Evaluation of Education, Attitude, and Practice of the Turkish Anesthesiologists in Regional Block Techniques

Abstract

BackgroundThe demand for regional blocks from both patients and surgeons has significantly increased in anesthesia practice during the last 30 years. Although the studies show that the complications are rare, regional blocks still have serious difficulties which can be prevented by training programs.ObjectivesThe purpose of this study was to determine the factors affecting the educational methods, attitude and practice of the Turkish anesthesiologists in regional blocks during and following residency programs.Patients and MethodsAnesthesiologists were asked to answer a questionnaire. Educational proficiency was determined by at least 50 spinal, 50 epidural and 50 peripheral block applications during residency. Specialists were asked for the numbers of spinal, epidural and peripheral blocks (PBs) they applied in 2009. The mean and median values were calculated.ResultsOne hundred and eighty-eight anesthesiologists (84.3 %) agreed to participate in the study. While all participants had made their first attempts in neuraxial blocks (NBs) when they were residents, this ratio was detected as 96.8% for PBs. All participants learned neuraxial and PBs on patients in the operating theater. Education proficiency ratios for spinal, epidural and PBs were 98.1 %, 92.5 % and 62.3 %, respectively. Age, perception of adequate training, nerve block rotation, adequate application in education, following innovations were the factors which significantly affected the number of PBs in practice according to univariate analysis. The participants who consider their applications on NBs were adequate (P = 0.029) and the ones working in state or private hospitals (P = 0.017), applied NBs significantly above the median number.ConclusionsAnesthesiologists had adequate education and practice of NB applications but a significant proportion of participants (51.8%) lacked both in PBs applications. We believe that NBs are more easily learned than PBs during residency training program.

Which types of peripheral nerve blocks should be included in residency training programs?

“…The degree of exposure is great enough to ensure confidence in clinical performance after the training, which far exceeds ACGME requirements. Other studies performed abroad have obtained similar results [ 8 ].…”

A Survey of Regional Anesthesia Use in Greece and the Impact of a Structured Regional Anesthesia Course on Regional Techniques Knowledge and Practice

“…Another aspect of the same problem is the fact that traditionally and before the era of US, PNBs for the lower extremities were practiced less frequently and were considered technically more demanding and cumbersome because of the need to perform multiple blocks to anesthetize the entire limb, whereas this was not the case for peripheral blocks of the upper extremity. This trend has been reported in various surveys [ 1 , 3 , 10 , 21 , 22 ]. Additionally, neuraxial anesthesia, in which anesthesiologists feel more confident as mentioned above, is usually a viable alternative for lower extremity surgery, whereas there is no alternative for upper extremity blocks.…”

A Survey of Regional Anesthesia Use In Greece And The Impact of A Structured Regional Anesthesia Course On Regional Techniques Knowledge And Practice

“…Another aspect of the same problem is the fact that traditionally and before the era of US, PNBs for the lower extremities were practiced less frequently and were considered technically more demanding and cumbersome because of the need of the performance of multiple blocks to anesthetize the entire limb, whereas this was not the case for peripheral blocks of the upper extremity. This trend has been reported in various surveys [6,8,15,22,28,29]. Additionally, neuraxial anesthesia in which anesthesiologists feel more con dent as mentioned above, is usually a viable alternative for lower extremity surgery, whereas there is no alternative for upper extremity blocks.…”