Sonoanaesthesia: ultrasound guided regional anaesthesia
Authors: Andrew Brammar
Publication date: 11 May 2012
Ultrasound guided regional anaesthesia of upper and lower limb is a two day course run by consultants and senior registrars in anaesthesia who have a strong interest in regional anaesthesia. It is designed to provide anaesthetists with hands on experience of ultrasound anatomy and nerve block techniques.
Who’s it for?
The course is aimed at anaesthetists of all grades who want to perform nerve blocks under ultrasound guidance as part of their practice. It would also be useful for trainees who are preparing for the Final Examination of the Diploma of Fellowship of the Royal College of Anaesthetists.
When did you do it?
I did the course in September 2011 as a specialty registrar year 5 in anaesthesia. The other delegates included specialty trainee and consultant anaesthetists from around the UK.
Where, when, and how much?
The course is run by sonoanaesthesia.com at one of several centres in north west England. There are three courses a year. They cost £350-£400 depending on location, and include good quality breakfast and lunches.
Why did you do it?
Ultrasonography is widespread in anaesthetic practice. It is used for performing nerve blocks to prevent acute pain, and also in obstetric anaesthesia, critical care, emergency medicine, and for vascular access. Junior trainees in anaesthesia will start picking up these skills early in their careers, but training in ultrasound guided regional anaesthesia can be patchy. As a senior trainee with an interest in the management of acute pain, I wanted to fill an important gap in my knowledge, and gain skills to reduce the pain experienced perioperatively by surgical patients.
What is the structure?
The course consists of a mixture of short lectures, videos, and workshops. About 20 delegates are split into small groups with varying levels of experience, supported by a very knowledgeable faculty. Teaching is interactive and relaxed, and there is a chance to try out different ultrasound machines and nerve block needles. There is no formal assessment, but contact with different faculty members during the course allows problems with technique to be addressed. Lots of practical tips and tricks are helpfully provided, which can be incorporated into clinical practice.
What is covered?
Short lectures and videos over the two days cover ultrasound physics and anatomy related to nerve blocks of the limbs and trunk. Also, the session on optimising the settings of ultrasound machines is invaluable given the complexity of some models. Workshops using adult volunteers help you become better at visualising normal sonoanatomy. The manipulation of needles under ultrasonography is practised on high fidelity “phantom” models throughout the course. It’s a skill that has a steep learning curve, but it is essential for safe practice. Talking informally to members of the faculty allows you to find out the pros and cons of using nerve blocks in a variety of clinical situations.
Was it worth it?
Yes. Since then I have been able to consolidate the skills I learnt in clinical practice, and have more options to manage the pain of patients I care for. I would recommend the course to anaesthetists of any grade who want to improve their skills in carrying out nerve blocks under ultrasound guidance. It would also be very useful for anyone preparing for clinical examinations in anaesthesia.
Read over the basics of nerve plexus anatomy before attending to get the most from the workshops
Ask how different nerve blocks are used by faculty members. This will help you apply what you learn
Competing interests: None declared.
Andrew Brammar ST5 in anaesthesia
North West Deanery, UK