This episode of RAPM Focus challenges physicians to think differently about pain after cesarean delivery by showcasing a new approach for patient care after cesarean delivery. RAPM Executive Editor Eric Schwenk, MD, explores the SPACE-postpartum model with Sarah Ciechanowicz, BMBCh, FRCA, following the October 2025 publication of her brief technical report, “SPACE-Postpartum: a multidomain biopsychosocial framework for predicting chronic pain and impaired recovery after cesarean delivery – proof-of-concept report.”

The SPACE-postpartum model is essentially a multidomain symptom system for understanding recovery after cesarean delivery. This biopsychosocial framework brings together five interconnected symptom areas—sleep, pain, affect, cognition, and energy—for early risk assessment after surgery, offering a comprehensive approach to the entire recovery process after cesarean delivery.

Early recovery is not just about pain scores, but about a pattern of symptoms that tend to cluster and shape a patients’ long-term trajectory. By assessing that pattern early on, we could potentially identify a modifiable risk profile for chronic pain and impaired recovery.

Dr. Sarah Ciechanowicz (“Chye-kha-no-vich”) is a consultant anesthetist at University College London Hospitals, researcher at Imperial College London, and former visiting fellow in obstetric anesthesia research at Stanford University. Her work focuses on improving postpartum recovery and pain prediction after caesarean delivery. She developed the SPACE-Postpartum framework—a multidomain biopsychosocial model designed to identify women at risk of chronic pain and inform intervention in the early postpartum period.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

The management of complex regional pain syndrome (CRPS) continues to challenge clinicians—especially when conservative and interventional strategies fall short. This episode of RAPM Focus, hosted by RAPM Editor and Social Media Editor Ryan D’Souza, MD, explores these challenges in managing CRPS with Daniël van der Spek, MD, and Frank Huygen, MD, PhD, FIPP, FFPMCAI, following the August 2025 publication of their original research paper, “Long-term outcomes of amputation in patients with complex regional pain syndrome (CRPS): a mixed-methods study.”

In rare and severe cases, amputation has been proposed as a last resort intervention, but the topic remains completely controversial. How does one weigh the potential relief of unrelenting pain against the risk of further complications and disability from an amputation? This episode explores a fascinating, mixed-method study into the long-term outcomes of patients with CPRS undergoing limb amputation in hopes of pain relief, despite risks of residual pain or phantom limb pain.

Dr. Daniël van der Spek is a medical doctor and PhD candidate at the Erasmus University Medical Center under the supervision of Professor Huygen his research focus is on CPRS with a particular emphasis on interventional pain management.

Dr. Frank Huygen is an anesthesiologist and pain physician serving as the head of the Department of Pain Medicine at Erasmus University Medical Center, and has been a full professor since 2009. His expertise focuses on CPRS and neuromodulation. He leads multiple national and international research projects, and maintains close collaborations with CRPS patient organizations, in both the Netherlands and the United States.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

Kick off 2026 with the January episode of RAPM Focus, where RAPM Social Media Editor Alopi Patel, MD, converses with Josh Gleicher, MD, MSc, FRCPC, and Hermann dos Santos Fernandes, MD, PhD, following the September 2025 publication of their original research paper, “Outpatient continuous adductor canal block (CACB) for total knee arthroplasty: a double-blinded randomized placebo-controlled trial.”

Dr. Gleicher is a staff anesthesiologist and regional anesthesia expert at Mount Sinai Hospital in Toronto, Canada. He completed his anesthesiology training and fellowship in regional anesthesia at the University of Toronto and holds a master’s degree in quality improvement and patient safety. Dr. Gleicher has extensive experience leading clinical trials in acute postoperative pain, with multiple funded studies and recognized expertise in anesthesia research. He is also a co-developer of the ISAFE technique for adductor canal catheter placement. In his spare time, he enjoys skiing and spending time with his wife and three kids.

Dr. dos Santos Fernandes is a specialist in anesthesiology and pain management, trained at University of São Paulo, where he also achieved his PhD and completed a post-doctorate program. He has fellowship training in regional anesthesia and medical education at Mount Sinai Hospital, University of Toronto, and holds multiple certifications, including the superior title in anesthesiology and European diploma in anesthesiology and intensive care. Currently, he is an assistant professor at the University of Toronto and a staff anesthesiologist at Mount Sinai Hospital, with research and clinical focus on regional anesthesia. A retired basketball player and aspiring tennis player, he likes to travel with the family in his free time.

*The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.