It certainly was a fantastic meeting - well organized, amazing speakers (Pawa can talk a lot ๐ - who knew?!) all so relevant and engaging! Best regional Anaesthesia meeting ever ๐๐ป
As #RegionalAnaesthesia#RegionalAnesthesia Meetings go, the #ASURA25 meeting put on by @ANZRA_X was one if the best!
What struck me was the talent of the speakers, the quality of the programme and the diversity of the faculty.
It is great to see & proud to be part of
Another great listen to the guys talking blocks in the ED for analgesia esp SiFi for #nof - facial plane blocks โ working together ED anesthesia. Itโs a great idea.
Whaaaat?! You mean thereโs pain when the LA from a block wears off? ๐คทโโ๏ธkidding ๐คฆ๐ผโโ๏ธ ! Need to nom nom those multi-modals straight from PACU peeps ๐๐ป & some IR prn as backup.
Best RA pod with star guest @GongGasGirl talking in kiwaussie with the boys. My admin mind mixed with unit head & RA heart captivated listening to challenges of novice/expert/registrar/consultant/supervisor - itโs a bell curve. Iโm aiming all 2SD from mean.
Yep. Enough said. Block = analgesia for cut nerves. The rest is Anaesthesia for unconsciousness and prevention of recall. Together = safe and satisfied patient.
I once had a breast surgeon say โmastectomy patients donโt hurt afterwards because we cut the nerves.โ Iโฆdonโtโฆ.evenโฆ.*shakes head* Anyway, I like these for simple mastectomy. Theyโre not QUITE enough IMHO as surgical block, but with prop TIVA & LMA, itโs fab! Easy & safe. ๐
The axillary BPB was one of the first I learned with ultrasound, and itโs ALSO funโฆbeing able to see and block each separate nerve is hugely satisfying. However, you donโt need to! If you just place local on either side of the artery, youโll get excellent results. #Blocktober24
For an in-depth step by step discussion of axillary BPB, check out this video, which includes tips for tracing and finding those nerves when theyโre not all that obvious in the axilla: #Blocktober24youtu.be/vBpWpL0al9s?si=KttWโฆ
IV glycopyrrolate if no contraindication
5% lignocaine paste โlollipopโ to back of tongue
2% lignocaine spray via DeVilbiss w HFNO applied. Exhale to residual volume before spray (so patient can only breathe in).
( cophenylcaine spray & 2% lignocaine gel coated NPA if nasal)
Great summary! Exhalation best tip as highest inspiratory flow at start of inspiration to pick up aerosolized DeVilbiss Lidocaine. Added extra for #blocktober24 & as RA anaes I often will pop 2-3ml Lidocaine thru cricothyroid membrane pushed by 2ml air. The cough does the rest ๐
IV glycopyrrolate if no contraindication
5% lignocaine paste โlollipopโ to back of tongue
2% lignocaine spray via DeVilbiss w HFNO applied. Exhale to residual volume before spray (so patient can only breathe in).
( cophenylcaine spray & 2% lignocaine gel coated NPA if nasal)
Oooh I luuuv the PENG - my go to and fave for #nof . Been teaching more and more trainees this one. Great results. Love that bony point and fabbo lit up psoas tendon to sneak the local under. ๐
But primarily we use PENG (both THA and hip fracture repair), b/c we need patients to dance out the door and canโt risk motor weakness. PENG = SIFI for analgesia, which is great. And itโs easy to teach and learn. Hereโs that video... #Blocktober24youtu.be/mvqvDk0N0w0