Breast Regional Anesthesia Practice in the Italian Public Health System (BRA-SURVEY): A Survey-Based National Study

Bonvicini, Daniele; Cassai, Alessandro De; Andreatta, Giulio; Salvagno, Michele; Carbonari, Ilaria; Carere, Anna; Fornasier, Marcello; Iori, Davide; Negrello, Michele; Grutta, G. La; Navalesi, Paolo

doi:10.1213/ane.0000000000005649

Cited by 6 publications

(3 citation statements)

References 29 publications

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“…Indeed, during SBET, residents can perform multiple blocks in low-stress conditions without the risk of harm to the patient and might receive individualized feedback from experts in the field. Moreover, simulators allow the residents to exercise and perform peripheral blocks less frequently encountered during the clinical training (18).…”

Section: Discussionmentioning

confidence: 99%

Simulation-Based Medical Education and Training Enhance Anesthesia Residents' Proficiency in Erector Spinae Plane Block

et al. 2022

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BackgroundAdvances in regional anesthesia and pain management led to the advent of ultrasound-guided fascial plane blocks, which represent a new and promising route for the administration of local anesthetics. Both practical and theoretical knowledge of locoregional anesthesia are therefore becoming fundamental, requiring specific training programs for residents. Simulation-based medical education and training (SBET) has been recently applied to ultrasound-guided regional anesthesia (UGRA) with remarkable results. With this in mind, the anesthesia and intensive care residency program of the University of Milano-Bicocca organized a 4-h regional anesthesia training workshop with the BlockSim® (Accurate Srl, Cesena) simulator. Our study aimed to measure the residents' improvement in terms of reduction in time required to achieve an erector spinae plane (ESP) block.MethodsFifty-two first-year anesthesia residents were exposed to a 4-h training workshop focused on peripheral blocks. The course included an introductory theoretical session held by a locoregional anesthetist expert, a practical training on human models and mannequins using Onvision® (B. Braun, Milano) technologies, and two test performances on the BlockSim simulator. Residents were asked to perform two ESP blocks on the BlockSim: the first without previous practice on the simulator, the second at the end of the course. Trainees were also also asked to complete a self-assessment questionnaire.ResultsThe time needed to achieve the block during the second attempt was significantly shorter (131 [83, 198] vs. 68 [27, 91] s, p < 0.001). We also observed a reduction in the number of needle insertions from 3 [2, 7] to 2 [1, 4] (p = 0.002), and an improvement aiming correctly at the ESP from 30 (58%) to 46 (88%) (p < 0.001). Forty-nine (94%) of the residents reported to have improved their regional anesthesia knowledge, 38 (73%) perceived an improvement in their technical skills and 46 (88%) of the trainees declared to be “satisfied/very satisfied” with the course.ConclusionsA 4-h hands-on course based on SBET may enhance first-year residents' UGRA ability, decrease the number of punctures and time needed to perform the ESP block, and improve the correct aim of the fascia.

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Section: Discussionmentioning

confidence: 99%

Simulation-Based Medical Education and Training Enhance Anesthesia Residents' Proficiency in Erector Spinae Plane Block

et al. 2022

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“…However, because the paraspinal space is so close to the pleura, it is an advanced technique with a potential risk of complications, and many clinicians are hesitant to use it ( 10 ). Study has also shown that due to a lack of appropriate training, the rate of regional anesthesia techniques used in breast surgery is low ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Visualization analysis of thoracic paravertebral block in breast surgery based on bibliometrics

Han

Liu

2023

Gland Surg

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Background Breast surgery is one of the most common surgeries in the world, and pain after breast surgery is very common, representing one of the key factors affecting the quality of life after surgery. With the development of clinical techniques, thoracic paravertebral block (TPVB) has gradually become the preferred regional anesthesia technique for postoperative breast analgesia. Methods Using Web of Science as the data source, medical articles about the application of TPVB in breast surgery published from 1900 to 2022 were retrieved and imported into CiteSpace and VOSviewer software. Using bibliometrics and knowledge mapping visualization methods, the literature was analyzed from the aspects of publication, author, institution, country, high-frequency keywords, keyword clustering, emergence words, and so on. Results A total of 299 articles were included. according to the yearly numbers of articles, the trend is increasing annually. The most published authors in this field are Susan M. Steele, Roy A. Greengrass, Brian M. Ilfeld, Karmakar Manoj Kumar, and Stephen M. Klein. The League of European Research Universities, University of Toronto, and Duke University are the 3 institutions with the largest number of publications, and their cooperation degree is relatively low. Articles of American origin predominated. TPVB is the major keyword associated with the application of TPVB in breast surgery, which appears most frequently and has a high research interest. Conclusions The trend and characteristics of TPVB application research in breast surgery were visualized, and the studies in this field are generally increasing annually in number, providing useful bibliometric analysis for researchers to further explore in this field.

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“…Among these treatments, resection is a predominant strategy. Unfortunately, patients with breast cancer after resection may experience severe postoperative complications (8)(9)(10)(11). One of the most threatening complications is deep vein thrombosis (DVT), a severe disease in the venous system, which is a vital cause of high mortality of breast cancer (10,12,13).…”

Section: Introductionmentioning

confidence: 99%

Incidence and Related Factors for Low-Extremity Deep Vein Thrombosis in Breast Cancer Patients Who Underwent Surgical Resection: What Do We Know and What Should We Care

et al. 2022

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Malignancy, surgical resection, and neoadjuvant and/or adjuvant chemotherapy increase the low-extremity deep vein thrombosis (LDVT) risk in patients with breast cancer, bringing in great physical burdens, disabilities, and worse survivals. However, LDVT in surgical breast cancer patients is scarcely reported. Therefore, this study aimed to evaluate the incidence and related factors for LDVT in these patients. Patients with breast cancer who underwent surgical resection were included. LDVT was examined on the day of discharge and 1 month after the discharge. A total of 491 eligible patients were included, among which 11 (2.2%) patients occurred LDVT. Besides, higher age, history of diabetes mellitus, advanced T and tumor node metastasis (TNM) stages, higher platelet count, and shorter activated partial thromboplastin time (APTT) were correlated with increased LDVT incidence (all p < 0.05). Additionally, higher age [p = 0.004, odds ratio (OR) (95% CI): 1.082 (1.023–1.144)], history of diabetes mellitus [p = 0.003, OR (95% CI): 10.426 (2.219–48.986)], and a higher platelet count [p = 0.008, OR (95% CI): 1.017 (1.004–1.029)] were independent factors for increased LDVT incidence, while higher APTT [p = 0.004, OR (95% CI): 0.636 (0.467–0.866)] was an independent factor for decreased LDVT incidence. Lastly, the risk prediction model involving age, history of diabetes mellitus, platelet count, and APTT showed a good ability to predict LDVT occurrence (area under curve: 0.919, 95% CI: 0.869–0.968). In conclusion, the LDVT incidence is 2.2%, and its independent factors consist of age, history of diabetes mellitus, platelet count, and APTT in patients with breast cancer who underwent surgical resection, which provides evidence for the prevention and surveillance of LDVT in surgical breast cancer.

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Breast Regional Anesthesia Practice in the Italian Public Health System (BRA-SURVEY): A Survey-Based National Study

Cited by 6 publications

References 29 publications

Simulation-Based Medical Education and Training Enhance Anesthesia Residents' Proficiency in Erector Spinae Plane Block

Simulation-Based Medical Education and Training Enhance Anesthesia Residents' Proficiency in Erector Spinae Plane Block

Visualization analysis of thoracic paravertebral block in breast surgery based on bibliometrics

Incidence and Related Factors for Low-Extremity Deep Vein Thrombosis in Breast Cancer Patients Who Underwent Surgical Resection: What Do We Know and What Should We Care

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