Teaching Practices of Thoracic Epidural Anesthesia in the United States: Should Lumbar Epidurals Be Taught Before Thoracic Epidurals?

Saied, Nahel N.; Helwani, Mohammad A.; Tabakian, Hagop M; Srinivasan, John David

doi:10.1053/j.jvca.2006.03.020

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…This discrepancy is somewhat intriguing considering the routine use of TEA in many teaching institutions. [51][52][53] Although one could advocate similar learning curves for lumbar and TEA, such parallel may be fallacious. On one hand, lumbar epidural blocks cross-fertilize the learning process of TEA.…”

Section: Required Training For Teamentioning

confidence: 99%

Primary Failure of Thoracic Epidural Analgesia in Training Centers

Tran

Zundert

Aliste

et al. 2016

Regional Anesthesia and Pain Medicine

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In teaching centers, primary failure of thoracic epidural analgesia can be due to multiple etiologies. In addition to the difficult anatomy of the thoracic spine, the conventional end point-loss-of-resistance-lacks specificity. Furthermore, insufficient training compounds the problem: learning curves are nonexistent, pedagogical requirements are often inadequate, supervisors may be inexperienced, and exposure during residency is decreasing. Any viable solution needs to be multifaceted. Learning curves should be explored to determine the minimal number of blocks required for proficiency. The problem of decreasing caseload can be tackled with epidural simulators to supplement in vivo learning. From a technical standpoint, fluoroscopy and ultrasonography could be used to navigate the complex anatomy of the thoracic spine. Finally, correct identification of the thoracic epidural space should be confirmed with objective, real-time modalities such as neurostimulation and waveform analysis.

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Section: Required Training For Teamentioning

confidence: 99%

Primary Failure of Thoracic Epidural Analgesia in Training Centers

Tran

Zundert

Aliste

et al. 2016

Regional Anesthesia and Pain Medicine

View full text Add to dashboard Cite

show abstract

“…In a survey done in the United States and reported in 2006, Saied et al 7 reported that TEA blocks are widely taught in US residency programs. In addition, they reported that most anesthesiology residency programs teach lumbar epidural blocks before TEA blocks.…”

mentioning

confidence: 99%