The Current Role of Ultrasound Use in Teaching Regional Anesthesia: A Survey of Residency Programs in the United States
Pain Medicine, 08/01/2012
Helwani MA et al. – Ultrasound–guided peripheral nerve blocks (PNBs) are universally taught across residency programs in the United States. Most teaching physicians believe that ultrasound increases PNB's success and improves safety of regional anesthesia. Barriers to ultrasound use are lack of faculty training and unavailability of ultrasound equipment.Methods
- A survey was distributed to all American Board of Anesthesiology–accredited residency programs via email and/or the U.S. postal service.
- The survey was designed to determine the number of peripheral nerve blocks (PNBs) performed, the role of the ultrasound guidance, the barriers to its use, and the methods by which teaching physicians acquired their ultrasound skills.
- The authors received 82 responses (62%) of the 132 programs surveyed.
- Eighty–eight percent of the responding programs performed more than 20 PNBs/week and 46% performed more than 40 PNBs/week.
- Three–fourths of the respondents relied on ultrasound to guide the majority of single injection and continuous PNBs.
- When using ultrasound, most programs (79%) used real–time ultrasound without nerve stimulator.
- Most teaching physicians supervising ultrasound–guided PNBs received their training via workshops and/or from other colleagues.
- The three main reasons for using ultrasound were to 1) achieve a higher success rate; 2) improve safety; and 3) teach anesthesia trainees.
- However, the three main barriers to using ultrasound were 1) lack of training; 2) perceived decreased efficiency; and 3) the lack of immediate availability of equipment.
- Overall, ultrasound was less utilized to guide lower extremity vs upper extremity PNBs.