co-hosts debate Arun and Andrew over the ideal block for hip fracture, a slick way to reduce a shoulder dislocation, cheeky femoral blocks, and the role of fascial plane blocks in the ED.
Links:
The sponsor of this episode is GE Healthcare Venue Family of Ultrasound Machines: https://tinyurl.com/gehealthcarevenue
Article on spontaneous reduction hip dislocation after PENG block: https://pubmed.ncbi.nlm.nih.gov/39781033/
Blockheads website: www.blockheads-em.com
5 Minute Sono: https://coreultrasound.com/5ms/
POCUS Atlas: https://www.thepocusatlas.com/
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Amit and Jeff are joined by Dr. Robbie Erskine from Daaaarrby, UK, sharing his immense wealth of knowledge and experience (and which Bond film is his fave) on spinal anesthesia technique and how to make ambulatory spinals work for everyone!
Link to the BJA Education article on neuraxial anesthesia in patients with challenging anatomy:
https://www.bjaed.org/article/S2058-5349(23)00154-3/fulltext
Link to Robbie's review article on ambulatory spinal anesthesia:
https://www.bjaed.org/article/S2058-5349(19)30107-6/fulltext
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Amit and Jeff are joined by two Emergency Medicine experts (and self-described Blockheads!) with a passion for keeping injured patients comfortable. Drs. Arun Nagdev and Andrew Goldsmith talk to us about the role of regional anesthesia in the ER, what blocks are high-impact, what exactly is meant by a "tube and lube rotation" for trainees, and more!
Link to the JAMA paper on regional anesthesia in the ER and complications: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2826105
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
In part 2, Amit and Jeff tackle probe positioning, needle trajectory and something called Pawa's Pleural Groan...Why is the PVB poised to have a renaissance? Should we block one level? Every level? What's the risk of pneumothorax and should this block be done in anti coagulated patients? (spoiler: 2 out of 2 hosts say YES!) Join us for all this and more as we round out this in-depth discussion into one of our FAVE block techniques. Oh, and jokes. Always the jokes.
Link to the Cho study on paravertebral micro-CT anatomy:
https://pubmed.ncbi.nlm.nih.gov/33990438/
Link to the paper on intermittent bolus vs continuous infusion for PV catheters:
https://pubmed.ncbi.nlm.nih.gov/30674696/
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
In this episode, Amit and Jeff hold court while discussing the crown jewel of regional techniques, the paravertebral block. Join us for some controversies, debates and jokes while we give paravertebral anatomy and block technique the royal treatment.
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
Grab an eggnog & a mince pie or two and join Amit and Jeff for a frosty and festive finale to Season 2, featuring answers to some listener questions and a joyful round of dad jokes!
Links to things discussed:
University of Florida study on intercostobrachial nerve block: https://pubmed.ncbi.nlm.nih.gov/35308761/
Good paper explaining how regional anesthesia does NOT block ischemic pain: https://pubmed.ncbi.nlm.nih.gov/24102987/
Puzzling paper attributing acute compartment syndrome after tibial shaft fracture to a femoral nerve block: https://pubmed.ncbi.nlm.nih.gov/8636198/
RAUK algorithm for managing nerve injury: https://www.ra-uk.org/index.php/12-guidelines/266-ra-uk-algorithm-for-management-of-nerve-injury-associated-with-regional-anaesthesia
Sternal hematoma block with catheter: https://pubmed.ncbi.nlm.nih.gov/16988309/
Paper on rebound pain (it's not a thing btw): https://pubmed.ncbi.nlm.nih.gov/33390261/
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
In this engaging conclusion of our two-parter, we continue to share some laughs with the amazing Tanya Selak while discussing the value of SoMe collaboration, how to set boundaries when things get rough, and why she's NOT quitting Twitter (X) quite yet. In the meantime, Amit quotes Vanilla Ice, while Tanya seeks redemption as she gets another shot at the Dad-joke title.
Join us each month for another sassy conversation about anesthesiology, emergency medicine, critical care, POCUS, pain medicine, ultrasound guided nerve blocks, acute pain, and perioperative care!
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Thinking about Joel's case, I think that the 'safety margin' afforded by the adrenaline doesn't apply to perivascular local anaesthetic. The adrenaline is supposed to slow resorption via capillaries and small vessels, but that won't work next to a big artery/vein.