Anesthesia and Analgesia Commons^™

An Update On The Role Of Multimodal Analgesia In Perioperative Pain Management, Whitney N. Kuwamoto, Grace C. Eddy, Edward R. Mariano, Eric S. Schwenk

Department of Anesthesiology Faculty Papers

Multimodal analgesia has become a foundational principle of acute perioperative pain management and enhanced recovery and involves the application of nonpharmacologic, pharmacologic, and/or interventional techniques. The overall goal of this approach is to apply a combination of different modalities that target discrete points along the pain pathway and thereby avoid the overreliance on opioids and associated side effects. Since our review in 2018, there have been significant developments that have prompted an updated review of multimodal analgesia. In this article, we identify and summarize important trends that influence the current approach to acute perioperative pain management as well as provide …

Implementation Of A Planned Extubation Nurse-Led Safety Bundle In A Pediatric Cardiac Intensive Care Unit, Broderick Sutton

Doctor of Nursing Practice Final Project Abstract

Purpose: To implement and evaluate a nurse-led planned extubation safety bundle designed to improve nurse preparedness, interdisciplinary communication, workflow consistency, and confidence during planned extubation events in a pediatric Cardiac Intensive Care Unit (CICU).

Background: Planned extubation in critically ill pediatric cardiac patients requires effective interdisciplinary coordination. Variability in nurse preparation, communication, and knowledge of sedation pharmacokinetics contributed to workflow inefficiencies and patient safety concerns. Evidence supports standardized nurse-led protocols to improve extubation readiness and reduce practice variability.

Methodology: A prospective pre-post quality improvement project was conducted over eight weeks in a pediatric CICU. The intervention included a nurse-led planned …

Evaluating Headache Treatment Efficacy Across Rural And Urban Emergency Departments, Logan Stacey, Alan Sazama, Benjamin Aaker

Scholarship Pathways Program

Evaluating Headache Treatment Efficacy Across Rural and Urban Emergency Departments

Logan Stacey, MD | Alan Sazama, MD, Benjamin Aaker, MD

Introduction: Headaches are a common chief complaint in emergency departments (EDs), with rural patients facing unique challenges such as geographic isolation and limited access to care. This study aims to compare treatment efficacy for this top five ED chief complaints between rural and urban EDs.

Methods: Patients treated for headaches from 2020-2023 were identified using diagnosis codes and electronic health records. Treatment plans and patient demographics were abstracted from identified charts. EDs were categorized as rural (populations under 50,000) or …

Procedural Narration As An Important Cognitive Adjunct To Analgesia: Naming And Neurobiologically Grounding An Established Emergency Medicine Practice, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Experienced emergency physicians routinely provide real-time verbal guidance during procedures. Although widespread and intuitive, this practice has not been commonly conceptualized within pain neuroscience.

Objective: To name and mechanistically ground procedural narration as a form of cognitive analgesia, and to promote its intentional use and teaching in Emergency Medicine.

Methods: Narrative review integrating predictive coding theory, placebo/nocebo research, affective neuroscience, descending inhibitory pathway literature, and attentional modulation studies.

Results: Procedural narration reduces uncertainty, aligns expectation with sensation, modulates limbic threat processing, engages prefrontal cortical regulation, and supports descending inhibitory control of nociception.

Conclusion: Procedural narration is not a novel …

Efficacy Of Repetitive Transcranial Magnetic Stimulation In Reducing Pain Intensity In Chronic Neuropathic Pain: A Sham-Controlled Analysis, Aprupa Alahari, Nathan Nhan, Cindy Nguyen, Samnit Gill, Simran Parmar, Annelisse Zara

Rowan-Virtua Research Day

Background 

Chronic neuropathic pain (CNP) can be refractory to traditional pharmacologic therapies, giving rise to the investigation of non-invasive alternatives such as repetitive transcranial magnetic stimulation (rTMS). rTMS utilizes magnetic fields to modulate neuronal activity within specific brain regions, offering a targeted approach to analgesia without the side effects of systemic medication1,2,3,4.

Hypothesis 

rTMS produces a greater reduction in reported pain intensity compared to sham stimulation in adults diagnosed with CNP.

Methods 

A systematic review and analysis  were conducted, utilizing PubMed and Embase (2004–2025) for sham-controlled randomized controlled trials (RCTs) and relevant meta-analyses. The review focused on outcomes such as …

Bilateral Intracranial Subdural Hematoma Following Epidural Anesthesia, Eric B. Cox, Adaeza Onuoha

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

When Analgesia Is Contraindicated: Non-Pharmacologic Resolution Of Pain Enabling Rehabilitation Participation, Zane Shah, Anand Allam

Gulf Coast Division GME Research Day 2026

No abstract provided.

Tylenol Or Toradol? Iv Acetaminophen Vs. Parenteral Ketorolac For Prehospital Analgesia, Conrad Stallings, Kevin Crocker, Michael Wells, Nick Smith, Casey Patrick

Gulf Coast Division GME Research Day 2026

No abstract provided.

Breaking The Pain Cycle: Ultrasound-Guided Sciatic Nerve Blocks For Acute Sciatica In The Ed, Pranav Bommineni, Taryn Hoffman

South Atlantic Division GME Research Days 2026

No abstract provided.

7-Hydroxymitragynine Induced Perioperative Hyperalgesia In 27-Year-Old Trauma Patient, William Hickman, Katherine David, Vincent Hoffman, Ruzanna Nalbandyan

South Atlantic Division GME Research Days 2026

No abstract provided.

A Multidisciplinary Approach To Acute-On-Chronic Pain Management In The Emergency Department, Lisa Persaud, Cameron Burr, Ursula Des Bordes, Noah Novembre, Abhishek Desai, Kaitlyn Phelps, Desiree Aird

South Atlantic Division GME Research Days 2026

No abstract provided.

The Great Mimicker: Intrathecal Opioid-Induced Esophageal Dysfunction, Abhishek Desai, Lisa Persaud, Desiree Aird

South Atlantic Division GME Research Days 2026

No abstract provided.

Subanesthetic Ketamine Use For Uncontrolled Pain In Hospice Care, Tiffany Rey, Ana Sanchez

South Atlantic Division GME Research Days 2026

No abstract provided.

Intraosseous (Io) Analgesia Medication Administration In Orthopaedic Surgery: A Brief Review, Jenna Chrabolowski, Troy B. Puga, Abanoub Attallahm, Mckenna W. Box, John T. Riehl

North Texas GME Research Forum 2026

Introduction

Intraosseous (IO) analgesia is a novel strategy for pain control in orthopaedic surgery. This brief review aims to provide an overview of IO analgesia in orthopaedic surgery.

Methods

A search was conducted across seven databases. Titles and abstracts were screened followed by full-text review for inclusion criteria. Demographics and results were extracted from included articles.

Results

Ten studies met inclusion criteria and involved patients undergoing knee surgery and spinal surgery. IO lidocaine was shown to be effective for postoperative and intraprocedural pain control during vertebroplasty and kyphoplasty. IO morphine and IO NSAIDs were shown to be effective in reducing …

Nitrous Oxide Vs. Ketamine: Impacts On Pediatric Emergency Department Length Of Stay, Tabitha Brock, Anna Suessman

North Texas GME Research Forum 2026

Background Nitrous oxide (N₂O) is a well-established analgesic and anxiolytic agent, widely used for procedural sedation in pediatric dentistry. Despite its demonstrated safety and efficacy, its use in Pediatric Emergency Departments (PEDs) remains limited and underexplored. To address this gap, we implemented a comprehensive training program for PED providers and introduced N₂O as an alternative sedation agent.

Objective We hypothesized that using N₂O for procedural sedation would significantly reduce patient length of stay (LOS) without compromising safety or outcomes.

Methods We conducted a retrospective chart review of pediatric patients who underwent painful procedures in a tertiary children’s hospital emergency department. …

Utilization Of Multimodal Therapy Including Ketamine And Methadone In Cancer-Related Pain: A Case Report, Austin Mccrea, Carol Elsakr, Tyler Kilgore

South Atlantic Division GME Research Days 2026

No abstract provided.

Education For Residents And Patients On Pain Management For Gyn Procedures, Claire Moen, Jeffrey Edwards, Dominique Rehl, Kenyon Weidle

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Beans! Baseline Evidence-Based Analgesia, Not Substitutes: Implementation Of Evidence-Based Multimodal Pain Control At An Inpatient Rehabilitation Facility, Bernard Zhou, Jay Dixon, Karen Yang, Tyne Tyson, Douglas Mcgill

South Atlantic Division GME Research Days 2026

No abstract provided.

A Single-Center, Retrospective Analysis Of The Safety And Efficacy Of Disc Tissue Allograft Supplementation For Discogenic Axial Low Back Pain, Nomen Azeem, Ali Amirzadeh

West Florida Division GME Research Day 2026

No abstract provided.