Editorial – In Nabil’s Corner: Thinking Outside the Box

Jul 11, 2018, 09:50 AM by Nabil Elkassabany, MD, MSCE

At the end of August, I headed to Schaumburg, Illinois, as part of a 12-member technical expert panel. The panel is composed of members of the American Society of Anesthesiologists (ASA) and ASRA and is working on the development of outcome metrics related to regional anesthesia and pain medicine (RAPM). I was happy to see ASA and ASRA leaders working together to give the RAPM community a voice in suggesting which metrics we should use to measure performance in these subspecialties. I expect more collaboration in the future between the two societies.

This was one of many advocacy efforts ASRA does on your behalf. This first in-person meeting concluded with six measures to be developed by this committee and later posted for public comment. These measures include use of multimodal analgesia, use of regional anesthesia for total knee arthroplasty, and implementing safeguards to ensure safe opioid use by pain practitioners.

 As a side note, this was my first visit ever to the ASA headquarters in Schaumburg, Illinois. ASA has done a very nice job in putting together a spectacular mural timeline exhibit (from darkness to light) representing the history of anesthesiology (Figure 1). I was particularly interested in some of the artifacts that represent the evolution of RAPM (Figure 2). If you are in the area, I encourage you to arrange a visit to ASA headquarters and spend some time in the Wood Library-Museum of Anesthesiology. I was glad I had this opportunity. The more I get involved with the RAPM community, the more I realize how creative these folks are. They always have a knack for innovation and thinking outside the box.

This issue of the ASRA News features some cutting-edge uses of regional anesthesia in critically ill patients and cardiac surgery. In addition, we feature an article about use of nerve blocks for patients having head and neck, ear, nose, and throat surgery. We also present the third installment of the problem-based learning discussion (PBLD) series. This article puts social media to work in an innovative and unprecedented way. As we have done in the prior two PBLDs, we solicit responses to different “twists” in the case scenario from experts in the field, compile these responses, and present to you the summary of these experts' opinions. We also post the stem case on the ASRA website, design a Twitter poll with questions about the case, and open it to all RAPM tweeps from around the globe to participate. It is impressive to see such a large number of responses representing a wide range of practice from different parts of the world. If you want to be part of this ASRA News feature, send an e-mail to asranewseditor@ You can contribute an interesting case scenario you experienced or be part of the expert panel that answers the discussion questions. You can also tweet about it using the hashtag #ASRAPBLD.

“The more I get involved with the RAPM community, the more I realize how creative these folks are.”

In the May 2017 issue of the ASRA News, Dr Steve Hanling and colleagues presented an article about using stellate ganglion block for treatment of depression and posttraumatic stress disorder. This article stirred up a lot of discussion at that time, especially since a similar article was published concurrently in the Wall Street Journal. Dr Lipov, the medical director of the pain clinic at Illinois Masonic Hospital in Chicago, sent us a comment regarding Dr Hanling's article. We have included the comment and response from Dr Hanling in our Letters to the Editor section.

The 16th Annual Pain Medicine Meeting being held November 16–18 is almost here, and I am excited to read about all the educational offerings that ASRA has planned. I am also excited about the upcoming 2018 World Congress on Regional Anesthesia and Pain Medicine being held April 19–21, 2018, in the city that never sleeps: New York City. In this issue, you can learn about the history of the World Congress and preview some of what we have in store for you during the meeting. See you in New York!

All of this is included in this special issue of ASRA News, but there's even more. You have to read it all to learn it all.

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