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NYSORA.com is my go-to for any question on RA. I’ve been to a couple of workshops as well - definitely worth every penny.
Karen Nannini
I’ve been practicing anesthesia for more than thirty years, and regional for more than 10. I trust NYSORA to get my info from and follow everything new they release. My favorite source.
Dian Wibowo

NYSORA is an educational organization focusing on anesthesia, pain, ultrasound and MSK medicine. Since its creation in 1995, NYSORA has been contributing to education and advancement in the science and practice of anesthesiology. NYSORA.com is read by 4M readers annually.

Yes! The content on NYSORA.COM has been a free source of education as of 1994, and it will be free until the end of time.

Support for NYSORA.com comes from grants, advertising revenue and subscriptions to NYSORA’s Premium Educational content (the NYSORA LMS and NYSORA’s mobile apps).

The NYSORA LMS is interactive e-learning platform created to bring educational content to life.

By registering to the NYSORA Learning System, you will:

  • Stay up to date. Real-time updates and regular additions of brand-new teaching material
  • Get access to NYSORA’s regional anesthesia procedures and patient management protocols
  • Get instantly useable infographics
  • A time-saver. Logical step-by-step technique instructions
  • Learn visually with  NYSORA’s trademark visual aids, such as functional regional anatomy and reverse ultrasound anatomy used in lectures worldwide
  • Be organized with a notes-taking tool where you can append images, videos, articles, and make your own study scripts

NYSORA’s Compendium of Regional Anesthesia is NYSORA’s most comprehensive, and practical curriculum on Regional Anesthesia from A to Z, featuring NYSORA’s Premium content. As opposed to textbooks and e-books, the Compendium is continuously updated and features NYSORA’s newest videos, animations, and visual content. The Compendium is subscription-based.

The Compendium is one of several gold-standard educational courses on NYSORA’s Learning System (the NYSORA LMS), and registration to NYSORALMS.com is free. The FULL access to the Compendium, however, is based on an annual subscription, as it requires an army of illustrators, video editors, and an educational team to continue making it the BEST tool for education on everything regional anesthesia. While you can think of the compendium as an ebook on steroids, a quick test drive will give you a real-time feel of how incredible the Compendium really is. Your subscription will transform the way you read about regional anesthesia: 

  • Learn visually: Everything regional, including spinal, epidural, and nerve block procedures and management protocols
  • Review step-by-step techniques instructions for over 60 nerve blocks 
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  • Access RA info on any device via the desktop platform and mobile app
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  • Review infographics for exam preparation (e.g. EDRA)
  • Use the Community feed with real case discussions, images and videos are posted and discussed by subscribers and world’s top experts alike. 

The NYSORA LMS is the learning platform with all of NYSORA’s premium educational content, such as the Compendium of Regional Anesthesia, CME courses, ultrasound, MSK, and more. Accessible anywhere, on any device. To keep the content on NYSORA.com free, the educational products on the NYSORA LMS are subscription-based.

Think of the Compendium of Regional Anesthesia as a comprehensive guidebook on everything regional anesthesia from A to Z, including spinal, epidural, nerve blocks, ultrasound, perioperative management, ERAS protocols, and more.

NYSORA’s Nerve Blocks Manual is, as the name implies, a highly practical collection of detailed nerve block techniques, richly illustrated in a blend of art and medicine. 

NYSORA’s Nerve Blocks app is NYSORA’s micro-learning refresher for clinical practice. Think of it as NYSORA’s skinny version, made for use at point of care.

If you love regional anesthesia, all three are MUST have. Think about these three hugely popular educational products by NYSORA as:

  • Compendium serves as a comprehensive textbook on everything regional.
  • The Nerve Blocks Manual is a practical manual, with all things focusing only on nerve blocks.
  • The Nerve Blocks app is a condensed, practical tool for use at point of care as a refresher and teaching.

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The content on NYSORA.com has been and remains a free educational resource. Therefore, there is no need to subscribe or unsubscribe from NYSORA.com.

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Medicine is an ever-changing science. As new research and clinical experience broaden, changes in treatment and drug therapy are required. The authors and publisher of NYSORA have checked with sources believed to be reliable in efforts to provide accurate information within the available or accepted standards of care. However, given the possibility of human error or changes in medical practice, neither the authors nor the publisher, nor any other party involved in the preparation of this platform warrants that the information contained herein is in every aspect accurate or complete, and they disclaim all responsibility for any errors or omissions for the results obtained from the use of the information contained in this work. Readers are advised to confirm the information contained herein with other sources. For example, readers are advised to check the product information of each drug mentioned, and that any information contained on NYSORA is accurate.

Ivan Keser

Thiopental (first described in 1939) is a barbiturate used to induce general anesthesia, treat convulsions, and reduce intracranial pressure.

The barbiturate thiopental has been the primary IV induction agent for more than 50 years and is considered the standard by which newer induction agents are judged.

In some countries it has not been used for a sometime (in the USA production was stopped in 2010), while in others it is used routinely and is still the gold standard for some procedures (GA for C- section).

Do you use this old but well-known drug or do you think that we have better solutions?

Does thiopental have a place in today’s anesthesia or does it belong only in truth museum of anesthetics or in some other lethal combination?

Ivan Keser

Challenges in the anesthetic management of a patient with Charcot-Marie-Tooth disease

The most common hereditary neuropathy, frequency – 1 in 25000. It is a progressive disease with an initial presentation – weakness in the lower limbs, and in the later stage of the disease – weakness of the hands and forearms, weakness of the respiratory muscles, disorders of the function of the diaphragm, abnormalities of the chest that lead to limited lung function and sleep apnea.

Anesthesia considerations:

There is increased risk of MALIGNANT HYPERTHERMIA, UNPREDICTABLE RESPONSE TO NON-DEPOLARIZING NEUROMUSCULAR BLOCKERS, special attention should be paid to the PATIENT’S POSITION, avoid the use of succinylcholine due to the increased risk of HYPERKALIEMIA

Case report:

A 41-year-old woman with Charcot-Marie-Tooth (CMTD) disease comes to surgery for acute cholecystitis, she was diagnosed with CMTD four years ago with pronounced weakness in the lower extremities and inability to walk without a cane, fatigue, smoker, with non-insulin-dependent diabetes mellitus

On the day of the operation, sodium-lime, filters and the anesthesia circuit were changed, residual gases from the anesthesia machine were eliminated with O2, with a flow rate of 10 L/min for 15 minutes.

Propofol was used for induction and maintenance (TIVA – total intravenous anesthesia), fentanyl as an analgesic, and atracurium for muscular paralysis.

At the end of the surgical procedure, the neuromuscular block was reversed with neostigmine and atropine, patient was extubated and admitted to the ICU overnight and discharged to the ward the next day.

What is your experience with this rare but common disease, would you do anything differently?

Admir Hadzic

Another member of our NYSORA EU orthopedic surgery-anesthesia service defends a doctorate. Prof Pieter Caekebeke, congratulations!!!

Ivan Keser

Acupuncture is a traditional Chinese medical technique that plays an important role in pain control, prevention and functional improvement. In 1979, the World Health Organization (WHO) introduced acupuncture as a remedy for 43 diseases.

Good therapeutic results support the role of acupuncture as part of multimodal therapy in pain management despite no clear mechanism of action and insufficient evidence for clinically worthwhile benefit.

What is your opinion on acupuncture, is it complementary or alternative medicine and does it have a place in modern EBM?

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