视频技术对提高眼科内眦球结膜麻醉成功率的影响。

Impact of Video Technology for Improving Success of Medial Canthus Episcleral Anesthesia in Ophthalmology.

机构信息

From the *Service d'Anesthésie-Réanimation, Hôpital Cochin Hôtel-Dieu, †Département de Simulation en santé iLumens, and ‡Service d'Ophtalmologie, Hôpital Cochin Hôtel-Dieu, Université Paris Descartes, Paris, France.

出版信息

Reg Anesth Pain Med. 2017 Nov/Dec;42(6):757-759. doi: 10.1097/AAP.0000000000000658.

DOI:10.1097/AAP.0000000000000658

PMID:28961602

Abstract

BACKGROUND AND OBJECTIVES

Efficient learning of regional anesthesia in ophthalmology remains challenging because trainees are afforded limited opportunity to practice ocular anesthesia. The aim of this prospective, randomized, blinded study was to determine whether teaching with video improves regional anesthesia skills of residents in ophthalmology.

METHODS

From January to October 2016, 32 novice anesthesiology residents were evaluated while performing medial canthus episcleral procedures during a 5-day rotation. Residents were randomly assigned to either receive or not receive a video review of their performance at day 3. The primary outcome was a comparison of akinesia using a 12-point scale before incision assessed by the blinded surgeon.

RESULTS

A total of 288 blocks were performed by 32 residents and were assessed by 3 surgeons before the intervention (144 blocks) and after the intervention (144 blocks). Residents in the review group improved to a greater degree compared with residents in the no-review group. The median overall akinesia scores for the review and no-review groups were similarly low (6; interquartile range [IQR], 2-11; and 6 [IQR, 2-9], respectively) on day 1 of the rotation, whereas anesthesia performed by residents in the video group provided a better akinesia score (12 [IQR, 10-12] vs 8 [IQR, 6-10]; P < 0.001) on day 5 of the rotation.

CONCLUSIONS

Video-assisted teaching significantly improves performance of medial canthus episcleral anesthesia performed by novice trainees.

摘要

背景与目的

眼科局部麻醉的高效学习仍然具有挑战性，因为学员只有有限的机会练习眼部麻醉。本前瞻性、随机、盲法研究旨在确定视频教学是否能提高眼科住院医师的区域麻醉技能。

方法

2016 年 1 月至 10 月，32 名新手麻醉学住院医师在为期 5 天的轮转中进行内眦球结膜手术时接受评估。住院医师被随机分为接受或不接受视频回顾其第 3 天表现。主要结果是由盲法外科医生评估切口前使用 12 分制评估的无动症的比较。

结果

32 名住院医师共进行了 288 次阻滞，由 3 名外科医生在干预前（144 次阻滞）和干预后（144 次阻滞）进行评估。与无复习组相比，复习组的住院医师有更大程度的改善。复习组和无复习组的总体无动症评分中位数在旋转第 1 天相似较低（6[四分位距（IQR），2-11]和 6[IQR，2-9]），而视频组住院医师进行的麻醉在旋转第 5 天提供了更好的无动症评分（12[IQR，10-12]比 8[IQR，6-10]；P<0.001）。