title: Resident versus staff anesthesiologist performance: coracoid approach to infraclavicular brachial plexus blocks using a double-stimulation technique.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, France. vincentminville@yahoo.fr
authors.forename: Vincent
authors.initials: V
authors.lastname: Minville
authors.forename: Karim
authors.initials: K
authors.lastname: Asehnoune
authors.forename: Clément
authors.initials: C
authors.lastname: Chassery
authors.forename: Luc
authors.initials: L
authors.lastname: N'Guyen
authors.forename: Claude
authors.initials: C
authors.lastname: Gris
authors.forename: Olivier
authors.initials: O
authors.lastname: Fourcade
authors.forename: Kamran
authors.initials: K
authors.lastname: Samii
authors.forename: Dan
authors.initials: D
authors.lastname: Benhamou
mesh_terms: 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