Survey of regional anesthetic practice among French residents at time of certification

Bouaziz, Hervé; Mercier, F; Narchi, P.; Poupard, M.; Auroy, Yves; Benhamou, Dan

doi:10.1016/s1098-7339(06)80004-0

Cited by 37 publications

(16 citation statements)

References 4 publications

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“…This limited use of epidural analgesia may have contributed to the high maximal pain score obtained in our survey and does not facilitate the development of rehabilitation programs [9,58]. The reasons for this limited use may include higher risks [12], medical and legal concerns, insufficient reimbursement, insufficient training of anesthesiologists [10] and organizational difficulties.…”

Section: Discussion (1382 Words)mentioning

confidence: 89%

A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges

Fletcher

Fermanian

Mardaye

et al. 2008

Pain

254

133

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(249 words)We carried out a national survey on postoperative pain (POP) management in a representative sample (public/private, teaching/non teaching, size) of 76 surgical centers in France. Based on medical records and questionnaires, we evaluated adult patients 24 hours after surgery, concerning information, pre and postoperative pain, evaluation, treatment and side effects. A local consultant provided information about POP management. Data were recorded for 1900 adult patients, 69.3% of whom remembered information on POP.Information was mainly delivered orally (90.3%) and rarely noted on the patient's chart (18.2%). Written evaluations of POP were frequent on the ward (93.7%) with appropriate intervals (4.1 (4.0) hours), but not frequently prescribed (32.7%). Pain evaluations were based on visual analog scale (21.1%), numerical scale (41.2%), verbal scale (13.8%) or non numerical tool (24%). Pain was rarely a criterion for recovery room discharge (19.8%).Reported POP was mild at rest (2.7 (1.3), moderate during movement (4.9 (1.9) and intense at its maximal level (6.4 (2.0). Incidence of side effects was similar according to patient (26.4%) or medical chart (25.1%) including mostly nausea and vomiting (83.3%). Analgesia was frequently initiated during anesthesia (63.6%). Patient-controlled analgesia (21.4%) was used less frequently than subcutaneous morphine (35.1%) whose prescription frequently did not follow guidelines. Non-opioid analgesics used included paracetamol (90.3%), ketoprofen (48.5%) and nefopam (21.4%). Epidural (1.5%) and peripheral (4.7%) nerve blocks were underused. Evaluation (63.4%) or treatment (74.1%) protocols were not available for all patients.This national, prospective, patient-based, survey reveals both progress and persistent challenges in POP management.

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Section: Discussion (1382 Words)mentioning

confidence: 89%

A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges

Fletcher

Fermanian

Mardaye

et al. 2008

Pain

254

133

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“…Aksiller blok kolay ve emniyetli olması nedeni ile Amerika ve Fransa'da da olduğu gibi ülkemizde de en sık uygulanan periferik sinir bloğu olarak görünmektedir. [20][21][22] Son yıllarda giderek daha yaygın kullanılmaya başlanan US klinikte blok tercihlerinde de bir değişime neden olmaktadır. US, sağladığı görsel rehberlik sayesinde pnömotoraks riski nedeni ile kör tekniklerle daha az uygulanan supraklavikular ve infraklavikular bloğun giderek daha yaygın kullanılmasına neden olmaktadır.…”

Section: Discussionunclassified

“…[26] Alt ekstremite blokları ise yine Amerika ve Fransa örneklerinde olduğu gibi ülkemizde de üst ekstremite bloklarına oranla daha az uygulanmaktadır. [20,21] Burada özellikle derin blokların uygulanmasın-da teknik zorluklar, daha düşük başarı oranları ve majör cerrahi için en az iki pleksus bloğu gereksinimi bu blokların daha az kullanılmasının sebeplerindendir. Tüm bunların yanı sıra alt ekstremitede periferik sinir bloklarına alternatif olarak, etkinliği kanıtlanmış ve anestezistlerin sık uyguladığı ve deneyimli oldukları spinal ve epidural anestezi önemli bir rakiptir.…”

Section: Discussionunclassified

Changing trends and regional anesthesia practices in Turkey

Gürkan¹,

Kuş²,

Aksu³

et al. 2014

Agri

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“…25 This experience-based or time-based training required completion of 50 epidural blocks, 50 spinal blocks, and 40 peripheral nerve blocks. A follow-up survey (following the establishment of a minimal number of blocks by the RRC) indicated that residents fulfilled the minimum requirement for spinal and epidural blocks in the United States and Europe 26,27 but failed to perform a sufficient number of peripheral nerve blocks. Data obtained from annual training reports submitted to the Anesthesiology RRC in 2000 revealed that approximately 40% of all residents had inadequate experience in peripheral nerve blockade.…”

Section: Skills Training In Regional Anesthesiamentioning

confidence: 99%

The future of regional anesthesia education: lessons learned from the surgical specialty

Niazi

Peng

et al. 2016

Can J Anesth/J Can Anesth

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Purpose Application of ultrasound in regional anesthesia has now become the standard of care and its use has shown to reduce complications. Nevertheless, gaining expertise in ultrasound-guided regional anesthesia requires the acquisition of new cognitive and technical skills. In addition, due to a reduction in resident working hours and enforcement of labour laws and directives across various states and countries, trainees perform and witness fewer procedures. Together, these issues create challenges in the teaching and learning of ultrasound-guided regional anesthesia in the time-based model of learning. Principal findings The challenges of teaching ultrasound-guided regional anesthesia are similar to those experienced by our surgical counterparts with the advent of minimally invasive surgery. In order to overcome these challenges, our surgical colleagues used theories of surgical skills training, simulation, and the concept of deliberate practice and feedback to shift the paradigm of learning from experience-based to competency-based learning. Conclusion In this narrative review, we describe the theory behind the evolution of surgical skills training. We also outline how we can apply these learning theories and simulation models to a competency-based curriculum for training in ultrasound-guided regional anesthesia.

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Survey of regional anesthetic practice among French residents at time of certification

Cited by 37 publications

References 4 publications

A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges

A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges

Changing trends and regional anesthesia practices in Turkey

The future of regional anesthesia education: lessons learned from the surgical specialty

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