Abstract ID: A8

Abstract Title: Administration of Local Anaesthesia by Non-Anaesthetists; Who's monitoring?

Authors: Fanning R¹, Halpenny M²
Beaumont Dublin Dublin Ireland¹, Beaumont Dublin Dublin Ireland²
Poster Type: Either

ABSTRACT BODY

Introduction
Local anaesthesia is widely used in procedures performed, outside the conventional operating suite, namely day theatre, wards, emergency room and outpatient departments. In the majority of cases, they are carried out by Non-Anaesthetists, mainly Surgeons, and Physicians. In our study, we set out to study the extent of such practices, and assess the training and knowledge base of clinicians involved.
Materials and Methods
We circulated a questionnaire to all non-anaesthetic residents, involved in the administration of local anaesthesia in a number of training hospitals. The questionnaire include demographic details, training issues, and a detailed portion on the basic physiology and pharmacology of local anaesthesia.
Results
80 questionnaires out of a total of 120 were returned. Most participants were between 3-5 years post qualification 90 % of participants used only local skin infiltration. Plastic surgeons were the likeliest to perform more complex blocks. Although most proceedures were performed in the presence of an assistant, < 50 % of proceedures were carried out using appropriate monitoring, only 30 % with O2. < 30 % were ACLS trained, and >40 % were unaware of the location of the resuscitation trolley in their operative location. The basic physiology/pharmacology section revealed poor basic knowledge, and more alarmingly lack of knowledge of their toxic doses of local anaesthetic agents.
Discussion
Local anaesthesia is not without risk(1).Current recommendations include appropriate monitoring and adequate training in resuscitative techniques by practitioners (2). This study illustrates such standards are often seriously lacking.
References
(1). D’EcamoEM J Oro/Maxillofac Surg 2003 July;61(7)793-0.
(2). MartenTJ Clin Plast surg 1991 Oct;18(4):877-9.

ATTACHED FILES

Reg Anesth Pain Med 2005; 30(3):A8