Jeff Gadsden

Follow @jeffgadsden

Oct 20 • 6 tweets • 29 min read

Good morning! It's the 20th of #Blocktober22 and it's also, once again, #ThrowbackThursday! Today let's talk about the various upper limb blocks that we've discussed over the years--what's your fave and why? @ASRA_Society @ESRA_Society @amit_pawa @EMARIANOMD @KalagaraHari

@ASRA_Society @ESRA_Society @amit_pawa @EMARIANOMD @KalagaraHari Let's start with interscalen brachial plexus block...I mean, for shoulder is there anything better? There are some nuances with needle position--should we go intraplexus or perplexus? I have some thoughts...#Blocktober22 @claralexlobo @Jerryblocksthat

@ASRA_Society @ESRA_Society @amit_pawa @EMARIANOMD @KalagaraHari @claralexlobo @Jerryblocksthat And then there's supraclav. Nice and compact beside the artery. Some swear that this is the spinal of the arm...@Steve_Coppens @HoltzMaggie @MonicaHarbellMD @dr_tgro @VeenaGraffMD @ajrmacfarlane @DrRobbieErskine @bobfunn @beckimarshRA @DrDiveshArora

@ASRA_Society @ESRA_Society @amit_pawa @EMARIANOMD @KalagaraHari @claralexlobo @Jerryblocksthat @Steve_Coppens @HoltzMaggie @MonicaHarbellMD @dr_tgro @VeenaGraffMD @ajrmacfarlane @DrRobbieErskine @bobfunn @beckimarshRA @DrDiveshArora But the REAL spinal of the arm is the infraclav! One injection at 6 o'clock and BOOM, you're done. Who is #TeamInfraclav?? @EHigginsMD @Siva6faces @SreeHPraveenKO1 @hjas18anes @tsmurali @AoraIndia @CA_PizzaHead @mariapsebastian @OuahidRahil @rljohnsonmd

@ASRA_Society @ESRA_Society @amit_pawa @EMARIANOMD @KalagaraHari @claralexlobo @Jerryblocksthat @Steve_Coppens @HoltzMaggie @MonicaHarbellMD @dr_tgro @VeenaGraffMD @ajrmacfarlane @DrRobbieErskine @bobfunn @beckimarshRA @DrDiveshArora @EHigginsMD @Siva6faces @SreeHPraveenKO1 @hjas18anes @tsmurali @AoraIndia @CA_PizzaHead @mariapsebastian @OuahidRahil @rljohnsonmd If you've got concerns about phrenic nerve block in a pulmonary cripple, we like suprascapular and axillary nerve blocks--any other phrenic-sparing strategies you're using?? #Blocktober22 @shaskinsMD @pritanand @pompeygasman @BaribeaultOFA @MKwesiKwofie

@ASRA_Society @ESRA_Society @amit_pawa @EMARIANOMD @KalagaraHari @claralexlobo @Jerryblocksthat @Steve_Coppens @HoltzMaggie @MonicaHarbellMD @dr_tgro @VeenaGraffMD @ajrmacfarlane @DrRobbieErskine @bobfunn @beckimarshRA @DrDiveshArora @EHigginsMD @Siva6faces @SreeHPraveenKO1 @hjas18anes @tsmurali @AoraIndia @CA_PizzaHead @mariapsebastian @OuahidRahil @rljohnsonmd @shaskinsMD @pritanand @pompeygasman @BaribeaultOFA @MKwesiKwofie And then there are just times when a distal block is nice--anesthetizing the hand and sparing the proximal muscles. LURVE these for finger fractures--how 'bout you?? #Blocktober22 @Duke_Anesthesia @DukeAnesRes @James_Kim_MD @PeterMerjavy @DrJeniMD

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More from @jeffgadsden

Jeff Gadsden

@jeffgadsden

Oct 18

Hiya, it's the 18th day of #Blocktober22 and today we're talking about a block used for upper limb trauma...you ARE doing blocks for trauma right? Follow along this thread to find out more and to chime in! @ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASALifeline

@ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASALifeline @amit_pawa @EMARIANOMD @Duke_Anesthesia @KalagaraHari @HoltzMaggie @AFSRAsociety @megs1970 @MariaaYasminee @NarouzeMD @dr_rajgupta The clavipectoral fascial plane block is a relatively new technique designed to do one thing: anesthetize the clavicle. Great for clavicle fracture repair when you DON'T want to block the whole arm...#Blocktober22 @fuzzymittens @zedunow @Docbasia @colinjmccartney @Jerryblocksthat

@ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASALifeline @amit_pawa @EMARIANOMD @Duke_Anesthesia @KalagaraHari @HoltzMaggie @AFSRAsociety @megs1970 @MariaaYasminee @NarouzeMD @dr_rajgupta @fuzzymittens @zedunow @Docbasia @colinjmccartney @Jerryblocksthat @dr_tgro @nelkassabany @VeenaGraffMD @rosie_hogg @ajrmacfarlane @Steve_Coppens @claralexlobo @MKwesiKwofie @Ropivacaine @Nadia_Hdz_MD Here's the link to our clavipectoral fascial plane block video: #Blocktober22 @anesthesiadocmd @garyschwartzmd @DrJeniMD @snouzin @dr_melissabyrne @BridgetPulos @PeterMerjavy @DrRobbieErskine @bobfunn @TomJelic @athmathottungal @SreeHPraveenKO1

Jeff Gadsden

@jeffgadsden

Oct 16

Hey it's the 16th of #Blocktober22 and--in response to some excellent chatter yesterday--we're doing a Mythbusters episode! Follow the 🧵 below to find out more...@ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASALifeline @ASA_Australia

@ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASALifeline @ASA_Australia @amit_pawa @EMARIANOMD @KalagaraHari @KartikBSonawane @HoltzMaggie @James_Kim_MD @garyschwartzmd @pritanand @colinjmccartney @MoosaFarhaan People have some strong opinions on this one...and we do too! #Blocktober22 @Steve_Coppens @claralexlobo @fuzzymittens @CarpenterAdam9 @L_D_White @mick_kerr @NarouzeMD @ashwani_doc @dr_tgro @rosie_hogg @LloydTurbitt @Nadia_Hdz_MD @rljohnsonmd @MKwesiKwofie @Jerryblocksthat

@ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASALifeline @ASA_Australia @amit_pawa @EMARIANOMD @KalagaraHari @KartikBSonawane @HoltzMaggie @James_Kim_MD @garyschwartzmd @pritanand @colinjmccartney @MoosaFarhaan @Steve_Coppens @claralexlobo @fuzzymittens @CarpenterAdam9 @L_D_White @mick_kerr @NarouzeMD @ashwani_doc @dr_tgro @rosie_hogg @LloydTurbitt @Nadia_Hdz_MD @rljohnsonmd @MKwesiKwofie @Jerryblocksthat @jon_bailey_anes @ajrmacfarlane @VeenaGraffMD @nelkassabany @Ropivacaine Here's a link to the Mythbusters Episode: #Blocktober22 @PeterMerjavy @athmathottungal @TomJelic @mokaeleni @AminaBenyoucef5 @DrRobbieErskine @bobfunn @SreeHPraveenKO1 @anesthesiadocmd @OuahidRahil @ZeNicoLs @BarbaraVersyck @svanhooreweghe @beckimarshRA

Jeff Gadsden

@jeffgadsden

Oct 15

Happy Saturday #Blocktober22 family! It's the 15th day--wow, time flies! Today we're discussing another lower limb technique that is incredibly useful and effective. Follow the 🧵 below to chime in! #DukeRAP @ASRA_Society @ESRA_Society @AoraIndia @LasraAnestesia @ASALifeline

@ASRA_Society @ESRA_Society @AoraIndia @LasraAnestesia @ASALifeline @amit_pawa @EMARIANOMD @Duke_Anesthesia @AmyPearsonMD @anesthesiadocmd @dr_tgro @nelkassabany @megs1970 @ajrmacfarlane @dr_rajgupta Lumbar plexus block is a 6-in-1 block (six!) that we've used for a variety of lower limb procedures and indications...#Blocktober22 @colinjmccartney @NarouzeMD @DrPhilipPeng @fuzzymittens @KalagaraHari @elboghdadly @MariaaYasminee @acopand @KristopherSchr6 @Docbasia @DrNatStrand

@ASRA_Society @ESRA_Society @AoraIndia @LasraAnestesia @ASALifeline @amit_pawa @EMARIANOMD @Duke_Anesthesia @AmyPearsonMD @anesthesiadocmd @dr_tgro @nelkassabany @megs1970 @ajrmacfarlane @dr_rajgupta @colinjmccartney @NarouzeMD @DrPhilipPeng @fuzzymittens @KalagaraHari @elboghdadly @MariaaYasminee @acopand @KristopherSchr6 @Docbasia @DrNatStrand @MonicaHarbellMD @rosie_hogg @James_Kim_MD @HoltzMaggie @garyschwartzmd @claralexlobo @_anapatriciaper @Steve_Coppens @SreeHPraveenKO1 @MKwesiKwofie Here's the link to the lumbar plexus video...enjoy! #Blocktober22 @docmorne @snouzin @hjas18anes @VeenaGraffMD @dr_melissabyrne @jon_bailey_anes @ChrisPrabhakar @galusweegie @TomJelic @rljohnsonmd @CA_PizzaHead @mariapsebastian @bobfunn @DrRobbieErskine

Jeff Gadsden

@jeffgadsden

Oct 13

Morning! It's #Blocktober 13th and it's also #ThrowbackThursday!! Today let's talk about all our fave lower limb block techniques--what's the one you CAN'T live without?? (best with 🔊) @ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASA_Australia

@ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASA_Australia PENG block is one of our go-to techniques for hip fracture as well as THA. It's motor-sparing (usually...) and in RCTs compares well with fascia iliaca. Who's using PENG in their practice? @amit_pawa @EMARIANOMD @KalagaraHari @ajrmacfarlane

@ASRA_Society @ESRA_Society @LasraAnestesia @AoraIndia @ASA_Australia @amit_pawa @EMARIANOMD @KalagaraHari @ajrmacfarlane The SIFI block is our true 3-in-1 and a solid player in the pantheon of blocks for lower limb trauma and elective surgery. Any SIFI fans out there?? #Blocktober22 @claralexlobo @HoltzMaggie @dr_rajgupta @dr_tgro @rosie_hogg @Nadia_Hdz_MD @Steve_Coppens

Jeff Gadsden

@jeffgadsden

Oct 12

Hey hey it's the 12th day of #Blocktober22 ! Today we'll be exploring a way to prolong those blocks beyond the usual 12-18 hours...follow the 🧵 below to follow along and chime in! #DukeRAP @ASRA_Society @ESRA_Society @AoraIndia @LasraAnestesia @AFSRAsociety @ASALifeline

@ASRA_Society @ESRA_Society @AoraIndia @LasraAnestesia @AFSRAsociety @ASALifeline @amit_pawa @EMARIANOMD @morefluids @dr_tgro @nelkassabany @VeenaGraffMD @dr_rajgupta @ruthi_landau @colinjmccartney @KiJinnChin Continuous catheters are an amazing way to prolong blocks for days to weeks. They CAN be a little tricky at times, and in today's video we'll offer up some of our own tips for making sure they go in easy, and stay in the right place! #Blocktober22 @fuzzymittens @NarouzeMD

@ASRA_Society @ESRA_Society @AoraIndia @LasraAnestesia @AFSRAsociety @ASALifeline @amit_pawa @EMARIANOMD @morefluids @dr_tgro @nelkassabany @VeenaGraffMD @dr_rajgupta @ruthi_landau @colinjmccartney @KiJinnChin @fuzzymittens @NarouzeMD @Steve_Coppens @ajrmacfarlane @DrRobbieErskine @bobfunn @claralexlobo @_anapatriciaper @rosie_hogg @LloydTurbitt @garyschwartzmd @MKwesiKwofie Here's the link to the video: #Blocktober22 @Duke_Anesthesia @AmandaKumarMD @wmbullockMDPhD @zedunow @Ropivacaine @SreeHPraveenKO1 @KalagaraHari @galusweegie @rljohnsonmd @James_Kim_MD @anesthesiadocmd @KohanLynn @CA_PizzaHead @mariapsebastian

Jeff Gadsden

@jeffgadsden

Oct 11

Hey it's day 11 of #Blocktober22 ! Today we're back to peripheral blocks, and will be discussing a lower limb block that has a lot of utility in certain settings...follow the 🧵 below to find out more... #DukeRAP @ASRA_Society @ESRA_Society @AoraIndia @LasraAnestesia

@ASRA_Society @ESRA_Society @AoraIndia @LasraAnestesia @Duke_Anesthesia @amit_pawa @EMARIANOMD @morefluids @dr_rajgupta @ankeetudani @ajrmacfarlane @rosie_hogg @Steve_Coppens @claralexlobo The obturator nerve block is used for amputations, to prevent reflex adductor contraction during TURBT, and a number of other indications. #Blocktober22 @BenjaminLukeFox @snouzin @fuzzymittens @docmorne @Neuro_Kellie @VeenaGraffMD @dr_tgro @nelkassabany @James_Kim_MD @HoltzMaggie

@ASRA_Society @ESRA_Society @AoraIndia @LasraAnestesia @Duke_Anesthesia @amit_pawa @EMARIANOMD @morefluids @dr_rajgupta @ankeetudani @ajrmacfarlane @rosie_hogg @Steve_Coppens @claralexlobo @BenjaminLukeFox @snouzin @fuzzymittens @docmorne @Neuro_Kellie @VeenaGraffMD @dr_tgro @nelkassabany @James_Kim_MD @HoltzMaggie @ESchwenkMD @galusweegie @DrJeniMD @AmandaKumarMD @paulhting @athmathottungal @MKwesiKwofie @Ropivacaine @jon_bailey_anes @SreeHPraveenKO1 Here's the link to the obturator nerve block video: #Blocktober22 @mjoldman @MonicaHarbellMD @KalagaraHari @rljohnsonmd @bobfunn @DrRobbieErskine @pritanand @tsmurali @CA_PizzaHead @mariapsebastian @lianazucco @AminaBenyoucef5

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