The American Society of Anesthesiologists (ASA) recently hosted their annual meeting, ANESTHESIOLOGY 2024 (ANES), in Philadelphia, PA from October 18-22nd. This prestigious event offered attendees a unique opportunity to delve into cutting-edge ideas and innovations, achieve professional goals, and expand their network within the field of anesthesiology. ASA stands as a strong advocate for patients in need of anesthesia or pain relief.

ANES 2024 featured groundbreaking research on pain, unveiling the latest developments and breakthroughs in the field. This research provides invaluable insights for healthcare professionals and researchers, offering new perspectives and potential solutions to enhance patient outcomes.

Let’s delve into the highlights of the research presented at ANES 2024, with a focus on pain, and explore the cutting-edge advancements that are shaping the landscape of anesthesiology.

The Efficacy of Pectoral Nerve II Block in Addition to Interscalene Nerve Block During Shoulder Surgery in Reducing Postoperative Pain: Preliminary Data from a Tertiary Healthcare Network

  • Interscalene nerve blocks (ISB) have long been utilized as an effective method for providing pain relief during and after shoulder surgery. However, the occurrence of axillary pain following complex shoulder procedures has posed a challenge, often necessitating the use of postoperative opioids in the post-anesthesia care unit (PACU) or, in rare cases, rescue pectoralis II nerve blocks (PECS II blocks). To address this issue, researchers have begun implementing preoperative PECS II blocks for many patients. In a retrospective case series, the researchers aimed to determine whether PECS II blocks could increase the likelihood of patients experiencing pain relief in the PACU.
  • While patients who received a PECS II block did demonstrate a higher chance of being pain-free in the PACU, the difference compared to those who received ISB only was not statistically significant. This lack of significance may be attributed to the size of the patient population studied.
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Parasternal intercostal nerve block for analgesia in surgeries requiring sternotomy, a systematic review and meta-analysis

  • The Parasternal Intercostal Nerve Block is a modern regional anesthesia technique that specifically targets the anterior cutaneous intercostal nerves responsible for providing sensory innervation to the sternum and the surrounding skin. This innovative approach has gained popularity as an integral component of multimodal analgesia following surgeries involving sternotomy. In a comprehensive systematic review and meta-analysis, researchers have meticulously assessed the effectiveness of the Parasternal Block (PSB) as documented in the existing literature. The findings suggest that the PSB demonstrates notable efficacy in reducing the need for opioids both during and after surgery.
  • While the PSB may not completely alleviate all sources of surgical pain following sternotomy, such as visceral nociception or issues related to surgical drains, it nonetheless represents a valuable addition to a comprehensive, opioid-minimized, multimodal analgesic regimen for patients undergoing sternotomy procedures.
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Preliminary Survey of Transgender and Gender Diverse Patient Satisfaction at a Chronic Pain Clinic

  • Transgender and Gender-Diverse Youth (TGDY) face unique challenges in comparison to cisgender youth. Studies have shown that adult LGBTQ+ individuals often report low satisfaction with medical care, leading to increased stress and potential impacts on chronic pain. However, there is a lack of research on TGDY patient satisfaction specifically. Transgender males, in particular, are at a heightened risk of experiencing pelvic pain following hormone therapy initiation, as well as chest and rib pain due to chest-binding practices. Understanding these distinct experiences is crucial for providing effective medical treatment. Unfortunately, many TGDY patients struggle to articulate their concerns due to fears of discrimination.
  • To enhance our comprehension of TGDY experiences and deliver more efficient and accessible care, a preliminary survey was administered to patients identifying as TGDY who were undergoing pain management at a comprehensive chronic pain clinic within a prominent pediatric hospital. Interactions between patients and other healthcare providers underscore the need for improvement across all specialties, not solely those catering to these populations. It is imperative to implement broader education on TGDY communities, encompassing provider sensitivity, name/pronoun usage, general knowledge, and discrimination prevention, to enhance satisfaction and care quality. By fostering a more inclusive environment, patients are likely to feel more at ease in sharing their concerns with healthcare providers, thereby informing their medical treatment.
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Perioperative Methadone in Pediatric Patients with Severe Obesity Undergoing Bariatric Surgery

  • The prevalence of severe obesity in children is on the rise, presenting a significant public health concern. As a result, bariatric surgery is increasingly being utilized as a treatment option. However, managing post-operative pain in these patients poses a unique challenge due to their heightened risk of respiratory complications. Methadone, a potent mu-opioid agonist with additional analgesic properties, has demonstrated efficacy in reducing post-operative opioid requirements and improving pain scores in adult bariatric surgery patients without increasing respiratory events. Despite this promising data, there is a lack of research on the use of methadone in pediatric bariatric surgical anesthesia care.
  • This study represents the first report of methadone utilization in pediatric bariatric surgery patients. In this cohort, the researchers found that the risk of respiratory compromise in the perioperative period was not elevated in methadone-treated patients compared to those who did not receive methadone. Additionally, methadone’s analgesic efficacy appeared to be superior, suggesting that it may be a safe and effective option for managing pain in pediatric patients with severe obesity.
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Buprenorphine-Naloxone Use as an Alternative to Full Agonist Opioids for Chronic Pain May Improve Patients’ Physical Function

  • Chronic pain is a widespread condition that impacts millions of individuals globally, resulting in a decrease in quality of life, mental health challenges, and functional limitations. Patients are in need of alternatives to opioids for managing this condition. Buprenorphine, an opioid partial agonist typically used to treat opioid use disorder, has shown promise in addressing chronic pain syndrome. Specifically, studies have demonstrated the effectiveness of buprenorphine-naloxone sublingual film (BNSF), also known as Suboxone, in treating this condition.
  • The objective of this study is to explore the impact of BNSF on the quality of life of non-opioid use disorder patients suffering from chronic pain syndrome. Initial findings from this research suggest that BNSF may offer potential benefits for this population, as evidenced by improvements in PROMIS physical function scores. However, further research is necessary to fully understand the long-term effects, safety considerations, and comparative effectiveness of BNSF in this specific group of patients.
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Opioid Use After Spine Surgery: A Prospective Survey Study

  • A recent study on opioid use following spine and joint surgery revealed that as much as 73% of prescribed opioids are left unused, adding to the growing issue of excess pills in our communities. Additionally, an analysis of a national claims database found that up to 11.7% of patients who were opioid-naïve prior to surgery developed chronic opioid use after undergoing spine surgery.
  • The objective of this study was to enhance the existing data on opioid prescribing practices and patient opioid consumption post-surgery by examining patient risk factors for heightened pain and opioid needs, prescribing trends, duration of post-operative opioid use, and disposal of unused medication among individuals undergoing cervical or lumbar spinal surgery.
  • This prospective study sheds light on the significant percentage of leftover opioids following surgery, with 11% of opioid-naïve patients still using opioids three months post-operation. While effective pain management is crucial for optimal recovery post-surgery, overprescribing opioids not only leads to surplus medication but also elevates the risk of opioid-related complications such as dependency, withdrawal, and potential misuse. Future research and prospective data will help identify pre-surgical factors that contribute to elevated levels of acute pain and chronic opioid use following spine surgery.
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Retrospective analysis of liver function after intravenous ketamine for the treatment of Complex Regional Pain Syndrome (CRPS)

  • Complex Regional Pain Syndrome (CRPS) is a debilitating condition characterized by severe pain, for which there are limited effective treatments available. One of the treatment options utilized for CRPS is intravenous ketamine infusions. However, there has been some controversy surrounding the potential impact of ketamine on liver function. A recent study was conducted to investigate the effect of ketamine on liver enzymes in patients receiving intravenous ketamine infusions for pain management in CRPS. The results of the study revealed that the administration of ketamine did not have a significant impact on liver function tests.
  • These findings suggest that intravenous ketamine infusions can be a safe and effective treatment option for individuals suffering from CRPS, without causing adverse effects on liver function. Further research is needed to fully understand the potential benefits and risks associated with ketamine therapy in the management of CRPS.
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Effects of super high-frequency electrical stimulation on post‐surgical pain and functional recovery in persons undergoing a total shoulder arthroplasty: A case study

  • Super High-Frequency Electrical Stimulation represents a cutting-edge stimulation technique developed to effectively manage pain. This innovative form of stimulation targets peripheral nerves to specifically address acute pain while preserving motor function, touch sensitivity, and proprioception. The treatment involves the precise placement of electrodes perineurally using ultrasound guidance. The stimulation lasts for 4 minutes, yet research indicates that its analgesic effects can persist for weeks. Following treatment, all electrodes are safely removed from the patient.
  • This study marks the inaugural application of Super High-Frequency Electrical Stimulation to the brachial plexus in individuals undergoing total shoulder arthroplasty (TSA). This groundbreaking approach has demonstrated remarkable success in alleviating post-surgical TSA pain for extended periods, all while safeguarding essential sensory and motor functions.
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Thank you for joining us for this recap of the ANESTHESIOLOGY 2024. We recommend visiting this link to explore the entirety of these posters as well as the many others showcased during this exciting event. 

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