Rueda Rojas V P, Meléndez Flórez H J, Orozco Galvis E
Servicio de Anestesiología y Reanimación, Hospital Universitario de Santander, Universidad Industrial de Santander, Bucaramanga (Santander), Colombia.
Departamento de Anestesiología y Reanimación, Especialidad de Medicina Crítica y Terapia Intensiva, Docencia Universitaria, Epidemiología, Universidad Industrial de Santander, Bucaramanga (Santander), Colombia.
Rev Esp Anestesiol Reanim (Engl Ed). 2019 May;66(5):241-249. doi: 10.1016/j.redar.2019.01.003. Epub 2019 Mar 12.
The teaching based on simulation and acquisition of skills is changing the paradigm of education and restructuring the clinical residences, with the aim of acquiring better skills, increasing procedural success, reducing complications, as well as providing safe, effective, and efficient and focused care of the patient. Peripheral nerve blocks have advanced as techniques for anatomical repairs, use of neurostimulator, and ultrasound. The posgraduate anaesthesiology program implemented a teaching program that included phases of theoretical teaching, training with simulated models, and application in real scenarios.
To analyse the success, the management of the ultrasound equipment and the incidence of complications of ultrasound-guided supraclavicular blocks (BSE) in the clinical scenario, performed by residents of anaesthesiology previously trained with a theoretical and simulated model.
Prospective cohort study among residents of anaesthesiology (R1, R2, R3, R4), who received previous theoretical-practical training on simulated models. The evaluation was performed by expert anaesthesiologists, with video analysis of the ultrasound screen performed at the time of BSE initiation.
The evaluation included 16 residents, who performed 156 BSE. None had previous experience in ultrasound-guided blocks. The success of the block was 96.15%. The team management was excellent (from 86% to 95%), with no significant differences among the residents. (P=.61) The incidence of complications was 0.64%, corresponding to arterial puncture.
In BSE, previous training with a theoretical and simulated model could increase the probability of success and reduce complications. With adequate training, first year residents managed to successfully carry out the procedure.
