Proficiency in interscalene anesthesia-how many blocks are necessary?

Area of Science:

• Anesthesiology
• Medical Education
• Regional Anesthesia

Background:

• Anesthesiology residents require proficiency in regional anesthesia techniques.
• The interscalene block is a common procedure for shoulder surgery.

Purpose of the Study:

• To determine the number of interscalene blocks necessary for anesthesiology residents to achieve autonomous success.
• To evaluate the adequacy of current training requirements for regional anesthesia expertise.

Main Methods:

• A survey questionnaire was administered to CA-1 and CA-2 residents at a university hospital.
• Data collected included previous block attempts, autonomy, and block adequacy for surgery.

Main Results:

• Seventeen residents performed 82 interscalene blocks over 8 months.
• Autonomous success rates increased with experience: 50% after 7-9 blocks and 87.5% after >15 blocks.
• 96.3% of blocks were adequate for surgery.

Conclusions:

• Current training requirements of 40 unspecified peripheral nerve blocks may not be sufficient for developing expertise in regional anesthesia.
• Anesthesiology residents need more experience with specific blocks like the interscalene block to achieve autonomous proficiency.