Pain management remains a significant challenge in clinical medicine, especially as the opioid crisis underscores the need for safer alternatives. Voltage-gated sodium channels (NaV) play a crucial role in pain signaling, with NaV1.8 being a key contributor in peripheral sensory neurons. Suzetrigine (VX-548), recently FDA-approved as Journavx™, is a highly…
Post dural puncture headache (PDPH) is a potential complication following neuraxial procedures when the dura is punctured and entry into the subarachnoid space permits drainage of cerebrospinal fluid (CSF). In the case of lumbar punctures (LP) and lumbar drains, this is intentional to drain CSF and measure intraspinal pressure. In…
Liposomal bupivacaine (Exparel) is a local anesthetic touted for the long duration of its activity. Molecules of bupivacaine are encapsulated within multivesicular liposomes composed of endogenous lipids like cholesterol and phospholipids; these liposomes undergo rearrangement to cause a slow release of bupivacaine over 2-3 days.
For the last several months, multiple manufacturing delays have led to a nationwide shortage of injectable, intravenous (IV) opioid medications like morphine, hydromorphone, and fentanyl. These medications are routinely utilized in the perioperative and intensive care settings for analgesia and sedation, so the shortage has forced us to incorporate other…
Although this chronic pain management rotation has been very relaxed, the month overall has been very hectic with my fellowship interviews. Many days I’ve had to catch flights immediately after work or, even better, come to work after returning to Houston well after midnight (…delayed flights… :mad: ). I’m just…
What a crazy day – the first epidural I’ve ever had to abandon, a myriad of acute pain consults, continuous block of the brachial plexus at the axilla, rectus sheath block x 6, post-op TAP block… and more Tegaderms than I want to remember right now. The culture here is all…
What a beautiful day in Houston! I’m halfway done with my first acute pain rotation and really enjoying my time back at the #1 cancer hospital in the country – MD Anderson Cancer Center. :-)
Last Thursday, a good classmate and I had the privilege of visiting a patient with metastatic cancer for our mandatory “palliative care experience.” Under the guidance of an attending physician, we explored how the patient coped with her diagnosis and subsequent therapies and probed her plans for the future.