Dr. Joshua John-Ram SchacterDr. Joshua Schacter, DO FAAOS, is America’s Holistic Orthopedic Surgeon, with nearly two decades of surgical expertise.

Ultrasound Guided Nerve Block - Minimizing Pain During BMAC

18 Jun 2023 · 1 min

Watch on YouTube

1:29

A procedure-focused YouTube video (creator: Dr. Joshua John-Ram Schacter; uploaded June 18, 2023) demonstrating ultrasound-guided nerve block technique to minimize pain during bone marrow aspiration (BMAC). The speaker narrates anesthetizing surrounding tissues, using ultrasound to guide placement, making a small incision, inserting a needle/Jam sheety instrument, and aspirating bone marrow in multiple syringes to reduce patient discomfort. Emphasis is on patient comfort, real-time feedback, and practical tips (e.g., aspirate in multiple syringes rather than one large syringe).

Questions this video answers

Dr. Joshua John-Ram Schacter (uploaded June 18, 2023).

60 cc (milliliters) of bone marrow.

Using six syringes at a time (rather than one large 60-ml syringe).

An instrument referred to in the transcript as a 'jam sheety'.

So now I'm just gonna anesthetize everything else. Right. Okay.
Deep breaths, my friend. You're doing great.
Doesn't really have hurt that bad. No, just numbing all the tissues and stuff around where I'm gonna be working.
So we're using the ultrasound a second time to make sure that we are right where we need to be. What this is going to allow me to do is again, get right into the bone, but I want to stay right where I'm anesthetized.
How we doing? I feel a little sharpness. That doesn't hurt.
Good.
All right, now I'm going to make a small incision.
Right now it's just a needle.
Okay. And then now we take the instrument called a jam sheety.
You're gonna feel pressure now. Okay. But again, pain, you tell me. We stop. Okay. Little vibration. This is that tap, tap, tap. It is loud, isn't it? It's okay. Cypher said. Yeah. I've had some patients tell me they feel it all the way into their abdomen.
That vibration just kind of spreads.
There we go.
We're aspirating now. Yeah, so that's what you're feeling. So we're aspirating a total of 60ccs or milliliters of bone marrow. In order to minimize discomfort for the patient. We do it six syringes at a time. If you use a big 60, it's a lot of pressure and it can be painful. So this way is much more comfortable for the patient. And as you can see, this patient's talking to us. He's letting us know how he's feeling. And right now he's feeling fine. When they teach this, they don't teach the anesthetic part of it very well.
You can see a very small incision. I'm just going to put a little pressure to help it stop bleeding, and then we're going to glue it shut.