Optimizing Genicular Nerve Blocks and Phenol for Knee Pain- Journal Club
AnesthesiaExam Podcast
Podcast Show Notes Episode Title: Optimizing Genicular Nerve Chemical Ablation: Insights from Dr. David Rosenblum Episode Summary: In this episode, we are joined by Dr. David Rosenblum, a New York-based interventional pain physician, who discusses optimizing genicular nerve chemical ablation. Dr. Rosenblum shares insights as well as his upcoming ultrasound course schedyke in New York City, focusing on regional anesthesia, interventional pain, and IV ultrasound placement. He emphasizes the significance of ultrasound in enhancing pain management procedures and the latest advancements in the...
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Using PRP or PNS to Treat Back Pain related to Multiifdus Atrophy
AnesthesiaExam Podcast
Exploring the Efficacy of Autologous Platelet Leukocyte Rich Plasma Injections in Chronic Low Back Pain & Understanding Degenerative Lumbar Spinal Stenosis Host David Rosenblum, MD Episode Date: October 25, 2024 In this episode, Dr. David Rosenblum discusses two significant studies related to chronic low back pain and degenerative lumbar conditions. The first study focuses on the use of autologous platelet leukocyte rich plasma (PLRP) injections for treating atrophied lumbar multifidus muscles, while the second study investigates the correlation between muscle...
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The use of Corticosteroids in Nerve Blocks- A Recent Review
AnesthesiaExam Podcast
Podcast Show Note Summary: Episode Title: "New Guidelines for Corticosteroid Injections in Chronic Pain Management" This podcast is a discussion about the recent review article In this episode, we dive into the recently published guidelines on the use of corticosteroid injections for managing chronic pain, developed by the American Society of Regional Anesthesia and Pain Medicine, along with several other prominent pain societies. These guidelines address the safety and efficacy of corticosteroid injections for sympathetic and peripheral nerve blocks, as well as trigger point...
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The Trigeminal Nerve Block and Cancer (Ultrasound and Flouroscopic Approaches)
AnesthesiaExam Podcast
PainExam Show Notes: Mandibular Division of the Trigeminal Nerve Block with Dr. David Rosenblum Introduction Host: Dr. David Rosenblum Topic: Mandibular Division of the Trigeminal Nerve Block for Cancer Pain Management Techniques: Ultrasound and Fluoroscopic Guidance Overview Purpose: Alleviate chronic facial pain, specifically in cancer patients suffering from trigeminal neuralgia or other related conditions. Focus: Detailed discussion on the anatomy, clinical presentation, and procedural techniques for effective nerve block. Anatomy of the Mandibular Nerve ...
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Regenerative Pain Medicine Journal Club: Interosseous vs Intraarticular vs ESW Inejctions
AnesthesiaExam Podcast
Dr. Rosenblum addresses 2 Studies on this Pain Management Journal Club Podcast Article 1: The Treatment of Bone Marrow Lesions Associated with Advanced Knee Osteoarthritis: Comparing Intraosseous and Intraarticular Injections with Bone Marrow Concentrate and Platelet Products Article 2: Autologous US-guided PRP injection versus US-guided focal extracorporeal shock wave therapy for chronic lateral epicondylitis: Aminimum of 2-year follow-up retrospective comparative study Editorial: Dr. Rosenblum poses some important questions: Why are regenerative therapies not covered? ...
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Collaborative Research. Exosomes & more with Christopher Robinson, MD PhD
AnesthesiaExam Podcast
Join us on this episode of the PainExam Podcast where rising star, Christopher Robinson, MD PhD discusses his upcoming paper on exosomes featuring some of the largest names in pain managment. Dr. Rosenblum also alludes to degenerative disc disease being a partially infectious podcast. Other topics discussed on this podcast: The Anesthesiology Job Market Pain Management Fellowship Duration of Pain Management Fellowships Should Pain Management be an Independent Residency? Other Announcements from : PainExam App almost ready Pain Management Board Prep...
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Intra-Discal Leukocyte Rich PRP: Treating DDD as an Infectious Disease.
AnesthesiaExam Podcast
Journal Club: Treating Degenerative Disc Disease with Leukocyte Rich PRP Dr. Rosenblum discusses an article written by Dr. Gregory Lutz describing Leukocyte RIch PRP's role in treating Degenerative Disc Disease and the theory that there is an infectious disease component to disc injury. Dr. Lutz describes multiple articles, as well as anectodal experience in which bacterial infectious was demonstrated in pathological discs, and PRP was successful in alleviating symptoms, modic changes and improved clinical as well as radiographic appearance. Other Announcements from : PainExam...
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Post Operative Pain after Shoulder Replacement: Peri-operative Ablation?
AnesthesiaExam Podcast
Dr. Rosenblum describes a patient with chronic shoulder pain who failed shoulder replacement, steroid injections, nerve blocks, cryotherapy, and peripheral nerve stimulation of the axillary and suprascapular nerve block. In this podcast, he discusses his perfomance of Shoulder Radiofrequency Ablation targeting the articular branches of the suprascapular nerve, axillary nerve, nerve to subscapularis and lateral pectoral nerve. Reference: ...
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IRO's (Independent Review Organizations)- Physicians Lobby for Oversight and Transparency
AnesthesiaExam Podcast
Advocating for Transparency and Oversight in Pain Management Introduction: Welcome back to Painexam, where we delve into the latest advancements and challenges in pain management. Today's episode highlights a significant advocacy effort made by leading Interventional Pain Physicians and industry experts. Summary of Lobbying Effort: On March 20, 2024, a group of esteemed physicians and industry leaders, including Drs. Sean Li, Peter Staats, Mehul J. Desai, David Reece, Hemant Kalia, and David Rosenblum, alongside industry figures Mark Stultz, Christopher Conrad, and Cecelia Ruble, visited...
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Stellate Ganglion, Ketamine Infusions and Interventional Psychiatry
AnesthesiaExam Podcast
Dr. Rosenbum discusses Interventional Psychiatry, the role of Stellate Ganglion Blocks in PTSD, Ketamine Infusions for Depression, and the role of Magnesium as a co-factor in ketamine infusions. Other Announcements from : PainExam App almost ready Pain Management Board Prep migrated to AnesthesiaExam Board Prep migrated to PMRExam Board Prep migrated to Ultrasound Interventional Pain Course Registration For Anesthesia Board Prep References References Górska N, Cubała WJ, Słupski J, Wiglusz MS, Gałuszko-Węgielnik...
info_outlineDavid Rosenblum, MD Garden City and Brooklyn Pain Physician, world renown for his work on the PainExam Podcast, PainExam Pain Management Board Review and NRAP Academy’s Continuing Medical Education Programs, discusses: a case of paresthesia in the upper neck realted to C3 and C4 stenosis and considers a selective nerve root block while wondering if a deep cervical plexus block would suffice.
Rational :
- Desire to avoid epidural due to proximity to spinal cord
- Ultrasound approach of cervial plexus may anesthetize C3 and C4 roots and may be sufficient to do with ultrasound alone
- Unfortunately, no data found to support this particular situation, however, it may be safe and effective if performed properly.
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Also discussed on this podcast:
The Superficial Cervical Plexus and applications for headache, neck pain, and clavicular fractures.
Caution: Phrenic Nerve
Anatomy
The cervical plexus is a complex network of nerves located in the neck region, originating from the anterior rami (branches) of the cervical spinal nerves, specifically those stemming from the upper cervical segments (C1 to C4). This intricate network serves to provide sensory and motor innervation to various structures within the neck and surrounding areas.
The cervical plexus is positioned within a groove between the longus capitis and the middle scalene muscles in the neck. It is organized into different nerve loops and branches that radiate outwards to supply various regions. The cervical plexus can be divided into deep and superficial components, each with distinct functions and innervation patterns.
Cervical Plexus: The plexus involves nerve loops and branches that provide both sensory and motor functions. The superficial sensory branches originating from adjacent anterior spinal nerves (C2 to C4) are responsible for providing sensation to specific areas of the skin, particularly in the head, neck, and shoulder regions. These sensory branches include the lesser occipital nerve (C2, C3), great auricular nerve (C2, C3), transverse cervical nerve (C2, C3), and supraclavicular nerves (C3, C4). These nerves typically run posteriorly and then penetrate the prevertebral fascia before reaching the skin and superficial structures.
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Ultrasound Workshops and Courses
Ultrasound Guided Regional Anesthesia and Pain Medicine NYC- July 19, 2023
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Regenerative Pain Medicine Course NYC- November 11, 2023
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Refereces
Kim JS, Ko JS, Bang S, Kim H, Lee SY. Cervical plexus block. Korean J Anesthesiol. 2018 Aug;71(4):274-288. doi: 10.4097/kja.d.18.00143. Epub 2018 Jul 4. PMID: 29969890; PMCID: PMC6078883. Read more!