Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, United States of America.
Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland.
PLoS One. 2021 Feb 1;16(2):e0244860. doi: 10.1371/journal.pone.0244860. eCollection 2021.
Regional anesthesia offers an alternative to general anesthesia and may be advantageous in low resource environments. There is a paucity of data regarding the practice of regional anesthesia in low- and middle-income countries. Using access data from a free Android app with curated regional anesthesia learning modules, we aimed to estimate global interest in regional anesthesia and potential applications to clinical practice stratified by World Bank income level.
We retrospectively analyzed data collected from the free Android app "Anesthesiologist" from December 2015 to April 2020. The app performs basic anesthetic calculations and provides links to videos on performing 12 different nerve blocks. Users of the app were classified on the basis of whether or not they had accessed the links. Nerve blocks were also classified according to major use (surgical block, postoperative pain adjunct, rescue block).
Practitioners in low- and middle-income countries accessed the app more frequently than in high-income countries as measured by clicks. Users from low- and middle-income countries focused mainly on surgical blocks: ankle, axillary, infraclavicular, interscalene, and supraclavicular blocks. In high-income countries, more users viewed postoperative pain blocks: adductor canal, popliteal, femoral, and transverse abdominis plane blocks. Utilization of the app was constant over time with a general decline with the start of the COVID-19 pandemic.
The use of an in app survey and analytics can help identify gaps and opportunities for regional anesthesia techniques and practices. This is especially impactful in limited-resource areas, such as lower-income environments and can lead to targeted educational initiatives.
区域麻醉为全身麻醉提供了一种替代方法，在资源有限的环境中可能具有优势。关于低收入和中等收入国家实施区域麻醉的实践，数据很少。我们利用一款免费的 Android 应用程序的访问数据，该应用程序具有经过策划的区域麻醉学习模块，旨在根据世界银行收入水平，估计全球对区域麻醉的兴趣和潜在应用于临床实践的情况。
我们回顾性分析了 2015 年 12 月至 2020 年 4 月期间从免费的 Android 应用程序“麻醉师”中收集的数据。该应用程序执行基本的麻醉计算，并提供有关执行 12 种不同神经阻滞的视频链接。根据是否访问了链接，对应用程序的用户进行了分类。神经阻滞也根据主要用途（手术阻滞、术后疼痛辅助、抢救阻滞）进行了分类。
低、中收入国家的从业者比高收入国家的从业者更频繁地访问该应用程序，这一点可以通过点击次数来衡量。低、中收入国家的用户主要关注手术阻滞：踝部、腋窝、锁骨下、肌间沟和锁骨上阻滞。在高收入国家，更多的用户查看术后疼痛阻滞：收肌管、腘窝、股神经和腹横筋膜平面阻滞。随着 COVID-19 大流行的开始，该应用程序的使用率随时间保持不变，总体呈下降趋势。
使用应用程序内调查和分析可以帮助确定区域麻醉技术和实践中的差距和机会。这在资源有限的地区（如低收入环境）尤其具有影响力，并可以导致有针对性的教育计划。
