A Survey of Regional Anesthesia Use in Greece and the Impact of a Structured Regional Anesthesia Course on Regional Techniques Knowledge and Practice.

Kassiani Theodoraki,Alexandros Makris,Eleni Moka,Evmorfia Stavropoulou

doi:10.3390/jcm10214814

Abstract

Background: Due to the growing interest in regional anesthesia (RA) techniques and the realization of the need for formalized education in them, the Greek Chapter of the European Society of Regional Anesthesia and Pain Therapy (ESRA-Hellas) has established a structured hands-on training course held annually since 2009, which is quite popular in the community of Greek anesthesiologists. The aim of the current survey was twofold: first, to provide an overview of the current practice of RA in Greece; secondly, to evaluate the effect the aforementioned training course has on participants’ knowledge and attitude towards RA. Methods: An electronic questionnaire was uploaded on SurveyMonkey and a link giving access to the questionnaire was forwarded via email to a mailing list of 825 practicing Greek anesthesiologists held in the electronic database of ESRA Hellas. The survey was totally anonymous and no identifying information was collected throughout. It contained questions relating to the anesthesiologists’ demographic characteristics, their RA practice, and information pertaining to the RA training course. Results: A total of 424 fully completed questionnaires were received, representing an overall response rate of 51.4%. Attendants of the course are more familiar than non-attendants with the performance of peripheral nerve blocks with neurostimulation and/or ultrasound guidance (p < 0.001). Attendants are also less likely to practice exclusively general anesthesia, more likely to use peripheral blocks for lower limb surgery, and more likely to consider taking the European Diploma of RA in comparison to non-attendants (p < 0.001, p = 0.018 and p = 0.002, respectively). Both cohorts consider the course of value and agree that the main reason to use regional techniques is to ensure optimal postoperative analgesia, while the main hindrance to RA practice is the lack of relevant education in the techniques, especially those under ultrasound guidance. Regarding improvement of the course, most participants suggested devoting ampler time in hands-on ultrasound practice and application. Conclusions: Greek anesthesiologists seek educational activities in the field of RA and the course seems to fulfil the majority of attendants’ expectations. There will be further effort by the organizers to improve weaknesses of the current course and undertake further educational initiatives in the field of RA according to international recommendations.

Highlights

During the past 30 years there has been a tremendous increase in the popularity of regional techniques, both for provision of anesthesia for surgery and as part of the armamentarium of postoperative pain management
Due to the growing interest in regional anesthesia (RA) and the realization that its administration is a core skill required by all anesthesiologists, many national anesthesia societies and education committees worldwide have established training courses aiming at educating anesthesiologists in regional techniques
(33.7%) reported that they work in central National Health Service (NHS) hospitals and that they are consultants with more than 10 years of experience in anesthesia practice (42.7%)

Summary

Introduction

During the past 30 years there has been a tremendous increase in the popularity of regional techniques, both for provision of anesthesia for surgery and as part of the armamentarium of postoperative pain management. Society of Regional Anesthesia and Pain Therapy (ESRA-Hellas) has established a structured handson training course held annually since 2009, which is quite popular in the community of Greek anesthesiologists. Attendants are less likely to practice exclusively general anesthesia, more likely to use peripheral blocks for lower limb surgery, and more likely to consider taking the European Diploma of RA in comparison to non-attendants (p < 0.001, p = 0.018 and p = 0.002, respectively) Both cohorts consider the course of value and agree that the main reason to use regional techniques is to ensure optimal postoperative analgesia, while the main hindrance to RA practice is the lack of relevant education in the techniques, especially those under ultrasound guidance. There will be further effort by the organizers to improve weaknesses of the current course and undertake further educational initiatives in the field of RA according to international recommendations

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Conclusion