In this episode of RAPM Focus, Editor in Chief Brian Sites, MD, discusses the pros and cons of perioperative gabapentinoids with author and RAPM Executive Editor Eric Schwenk, MD, and Kishor Gandhi, MD, following the November 2025 publication of her brief technical report, “Pro-con debate on perioperative gabapentinoids: a nuanced approach is the best one.”

Dr. Eric Schwenk is a professor of anesthesiology and perioperative medicine at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, PA and is the vice chair of faculty affairs and professional development. His clinical and research interests are outcomes after orthopedic surgery, chronic postsurgical pain, and ketamine in migraine. He serves on the ASRA Pain Medicine Guidelines and Regulatory Advocacy Committee.

Dr. Kishor Gandhi is a clinical associate professor and associate residency director at Virtua College of Medicine and Life Sciences at Rowan University in New Jersey. His clinical interests include regional anesthesia and acute pain. Dr. Gandhi has been in clinical practice for 20 years.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

This episode of RAPM Focus challenges physicians to think differently about pain after cesarean delivery by showcasing a new approach for patient care after cesarean delivery. RAPM Executive Editor Eric Schwenk, MD, explores the SPACE-postpartum model with Sarah Ciechanowicz, BMBCh, FRCA, following the October 2025 publication of her brief technical report, “SPACE-Postpartum: a multidomain biopsychosocial framework for predicting chronic pain and impaired recovery after cesarean delivery – proof-of-concept report.”

The SPACE-postpartum model is essentially a multidomain symptom system for understanding recovery after cesarean delivery. This biopsychosocial framework brings together five interconnected symptom areas—sleep, pain, affect, cognition, and energy—for early risk assessment after surgery, offering a comprehensive approach to the entire recovery process after cesarean delivery.

Early recovery is not just about pain scores, but about a pattern of symptoms that tend to cluster and shape a patients’ long-term trajectory. By assessing that pattern early on, we could potentially identify a modifiable risk profile for chronic pain and impaired recovery.

Dr. Sarah Ciechanowicz (“Chye-kha-no-vich”) is a consultant anesthetist at University College London Hospitals, researcher at Imperial College London, and former visiting fellow in obstetric anesthesia research at Stanford University. Her work focuses on improving postpartum recovery and pain prediction after caesarean delivery. She developed the SPACE-Postpartum framework—a multidomain biopsychosocial model designed to identify women at risk of chronic pain and inform intervention in the early postpartum period.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

The management of complex regional pain syndrome (CRPS) continues to challenge clinicians—especially when conservative and interventional strategies fall short. This episode of RAPM Focus, hosted by RAPM Editor and Social Media Editor Ryan D’Souza, MD, explores these challenges in managing CRPS with Daniël van der Spek, MD, and Frank Huygen, MD, PhD, FIPP, FFPMCAI, following the August 2025 publication of their original research paper, “Long-term outcomes of amputation in patients with complex regional pain syndrome (CRPS): a mixed-methods study.”

In rare and severe cases, amputation has been proposed as a last resort intervention, but the topic remains completely controversial. How does one weigh the potential relief of unrelenting pain against the risk of further complications and disability from an amputation? This episode explores a fascinating, mixed-method study into the long-term outcomes of patients with CPRS undergoing limb amputation in hopes of pain relief, despite risks of residual pain or phantom limb pain.

Dr. Daniël van der Spek is a medical doctor and PhD candidate at the Erasmus University Medical Center under the supervision of Professor Huygen his research focus is on CPRS with a particular emphasis on interventional pain management.

Dr. Frank Huygen is an anesthesiologist and pain physician serving as the head of the Department of Pain Medicine at Erasmus University Medical Center, and has been a full professor since 2009. His expertise focuses on CPRS and neuromodulation. He leads multiple national and international research projects, and maintains close collaborations with CRPS patient organizations, in both the Netherlands and the United States.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.