The Study of New Design of the Anesthesia Residency Rotation for Increasing the Exposure and Success Rate of Peripheral Nerve Block

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Malinee Wongswadiwat
Apinya Unchulee
Aumjit Wittayapairoj
Patt Pannangpetch

Abstract

Background and Objective: Peripheral nerve blocks (PNB) are one of the anesthesia and analgesia techniques that provide stable hemodynamic, prolong analgesia and also avoid airway instrumentation. Proper training of peripheral nerve block skills is required for our anesthesia residency training curriculum. There are variety of teaching model for increase exposure and skill in peripheral nerve block. Our model is two weeks at a time for the second and third year residency training program. We would like to evaluate our first year of new teaching model.

Methods: The new model has been employed since the year 2013. Five residents of the second and seven residents of the third year in our anesthesia residency training program were all enrolled. Peripheral nerve block rotation was arranged 2 weeks at a time in the second and the third year resident. The education consisted of basic anatomy, ultrasound guidance, workshop, multimedia, journal and review PNB technique during the rotation. PNBs were performed in postoperative care unit under the supervision of staff anesthesiologists. All PNBs were done under nerve stimulator and ultrasound guidance. Cases that have been done were recorded in logbook; number of patients, techniques, success rate was collected.

Results: The mean number of procedures were 12 PNBs during the two weeks of rotation. The success rate ranges between 87.5% - 100%. We found that nerve block for lower extremity procedures have been performed more than upper extremity (55% versus 45%). Femoral and sciatic nerve block were the most number of lower extremity block (34.2%) and axillary nerve block was the most number of upper extremity block (33.3%).

Conclusions: The new model of PNB rotation can increase the exposure and success rate of peripheral nerve block.

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