Cite as: Machi A. Editor's corner: The march of progress. ASRA Pain Medicine News 2025;50. https://doi.org/10.52211/asra080125.002.

Editor’s Corner

Medicine operates within an ever-evolving landscape. In medical school, I recall being told the popular adage that “half of what you are taught will eventually be proven wrong, and the trouble is that neither I nor any of your teachers know which half.” Hyperbole aside, the underlying message of the onward focus within medicine rings true. While aspects of healthcare may seem mired in the morass of delivery, disparity, bureaucracy, unsustainable costs, or some other malady, the forward progress of medicine itself remains deeply inspiring. This spirit of advancement is evident in regional anesthesia and pain medicine, where innovation continues to reshape clinical practice. In that spirit, we are delighted to bring you another edition of ASRA Pain Management News, sharing not only the substance of daily practice but also remarkable advancements that were inconceivable only a few years ago. This issue spans the practical to the visionary—from real-world techniques to contemplations of how our field might one day be practiced in deep space.

This issue features five highly practical articles: two clinical How I Do It (HIDI) pieces, one POCUS guide, an ASRA Answers, and a primer on remote teaching excellence. Both HIDI articles focus on hip analgesia. In the first, Drs. Lim, Deeble, and Sondekoppam offer a masterclass on contemporary lumbar plexus blockade. I highly recommend watching their accompanying video, which is truly a must-see! In the second, Drs. Almazidi, Meng, and I describe our approach to hip joint denervation using a combination of fluoroscopic and ultrasound guidance for enhanced safety and efficacy. Next, Drs. Kwofie, Kalagara, and Girón-Arango deliver a hands-on POCUS guide for diaphragm assessment—an invaluable tool across the OR, ICU, ED, and procedural settings. Following this is an ASRA Answers column highlighting the importance of a fundamental safety practice: the time out. This is followed by a collaborative piece between ASRA Pain Medicine and the Canadian Anesthesiologists’ Society addressing telesimulation for remote teaching of ultrasound-guided regional anesthesia. We are now in an era where exceptional “hands-on” education can be delivered from virtually anywhere to anywhere, thanks to the power of digital connectivity.

Building on the leap of telesimulation, Drs. Resop and Schroeder examine how artificial intelligence is influencing the field of regional anesthesia education. AI is poised to support not only knowledge acquisition but also programmatic training and skill development. Implications for procedural enhancement are near. Next, Drs. Yaras, Singla, and Kohan review a promising non-invasive technique: high-intensity focused ultrasound (HIFU) for the treatment of musculoskeletal and cancer-related pain. This approach delivers therapeutic ultrasound energy with precision, offering a potential alternative to more invasive interventions. While currently limited to research settings, HIFU represents an exciting frontier with meaningful clinical promise. And from there we travel even farther—into deep space. Drs. Dumont, Brownbridge, and Bailey provide a forward-thinking review of regional anesthesia in extraterrestrial environments, discussing minimal resource requirements, unique physiologic challenges, and offering insights on how to adapt our techniques for use beyond Earth.

The issue concludes with a celebration of exceptional women leaders in pain medicine, a compelling article on the outstanding burdens of prior authorizations in pain medicine, the literature review, and a pithy poem by Dr. Grzybowski.

And as always, I extend a warm thank you to the readers, authors, newsletter team members, editors, ASRA-PM staff, and all volunteers who make this and every edition of the newsletter possible. Your contributions fuel our collective mission to advance knowledge and care in regional anesthesia and pain medicine. I welcome your feedback and ideas at [email protected].