Resident versus staff anesthesiologist performance: coracoid approach to infraclavicular brachial plexus blocks using a double-stimulation technique.
OBJECTIVE
Infraclavicular brachial plexus block with double stimulation (ICB) is a safe technique for upper-limb anesthesia. However, the experience of learning this technique by anesthesiology residents has not been reported. The aim of this study was to compare staff with resident anesthesiologists in the performance of ICB.


METHODS
Patients scheduled for orthopedic surgery of the upper limb were included in a prospective, comparative, randomized study and were given ICB by either staff anesthesiologist (Group S, n = 110 patients) or resident anesthesiologist (Group R, n = 110 patients).


RESULTS
Time to perform the block was 3.9 minutes (95% confidence interval [CI 95%] = 3.5 to 4.3) for Group S and 5.8 minutes (CI 95% = 5.2 to 6.4) for Group R (P < .05). The onset time was 14.4 minutes (CI 95% = 13.5 to 15.3) for Group S and 15.9 minutes (CI 95% = 14.7 to 17.1) for Group R (P = NS). Success rate was 93% for Group S and 90% for Group R (P = NS). Supplementation was performed in 8 patients in Group S versus 11 patients in Group R (P = NS). No patient needed general anesthesia. One self-limited vascular puncture was made in Group S versus 3 in Group R (P = NS).


CONCLUSIONS
This report determines whether residents can perform this technique with comparable efficiency compared with staff. We conclude that ICB should be taught as part of all resident training programs.
Minville
Vincent
V
Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, France. vincentminville@yahoo.fr
Asehnoune
Karim
K
Chassery
Clément
C
N'Guyen
Luc
L
Gris
Claude
C
Fourcade
Olivier
O
Samii
Kamran
K
Benhamou
Dan
D
D000328:Adult; D000776:Anesthesiology / Q000592:standards*; D001917:Brachial Plexus; D002983:Clinical Competence / Q000592:standards*; D004558:Electric Stimulation; D005260:Female; D006225:Hand / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D007396:Internship and Residency; D008297:Male; D016343:Monitoring, Intraoperative; D009407:Nerve Block; D019637:Orthopedic Procedures; D011446:Prospective Studies