PainExam Podcast – Détails, épisodes et analyse

Summary

At some point this medication may show its face on the pain boards.  Whether or not Suzetrigine will appear on the pain boards, all of us need to know about this new class of analgesic.

Brought to you by NRAP Academy, home of the PainExam Board Prep

Here, Dr. David Rosenblum delivered a comprehensive lecture about a new pain medication called Journavx (Suzetrigine). He discussed its mechanism of action as a NAV 1.8 receptor inhibitor, its clinical applications, contraindications, and dosing guidelines. Dr. Rosenblum emphasized that this non-opioid medication represents a new class of pain management drugs with no addiction potential. He also shared information about upcoming educational events, including ultrasound courses and various pain management conferences. The lecture included detailed information about drug interactions, safety considerations, and clinical trial results comparing Journavx to placebo and hydrocodone-acetaminophen combinations. Key findings from clinical trials showed that Jornavix achieved pain relief in 119 minutes compared to 480 minutes for placebo in abdominoplasty trials, and 240 minutes versus 480 minutes in bunionectomy trials. The recommended dosing is 50mg tablets twice daily, with an initial loading dose of 100mg. While the drug showed promising results for moderate to severe acute pain management, it did not demonstrate superiority over hydrocodone in clinical trials. Important contraindications include CYP3A inhibitors, and special considerations are needed for patients with hepatic impairment or those taking hormonal contraceptives. The medication should be taken on an empty stomach, either one hour before or two hours after food, and patients should avoid grapefruit juice while on this medication.

For more infomation....

Chapters Introduction and Upcoming Events

Dr. Rosenblum announced several upcoming events, including an ultrasound course in New York City on May 17th, 2025. He mentioned offering ultrasound and IV training for healthcare professionals, particularly nurses, ICUs, PAs, and hospital doctors. He also highlighted upcoming conferences including ASPN, Pain Week, Latin American Pain Society, New York, New Jersey Pain Congress, ASIPP, and EPA.

Introduction to Journavx (Suzetrigine)

Dr. Rosenblum introduced Suzetrigine (Journavx), a new 50mg tablet medication. He emphasized that this discussion was not sponsored by any pharmaceutical company but rather focused on educating about a new class of pain medication. He noted its potential importance as a future board examination topic.

Mechanism of Action

Dr. Rosenblum explained that Jornavx works by inhibiting the NAV 1.8 receptor. He detailed how the drug blocks sodium ions from entering pain-sensing neurons, disrupting action potential initiation and propagation. He emphasized that the drug is highly selective, binding over 31,000 times more selectively to NAV 1.8 than other NAV subtypes.

Contraindications and Drug Interactions

Dr. Rosenblum outlined various contraindications, particularly focusing on CYP3A inhibitors and inducers. He listed specific medications in each category and emphasized the importance of careful monitoring when prescribing Journavx alongside these medications.

Clinical Trial Results and Dosing Guidelines

Dr. Rosenblum presented clinical trial results showing Journavx's effectiveness in treating moderate to severe acute pain. He detailed the dosing guidelines: 50mg tablets twice daily, with an initial loading dose of 100mg. He emphasized the importance of taking the medication on an empty stomach and avoiding grapefruit juice.

Q&A

No Q&A session in this lecture

Summary

The video covers a conversation between Dr. David Rosenblum and Dr. Hamed Sadeghipour, discussing board preparation experiences and the current state of pain management practice. Dr. Rosenblum begins by announcing upcoming events, including a May 17th ultrasound course in New York City and his lectures at various conferences. He also mentions shadowing opportunities at his office. Dr. Sadeghipour shares his board preparation experience, discussing three main resources he used: Huntoon book (800 questions), Board Vitals (700 questions), and Pain Exam. He achieved notably high scores using these resources. Regarding his current practice, Dr. Sadeghipour describes working both in academic anesthesia (40-50% time) and private pain practice, managing four offices with four nurse practitioners.   The discussion then shifts to the changing landscape of pain management, with both doctors noting concerning trends: increasing focus on surgery center procedures over office-based ones due to reimbursement differences, the challenge of maintaining competency in advanced procedures, and competition from non-specialists entering the field. They also discuss the future of the specialty, suggesting it's moving toward becoming a hybrid of neurosurgery and orthopedic surgery with traditional pain management procedures.

 

For pain medicine Board Prep go to NRAPpain.org

For ultraound training go to NRAP Academy

Highlights Introduction and Upcoming Events

Dr. Rosenblum introduces the podcast and announces several upcoming events, including an ultrasound course in New York City on May 17th, appearances at ASPN and Pain Week conferences, and opportunities for shadowing at his practice.

Board Preparation Experience Discussion

Dr. Sadeghipour details his board preparation strategy using three main resources: Huntoon book (800 questions), Board Vitals (700 questions), and Pain Exam(700 questions videos, lectures, ultrasound training, regenerative medicine training and more). He explains the strengths and limitations of each resource and mentions achieving exceptionally high scores.

Current Practice Structure

Dr. Sadeghipour describes his dual practice model: 

Evolution of Pain Management Practice

Both doctors discuss the shifting landscape of pain management, noting increased focus on surgery center procedures, reimbursement challenges, and competition from non-specialists. They address concerns about fellowship training adequacy and the financial pressures affecting new practitioners.

Future of Pain Management Specialty

The discussion concludes with perspectives on the specialty's future, suggesting it's evolving toward a combination of minimally invasive spine surgery and traditional pain management, with concerns about maintaining specialty integrity and the need for stronger regulatory oversight.

Podcast Show Notes Episode Title: Optimizing Genicular Nerve Chemical Ablation: Insights from Dr. David Rosenblum Episode Summary:

In this episode, we are joined by Dr. David Rosenblum, a New York-based interventional pain physician, who discusses optimizing genicular nerve chemical ablation. Dr. Rosenblum shares insights as well as his upcoming ultrasound course schedyke in New York City, focusing on regional anesthesia, interventional pain, and IV ultrasound placement. He emphasizes the significance of ultrasound in enhancing pain management procedures and the latest advancements in the field.

Key Topics Discussed:

• Overview of Dr. Rosenblum's upcoming ultrasound courses in NYC, including regional anesthesia and IV ultrasound placement. More information can be found here or at NRAPpain.org.
• The role of ultrasound in interventional pain management, specifically in optimizing genicular nerve chemical ablation.
• Discussion on the recent study comparing genicular nerve phenol neurolysis and radiofrequency ablation.
• Importance of updating anatomical targets for pain management.
• Recommendations for expanding the number of targets in pain interventions.
• Insights on the safety and efficacy of chemical neurolysis versus radiofrequency procedures.
• Challenges and considerations in performing neurolytic blocks.
• Future directions in personalized treatment for chronic pain patients.

Featured Article:

Dr. Rosenblum references an article from The Korean Journal of Pain discussing the optimization of genicular nerve chemical ablation. Key takeaways include:

• The evolution of anatomical understanding related to genicular nerves.
• The recommendation to consider multiple targets for pain management instead of the traditional three.
• The need for careful patient examination to map pain effectively before intervention.

• Discussion on Knee Pain Management

  • ArticlebyAndresRochaRomero:
  • Discussion on knee pain targeting genicular nerve ablation.
  • Co-authored by Tony Ng and King K Stanley Lam.
  • Published in Korean Journal of Pain.
  • Highlights differences in pain management practices outside the U.S.

  Other Points on Genicular Nerve Chemical Ablation discussed

  • Phenol ablation being used more internationally vs. radiofrequency ablations.

  • Considerations for more extensive targeting of genicular nerves:
    • Importance of the median branch of the nerve to the vastus intermedius. • Expansion of targeting to include 6 nerves, not just 3.
    • Anatomical variations require different approaches.

    Recommendations and Observations

    • Importance of considering patient-specific anatomy and pain. • Repeat procedures and rehabilitation:

    • Concerns about bio intensity and fascia integrity.
    • Emphasizes muscle strengthening exercises to support knee.

  • CRPS Considerations:
  • Elderly patients may develop CRPS post-knee replacement.
  • Importance of lumbar sympathetic block in diagnosis and treatment.

Host Bio:

Dr. David Rosenblum, MD is an interventional pain physician based in New York City. With extensive experience in pain management techniques, Dr. Rosenblum is dedicated to advancing the field through education and innovative practices. He is particularly focused on the integration of ultrasound technology into pain management procedures.

Course Information:

Dr. Rosenblum's upcoming ultrasound courses are CME supported, monthly hands on workshops to give clinicians experience with ultrasound imaging to identify targets for nerve block joint injection, soft tissue injection and more..

• Monthly IV Ultrasound Course in Manhattan:
• Ideal for nurses, PAs, anesthesiologists, ER docs.
• Provides practice with phantoms, short lecture on IV ultrasound. • Offers CME credits.

• Ultrasound Courses:
• Held one Saturday a month, mostly in New York, but travels if needed. • Upcoming dates: December 21st, January 11th in Manhattan.

• Presentation Invitation at Pain Expo in Dubai: April 26-27. •  

• Next LAPS conference in September in Chile.

Call to Action:

• Subscribe to our podcast for more episodes on advancements in pain management.
• Follow us on social media for updates on upcoming courses and events.
• Share this episode with colleagues who may benefit from learning about ultrasound techniques in pain management.

 

 

 

Upcoming Opportunities and Closing Remarks

• Dr. Rosenblum encourages attending his ultrasound courses and conferences.

• Mention of upcoming conferences in ASPN inMiami, Pain Expo in Dubai, and  LAPS inChile.

• Recommendations to subscribe to newsletters for updates and free info.

• The podcast aims to support pain management professionals.

SIS Guidelines on COVID Vaccination & Steroid Injections

Regional Anesthesia Virtual Training Sunday March 14, 2021...

Dr. Rosenblum discusses the precautions recommended by the Spine Intervention Society. Concerns addressed:

• How soon after a Covid vaccination can I get a steroid injection?
• How long after a steroid injection can I get a COVID Vaccination?
• Is it dangerous to get a steroid injection during the vaccination period?
• Does a steroid injection render the COVID Vaccination ineffective?

Ads By PainExam Ad Network-

Upcoming Ultrasound Training Workshop Event Schedule-

March 14, 2021-
Ultrasound Guided Regional Anesthesia for Anesthesiologists-

https://painexam.com/events/march-14-2020-anesthesiology-ultrasound-course-regional-anesthesia-acute-pain/

April 18, 2021-
Live Ultrasound Training in NYC for Pain and Regional Anesthesia-

https://painexam.com/events/in-person-live-ultrasound-training-april-18-nyc/

May 16th, 2021-
Advanced Ultrasound Guided Regional Injections for Emergency Room Doctors-

https://painexam.com/events/us_guided_pain_for_emergency_medicine_physicians/

Podcast Resources:
https://www.spineintervention.org/news/548668/Preliminary-Recommendations-on-Corticosteroid-Injections-and-COVID-19-Vaccinations.htm

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New Updates-

• New 1 on 1 Training Service!
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Dr. Rosenblum Interviews Amitabh Gulati, MD- WAPMU Faculty

Dr. Rosenblum sits down with Amitabh Gulati, MD
WAPMU Faculty, to Discuss Cancer Pain Topics.

Ads By PainExam Ad Network-

Upcoming Ultrasound Training Workshop Event Schedule-

March 14, 2021-
Ultrasound Guided Regional Anesthesia for Anesthesiologists-
https://painexam.com/events/march-14-2020-anesthesiology-ultrasound-course-regional-anesthesia-acute-pain/

April 18, 2021-
Live Ultrasound Training in NYC for Pain and Regional Anesthesia-
https://painexam.com/events/in-person-live-ultrasound-training-april-18-nyc/

May 16th, 2021-
Advanced Ultrasound Guided Regional Injections for Emergency Room Doctors-
https://painexam.com/events/us_guided_pain_for_emergency_medicine_physicians/

Resources:
About Amitabh Gulati, MD-
https://www.mskcc.org/cancer-care/doctors/amitabh-gulati#about-me

Ads By PainExam Ad Network-

New Updates-

• New 1 on 1 Training Service!
• New Hospital and Medical Network Group Training Program!
• Exclusive Dr/Medical Professional affiliate program! Leverage Your Social Network!
• PainExam "Complete" now available!
  

Subscribe to PainExam's Mailing List * indicates required Email Address *    

Download the PainExam Official Apps for Android and IOS Devices!

https://play.google.com/store/apps/details?id=com.painexam.android.painexam&hl=en_US

https://apps.apple.com/us/app/the-pain-management-review/id997396714

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Ginger and Muscle Pain? Dr. Rosenblum Discusses the Effects of Ginger on Muscle Pain and Updates on the Upcoming Ultrasound Training Workshops: Ultrasound Training Event Schedule-

February 28, 2021-
Ultrasound Guided Pain Procedures in the Pain Office
https://painexam.com/events/ultrasound-guided-interventional-pain-and-regional-anesthesia-virtual-training/

March 14, 2021-
Ultrasound Guided Regional Anesthesia for Anesthesiologists
https://painexam.com/events/march-14-2020-anesthesiology-ultrasound-course-regional-anesthesia-acute-pain/

April 18, 2021-
Live Ultrasound Training in NYC for Pain and Regional Anesthesia
https://painexam.com/events/in-person-live-ultrasound-training-april-18-nyc/

Podcast Resources:

Köhne JL, Ormsbee MJ, McKune AJ. Supplementation Strategies to Reduce Muscle Damage and Improve Recovery Following Exercise in Females: A Systematic Review. Sports (Basel). 2016 Nov 11;4(4):51. doi: 10.3390/sports4040051. PMID: 29910299; PMCID: PMC5968901.

Wilson PB. Ginger (Zingiber officinale) as an Analgesic and Ergogenic Aid in Sport: A Systemic Review. J Strength Cond Res. 2015 Oct;29(10):2980-95. doi: 10.1519/JSC.0000000000001098. PMID: 26200194.

Black CD, Herring MP, Hurley DJ, O'Connor PJ. Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise. J Pain. 2010 Sep;11(9):894-903. doi: 10.1016/j.jpain.2009.12.013. Epub 2010 Apr 24. PMID: 20418184.

Terry R, Posadzki P, Watson LK, Ernst E. The use of ginger (Zingiber officinale) for the treatment of pain: a systematic review of clinical trials. Pain Med. 2011 Dec;12(12):1808-18. doi: 10.1111/j.1526-4637.2011.01261.x. Epub 2011 Nov 4. PMID: 22054010.

Henrotin Y, Clutterbuck AL, Allaway D, Lodwig EM, Harris P, Mathy-Hartert M, Shakibaei M, Mobasheri A. Biological actions of curcumin on articular chondrocytes. Osteoarthritis Cartilage. 2010 Feb;18(2):141-9. doi: 10.1016/j.joca.2009.10.002. Epub 2009 Oct 8. PMID: 19836480.

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See you in Miami at ASPN this July....

Dr. Rosenblum sits down with Tim Deer and discusses work life balance, neuromodulation, pain management training, the American Society of Pain and Neuroscience...

Next Ultrasound Course for Pain Docs:

Virtual: February 28th

In Person: April 18th in NYC

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Annual ASPN Conference link:

https://aspnpain.com/annual-conference-2021/   March Madness Debate link (we’ll continue to update the page as more information becomes available): https://aspnpain.com/aspn-march-madness-debates/   The Superbowl of Debates link: https://aspnpain.com/aspn-the-superbowl-of-debates/   If desired, the 2021 Call for Poster Abstracts link: https://aspnpain.com/aspn-call-for-poster-abstracts/

Interscalene Block, Piriformis Trigger Point, & Propofol in the ED?

In preparation for this weekend's:

Ultrasound Pain Course for Emergency Medicine Physicians,

Dr. Rosenblum discusses two recent articles in the literature discussing Interscalene Brachial Plexus Blocks vs Propofol for anterior shoulder dislocation and Piriformis injections...

EM Physicians:  Opt in for the Emergency Room Ultrasound Pain Newsletter for Course Calendar!

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Course Schedule- Winter 2021 Released- Join our newsletter for updates!

Upcoming  Ultrasound Course Dates for Emergency Medicine Physicians, Anesthesiologists and Pain Physicians Learn Brachial Plexus, Femoral, Sciatic, Saphenous, Genicular, IPACK, TAP, Paravertebral, Inercostal, Sacroiliac, Peripheral nerves, Iliioinguinal, Cluneal nerve blocks and more! February 7, 2020
Ultrasound Guided Pain Procedures for Emergency Room Physicians

February 28, 2020
Ultrasound Guided Pain Procedures in the Pain Office

March 14, 2020
Ultrasound Guided Regional Anesthesia for Anesthesiologists   Podcast References:
1.  Ultrasound-guided interscalene nerve block vs procedural sedation by propofol and fentanyl for anterior shoulder dislocations. Author links open overlay pane lEsmaeilRaeyat DoostaMohammad MehdiHeiranbMitraMovahedicAmirhosseinMirafzalchttps://www.sciencedirect.com/science/article/abs/pii/S0735675717302966#!   2- Ultrasound‐guided trigger point injection for piriformis syndrome in the emergency department Victor M. Aquino‐Jose MD Veronika Blinder MD Jennifer Johnson BA Tatiana Havryliuk MD Journal of the American College of Emergency Physicians Open Volume 1, Issue 5

Dr. Rosenblum interviews Dr. Baxter on her thermo-mechanical neuro-modulatory pain relief platform.

Amy Baxter MD FAAP FACEP is a Clinical Associate Professor in Emergency Medicine at Augusta University and the founder and CEO of Pain Care Labs, the industry leader in noninvasive pain relief solutions. She is an academic, physician and research focused entrepreneur that invented a thermo-mechanical neuro-modulatory pain relief platform. Her patents include VibraCool® Vibrational Cryotherapy to treat tendinopathies and decrease opioid use, and her disruptive Buzzy® device, which has been used to control needle pain for over 37 million needle procedures. Dr. Baxter was awarded over 2.8MM in Fast-Track SBIRs by the NIH.

She also prepared and filed the FDA 510K submission for medical devices, securing the FDA expansion of the utilization to include muscle pain and cosmetic injection pain control. Dr. Baxter and Pain Care Labs were recently honored with the 2020 Tibbetts Award for Innovation for the substantial economic and social benefits the company’s pain-relieving medical devices have contributed to the United States. 

Buzzy for Healthcare, https://shop.paincarelabs.com/collections/healthcare

Buzzy for personal, https://shop.paincarelabs.com/collections/buzzy%C2%AE

VibraCool, https://shop.paincarelabs.com/collections/vibracool-r

Ultrasound Guided Interventional Pain Training

 

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Dr. Rosenblum preempts his upcoming Ultrasound Guided Interventional Pain Course for Emergency Medicine Physicians on February 7, 2021 with a Journal club describing the Erector Spinae Plane Block.   https://painexam.com/ultrasound-guided-regional-anesthesia-pain-management-regenerative-medicine/ Subscribe for US Course Schedule, Calendar & Discounts! * indicates required Email Address * First Name Last Name     February 7, 2020
Ultrasound Guided Pain Procedures for Emergency Room Physicians

February 28, 2020
Ultrasound Guided Pain Procedures in the Pain Office

March 14, 2020
Ultrasound Guided Regional Anesthesia for  Anesthesiologists Find out More! Private Session
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Register Now!         Reference  

1. Krishnan S, Cascella M. Erector Spinae Plane Block. [Updated 2020 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545305/

2. EnesAydinbEmreSengunaAtifBayramogluaHaci AhmetAlicibHigh-thoracic ultrasound-guided erector spinae plane block for acute herpes zoster pain management in emergency department. The American Journal of Emergency Medicine. Volume 37, Issue 2, February 2019, Pages 375.e1-375.e3ErdalTekinaAliAhiskalioglubMuhammed