Department of Anesthesia, University of Gondar, Gondar, Amhara, Ethiopia.
BMC Anesthesiol. 2024 Nov 4;24(1):398. doi: 10.1186/s12871-024-02783-4.
Regional anesthesia (RA) can improve patient outcomes and reduce perioperative complications including deaths. Despite its benefits, RA is less utilised in low-resource settings. The purpose of this study was to assess practice and challenges related to RA in Amhara Regional Hospitals, Northwest-Ethiopia.
A web- based survey was distributed among 360 anesthetists working in Amhara Regional Hospitals, Northwest-Ethiopia from November 15 - January 30, 2023. An English, semi-structure, self-administered questionnaire was disseminated by email and telegram following ethical clearance. The survey included questions about the use of RA, socio-demographic characteristics of anesthetist, types of practiced regional blocks, and barriers to perform RA. All volunteer respondents who filled online questionnaire during study period were included. The data were coded and analyzed using statistical package for social Sciences (SPSS) software-version 20. Both inferential and descriptive statistics were used to describe the results.
The overall response rate was 63.3% (223 out of 360 completed surveys). A total of 132 respondents (36.7%) did not provide a response, and 5 respondents (1.4%) submitted incomplete) surveys. The most frequently self-reported barriers to performing peripheral nerve blocks were a lack of equipment (regional procedure kit including block needle, ultrasound, nerve stimulator, or epidural set) 185 (82.9%), lack of knowledge 171(76.7%), lack of practical skills 112 (50.2%), and lack of drugs/medication 50 (22.4%).
The principal findings indicate that all respondents perform spinal anaesthesia, while the practice of peripheral RA varies. Reported barriers to performing RA are related to knowledge and training, as well as a lack of equipment (there aren't enough regional procedure kits available that include an epidural set, block needle, nerve stimulator, and ultrasound). A more stringent approach with specific requirements, distinguishing between neuraxial and peripheral blocks, enhance training opportunities for peripheral nerve blocks are required in Ethiopia.
区域麻醉（RA）可以改善患者的治疗效果并减少围手术期并发症，包括死亡。尽管它有很多益处，但在资源匮乏的环境中，RA 的使用率较低。本研究旨在评估在埃塞俄比亚阿姆哈拉地区医院中 RA 的实践情况和相关挑战。
我们于 2023 年 11 月 15 日至 1 月 30 日期间，通过电子邮件和电报向在阿姆哈拉地区医院工作的 360 名麻醉师分发了一份基于网络的调查问卷。该调查问卷为英文半结构式自填问卷，在获得伦理批准后进行分发。调查问卷包括关于 RA 使用情况、麻醉师的社会人口学特征、实施的区域阻滞类型以及进行 RA 的障碍等问题。所有在研究期间填写在线问卷的志愿受访者均被纳入研究。数据使用社会科学统计软件包（SPSS）软件版本 20 进行编码和分析。使用推断统计和描述性统计来描述结果。
总体回复率为 63.3%（223 份完成的调查问卷中有 223 份）。共有 132 名受访者（36.7%）未提供回复，5 名受访者（1.4%）提交了不完整的调查。实施外周神经阻滞时最常报告的障碍是缺乏设备（包括阻滞针、超声、神经刺激器或硬膜外套件的区域程序套件）185 名（82.9%）、缺乏知识 171 名（76.7%）、缺乏实践技能 112 名（50.2%）和缺乏药物/药物 50 名（22.4%）。
主要发现表明，所有受访者均实施脊髓麻醉，而外周 RA 的实施情况则有所不同。实施 RA 的报告障碍与知识和培训以及设备缺乏有关（可用的区域程序套件不足，包括硬膜外套件、阻滞针、神经刺激器和超声）。在埃塞俄比亚，需要采取更严格的方法，并制定具体要求，区分神经轴和外周阻滞，增加外周神经阻滞的培训机会。
