AAP/ ASRA Pain Management Collaborative Webinar: Prepping for Pain Medicine Fellowship- Anesthesia Fundamentals for the PM&R Applicant-AAP/ASRA

Video Transcription

Video Summary

This webinar, hosted by Eric Jones (a PM&R resident applying to Pain Medicine Fellowship) in collaboration with AAP and ASRA, aimed to provide insights for PM&R trainees interested in pain medicine, particularly anesthesia-related topics often less familiar to them. The session featured expert panelists Dr. Anuj Agarwal (Stanford), Dr. Bhavana Yalmuru (University of Virginia), and Dr. Reed Yarris (PM&R-trained pain physician), who covered foundational anesthesia concepts important in pain medicine fellowship.<br /><br />Dr. Agarwal discussed regional anesthesia, emphasizing the distinction between fascial plane blocks (safer, less dense, used for pain relief or diagnostic purposes) versus direct nerve blocks (dense, surgical-grade but higher risk). He highlighted the importance of understanding local anesthetic pharmacology—drug choice, concentration, volume—and the risks of local anesthetic systemic toxicity (LAST), stressing early recognition, lipid emulsion therapy, and adjusted ACLS protocols.<br /><br />Dr. Yalmuru focused on perioperative pain management, underscoring multimodal analgesia and opioid stewardship to reduce postoperative persistent opioid use and related harms. She detailed strategies for opioid weaning pre-surgery, managing patients with opioid use disorder (continuing medications like buprenorphine), patient education, and post-discharge opioid prescribing best practices.<br /><br />Dr. Yarris brought a PM&R perspective highlighting advanced interventional procedures like spinal cord stimulation, neuromodulation, and implant maintenance, stressing infection prevention, surgical skills, and interdisciplinary collaboration with surgeons. He emphasized that pain fellows continue learning procedural skills and clinical decision-making well beyond fellowship.<br /><br />Panelists agreed fellowship imparts critical clinical reasoning and foundational skills, but learning continues in practice. The webinar concluded with Q&A focused on preparing for fellowship, evolving pain populations, and the expanding role of pain physicians. The session provided valuable anesthesia-related knowledge and practical guidance for PM&R applicants transitioning into pain medicine.

Keywords

PM&R pain medicine fellowship

regional anesthesia

fascial plane blocks

local anesthetic systemic toxicity (LAST)

perioperative pain management

multimodal analgesia

opioid stewardship

spinal cord stimulation

neuromodulation

interdisciplinary collaboration