Regional Anesthesia & Pain Medicine

Regional Anesthesia & Pain Medicine RAPM is your authoritative medical source for regional anesthesia and pain knowledge – from pediatric

🔍 Does a continuous adductor canal catheter improve pain control after TKA?💉 Single-shot adductor canal block (ACBs) are...
06/17/2026

🔍 Does a continuous adductor canal catheter improve pain control after TKA?

💉 Single-shot adductor canal block (ACBs) are popular for TKA, but does extending the block with a catheter reduce the dreaded "rebound pain" after day 1?

A recent RCT found 👇
❌ No reduction in opioid use from 24–48 hours
❌ No improvement in satisfaction, recovery, or length of stay
❌ No difference in PACU opioid requirements
⚠️ Catheter-related issues occurred in 7% of patients

📖 Bottom line:
When combined with a robust multimodal analgesic regimen, a continuous adductor canal catheter did not outperform a single-injection ACB with dexamethasone.

👉 Sometimes, more isn't better.

🔗 READ HERE -> https://doi.org/10.1136/rapm-2026-107719

🧠⚡ Can psychological factors predict success after Spinal Cord Stimulation (SCS)?This new study in RAPM explores whether...
06/15/2026

🧠⚡ Can psychological factors predict success after Spinal Cord Stimulation (SCS)?

This new study in RAPM explores whether baseline psychological characteristics influence outcomes after SCS implantation in 217 patients with chronic pain.

🔍 Key Findings:
✅ Traditional psychological measures (depression, disability, personality traits) were NOT strong independent predictors of achieving ≥30% pain reduction after SCS.

📈 However:
• Higher depressive burden appeared to influence early pain-response dynamics at 6 months.
• Traits such as perfectionism and resistance to change were associated with smaller long-term pain improvement at 12 months.
• A tendency toward "denial of depression" may also be associated with lower odds of SCS success.

💡 Takeaway:
Psychological factors may not determine who succeeds or fails with SCS, but they may shape how patients respond to therapy over time. These findings reinforce the importance of a biopsychosocial approach to neuromodulation and suggest that cognitive and emotional characteristics deserve continued attention in patient selection and optimization.

🔗 READ HERE -> https://doi.org/10.1136/rapm-2025-107329

🦠💡 Can the gut microbiome distinguish different types of chronic low back pain?A new study published in RAPM explores wh...
06/13/2026

🦠💡 Can the gut microbiome distinguish different types of chronic low back pain?

A new study published in RAPM explores whether individuals with nociceptive low back pain, neuropathic low back pain, and pain-free controls have distinct gut microbial signatures.

🔍 Key Findings:
✅ No significant differences in overall gut microbial diversity between groups
✅ No major shifts in microbial community structure over time
✅ Differences, if present, appeared limited to low-abundance taxa rather than broad microbiome changes

📊 These findings suggest that while the gut microbiome may play a role in pain modulation through immune, inflammatory, and neurobiological pathways, microbiome-based stratification of chronic pain phenotypes remains challenging.

🚨 Takeaway:
The relationship between chronic pain and the gut microbiome is likely more nuanced than previously thought. Future studies with larger cohorts and multi-omics approaches will be critical to better understand the gut–pain connection and identify clinically meaningful biomarkers.

🔗 https://doi.org/10.1136/rapm-2026-107796

🚨 US Department of Defense consensus guidelines on neuromodulation for pain management in active-duty military personnel...
06/12/2026

🚨 US Department of Defense consensus guidelines on neuromodulation for pain management in active-duty military personnel 🚨

🎖️The first military-specific consensus guidelines for neuromodulation have arrived. Developed by pain medicine leaders from the Army, Navy, and Air Force and endorsed by the Defense Health Agency, these recommendations aim to standardize care for Service Members with chronic pain.

🔑 Key considerations include command involvement, opioid tapering before implantation trials, military occupational requirements, limited-duty periods after certain procedures, and functional testing before deployment.

💡 Neuromodulation can be transformative for select Service Members, but decisions must balance pain relief and function with military readiness, deployability, and career demands.

📖 An important step toward improving consistency, equity, and outcomes in military pain care.

🔗 READ HERE: https://doi.org/10.1136/rapm-2026-107787

🩻 Rib Fracture Analgesia: Beyond Pain ScoresRib fractures in older adults are associated with substantial morbidity, par...
06/09/2026

🩻 Rib Fracture Analgesia: Beyond Pain Scores

Rib fractures in older adults are associated with substantial morbidity, particularly pulmonary complications.

📚 This pilot randomized study compared three analgesic strategies:
• Erector Spinae Plane (ESP) catheter
• Intravenous lidocaine infusion
• Multimodal analgesia alone

✨ Key findings:
• Similar pain scores across groups
• Similar opioid consumption across groups
• Lower delirium rates in the ESP group
• Pneumonia occurred only in control patients
• Possible LAST symptoms were observed in 3 lidocaine patients

🔍 These findings suggest that future studies may need to focus on outcomes beyond pain and opioid use, including delirium, pulmonary complications, and safety.

📖 Schwenk ES, Bloom R, Torjman MC, et al.

🔗 Discover more in RAPM: https://doi.org/10.1136/rapm-2026-107865

🚨 Preoperative vitamin D level and postoperative pain in patients undergoing breast cancer surgery🔬 A new prospective ob...
06/07/2026

🚨 Preoperative vitamin D level and postoperative pain in patients undergoing breast cancer surgery

🔬 A new prospective observational study published in RAPM found that preoperative vitamin D deficiency was associated with:
🔹 Higher postoperative pain scores
🔹 Increased opioid consumption
🔹 Greater likelihood of moderate-to-severe pain after breast cancer surgery

📈 In patients undergoing unilateral modified radical mastectomy, vitamin D deficiency independently increased the odds of significant postoperative pain during the first 24 hours (adjusted OR 3.12).

💡 These findings highlight the potential importance of preoperative nutritional and metabolic optimization in perioperative pain management.

READ HERE -> https://lnkd.in/ejd6KTEN

🚨 Can GLP-1 medications do more than help with weight loss?📚 In a large study of patients with knee osteoarthritis, GLP-...
06/05/2026

🚨 Can GLP-1 medications do more than help with weight loss?

📚 In a large study of patients with knee osteoarthritis, GLP-1 receptor agonists were associated with a lower risk of progressing to total knee replacement surgery. The greatest benefit was seen with longer treatment duration and newer agents such as semaglutide and tirzepatide.

📉 After 3 years of treatment, patients on semaglutide or tirzepatide had a 28% lower risk of knee replacement compared with matched controls.

💡 While more prospective research is needed, these findings suggest GLP-1 therapies may have disease-modifying effects in osteoarthritis beyond weight loss alone.

📖 READ HERE -> https://doi.org/10.1136/rapm-2026-107658

🧠 Can spinal cord stimulation reduce opioid use in chronic pain patients?This systematic review and meta-analysis evalua...
06/03/2026

🧠 Can spinal cord stimulation reduce opioid use in chronic pain patients?

This systematic review and meta-analysis evaluated opioid consumption following spinal cord stimulation (SCS) implantation across 43 studies involving more than 3,000 patients.

✨ Key findings:
• SCS was associated with a 32% reduction in opioid consumption
• Mean opioid dose decreased by 18 MME/day at 12 months
• Odds of continued opioid use decreased by 53%
• Benefits appeared sustained up to 24 months after implantation

🔍 These findings support the potential opioid-sparing role of SCS as part of multimodal chronic pain management strategies, although certainty of evidence remains very low.

📖 Hunter Soleymani et al.

👉 Read the full article in RAPM: https://doi.org/10.1136/rapm-2026-107603

🚨 Sub-perception dorsal root ganglion stimulation vs sham stimulation in established responders📚 A new randomized, doub...
05/27/2026

🚨 Sub-perception dorsal root ganglion stimulation vs sham stimulation in established responders

📚 A new randomized, double-blind crossover clinical trial examined subperception (paresthesia-free) dorsal root ganglion (DRG) stimulation versus sham stimulation in established DRG responders with chronic neuropathic or nociplastic pain.

Key findings:
🔹 Active subperception DRG stimulation significantly reduced pain compared with sham stimulation
🔹 Improved patient satisfaction and PGIC outcomes
🔹 No serious or device-related adverse events reported

✅ These findings provide important sham-controlled evidence supporting the efficacy of subperception DRG stimulation during the maintenance phase of chronic pain treatment.

LINK -> https://doi.org/10.1136/rapm-2026-107906

🚨 Preoperative vitamin D level and postoperative pain in patients undergoing breast cancer surgery🔬 A new prospective ob...
05/20/2026

🚨 Preoperative vitamin D level and postoperative pain in patients undergoing breast cancer surgery

🔬 A new prospective observational study published in RAPM found that preoperative vitamin D deficiency was associated with:
🔹 Higher postoperative pain scores
🔹 Increased opioid consumption
🔹 Greater likelihood of moderate-to-severe pain after breast cancer surgery

📈 In patients undergoing unilateral modified radical mastectomy, vitamin D deficiency independently increased the odds of significant postoperative pain during the first 24 hours (adjusted OR 3.12).

💡 These findings highlight the potential importance of preoperative nutritional and metabolic optimization in perioperative pain management.

READ HERE -> https://doi.org/10.1136/rapm-2025-107495

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