Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · May 2009
Randomized Controlled Trial Comparative StudyClinical impact of epidural anesthesia simulation on short- and long-term learning curve: High- versus low-fidelity model training.
Epidural anesthesia is a technically challenging regional anesthetic technique that can be difficult to teach to novices. Epidural simulators are now available to allow realistic training within a safe and controlled environment before attempting the procedure on patients. Potentially, this may improve skill acquisition by novice residents. The purpose of this study was to examine the effect of a high-fidelity epidural anesthesia simulator on residents' ability to perform their first labor epidurals and on their learning curve compared with a group having training with a low-fidelity model. ⋯ Our study shows that a simple model can be as useful for learning how to place an epidural catheter as an expensive anatomically correct simulator. New and more technologically advanced simulators should be compared against lower fidelity models to establish their utility and cost-effectiveness.
-
Reg Anesth Pain Med · May 2009
Structural injury to the human sciatic nerve after intraneural needle insertion.
Recent clinical reports suggest that intraneural needle placement may not always lead to neurologic injury. To explain the absence of neurologic complications in these reports, we studied the risk and extent of nerve injury after intentional needle-nerve placement in a cryopreserved human sciatic nerve. ⋯ Our findings suggest that intraneural needle insertion may more commonly result in interfascicular rather than intrafascicular needle placement.