ASRA Resident Section Committee’s Guide to Peripheral Nerve Blocks

By Amy Pearson, MD    Mar 17, 2017

Many anesthesiology residents find their regional anesthesia rotation to be one of the most fast-paced, challenging, and satisfying experiences of their training years. Regional anesthesia residents spend their rotations gaining technical skills and honing their knowledge of peripheral nerve and musculoskeletal anatomy. The benefits of regional anesthesia become quickly apparent as they progress in the rotation: superior pain relief, earlier recovery of bowel function, easier participation in physical therapy, and even earlier hospital discharge.[1] Patients can often avoid the risks of general anesthesia and the side effects of opioid medications.

With this in mind, the members of the ASRA Resident Section Committee (RSC) identified some common, persistent regional anesthesiology knowledge gaps among residents. Based on their own experiences, the RSC members and their constituents expressed a desire to better understand the complication rates for regional blocks in order to improve their discussions with patients on the risks and benefits of these techniques.

Under the mentorship of Dr. Rebecca Johnson, assistant professor of Anesthesiology & Perioperative Medicine at the Mayo Clinic, members of the ASRA Resident Section Committee set out to narrow those gaps. The team consisted of president Eellan Sivanesan, MD (University of Miami), president-elect Chad Parvus-Teichmann, MD (University of Miami), and members Daniel Abraham, MD (Johns Hopkins), Amy Pearson, MD (Mayo Clinic), Jason Pawlowsky, DO (University of Pennsylvania), and Sarah Hensley, MD (University of Cincinnati).

The group decided to focus on two specific topics that frequently occur in regional anesthesia training: nerve root distributions and incidence of complications of common regional blocks. The RSC felt that a quick reference guide would be a useful addition to regional anesthesia training.

Eellan Sivanesan, ASRA Resident Section Committee Chair, reports, "This project focused on providing a flash card style primer on basic regional techniques for residents. With the support of ASRA mentorship, it was created as a collaborative effort that linked our ASRA resident/fellow section committee members throughout the country.”

The resident/fellow team worked together during ASRA national meetings and used a mobile application that allowed them to share group messages, files, and images in order to create the reference guide. The final product is an easily-downloadable 9-page PDF of brightly-colored graphics and information with more than 40 individual references.[2] It is broken down into categories: upper extremity, lower extremity, neuraxial, and truncal blocks, and includes up-to-date incidences of the common complications for each block.

The educational tool comes in PDF format and is easily accessible to current ASRA members from the ASRA website. The ASRA RSC is grateful for the support of ASRA leadership and encourages all ASRA members to use this tool to improve their regional anesthesia knowledge and communication skills.

References

  1. ASRA. Risks and benefits of regional anesthesia. Available at https://www.asra.com/page/43/risks-and-benefits-of-regional-anesthesia
  2. ASRA Resident Section Committee Guide to Peripheral Nerve Blocks. Available at https://www.asra.com/content/documents/asra-rsc-edu-2016-peripheral-nerve-blocks-2016-10-oct-27.pdf

 

 


Amy Pearson, MD,  is a physician anesthesiologist and pain fellow at the Mayo Clinic in Rochester, MN. She is a member of the ASRA Resident Section Committee and the ASA Pain Medicine Educational Track Subcommittee.

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