Gastric ultrasound can be so important in assessing aspiration risk in any number of patients preoperatively, and POCUS can be an incredibly valuable tool in this circumstance. In this episode of RAPM Focus, RAPM social media editor, Alopi Patel, MD, converses with Jacob Wrobel, MD, and Alexander Doyal, MD, MPH, FASA, following the June 2025 publication of “Developing a method for ultrasound estimation of gastric volume in patients with previous gastric sleeve.”

Dr. Jacob Wrobel is a recent graduate of the University of North Carolina School of Medicine and is preparing to begin his anesthesiology residency at the University of Pittsburgh Medical Center. He has a special interest in the applications for point-of-care ultrasound in the perioperative setting and plans to continue to pursue research in this area in his career as an anesthesiologist.

Dr. Alexander Doyal is an associate professor in the department of anesthesiology within the transplant and vascular anesthesia division at the University of North Carolina. He has a keen interest in POCUS, research, and education. He serves as the POCUS course director in the School of Medicine. He also leads workshops for residents, and teaches and mentors faculty at regional and national meetings. His research interests are varied, and included novel POCUS clinical applications.

*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.

In the era of fast-tracked surgery and same-day discharge, anesthesiologists are looking for strategies to optimize recovery without compromising safety or pain control. A long-standing debate centers around whether low-dose bupivacaine or mepivacaine is the better spinal agent to promote early ambulation after total knee arthroplasty. In this episode of RAPM Focus, RAPM Editor-in-Chief, Brian Sites, MD, explores this debate with Clinton Pillow, MD, following the May 2025 publication of “Mepivacaine versus bupivacaine spinal anesthesia for return of motor function following total knee arthroplasty: a randomized controlled trial.”

This episode explores a topic faced by every anesthesiologist that manages joint replacements, especially total knee arthroplasty, has grappled with—what is the ideal spinal anesthetic when time is money and same-day discharge is the goal?

Dr. Pillow is an assistant professor in the department of anesthesiology and perioperative medicine at the Medical University of South Carolina.

*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.

In this episode of RAPM Focus, Editor-in-Chief Brian Sites, MD, discusses the use of buprenorphine for acute pain management with Thomas Hickey, MD, MS, following the February 2025 publication of “Buprenorphine versus full agonist opioids for acute postoperative pain management: a systematic review and meta-analysis of randomized controlled trials.”

Dr. Hickey is full-time staff at the West Haven VA where he is medical director of preoperative evaluation and the PACU, and site director for the anesthesiology residency. Within the VA, he is chairman of the VA New England Healthcare System committee on preoperative evaluation and ERAS, co-chair of the VA’s national pain/opioid consortium for research workgroup on perioperative management of medications for opioid use disorder, and a member of the National Anesthesia Program Acute Pain Management Committee. He is board certified in both anesthesiology and addiction medicine. His research interests focus on the overlap between addiction medicine and acute pain management, particularly on the use of buprenorphine for acute pain management. He and his wife are kept busy by their three kids and all their activities.

*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.