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Chapter 73. Teaching Regional Anesthesia

Which of the following is the minimum number of regional anesthesia procedures as stipulated by the current Anesthesiology Residency Review Committee (RRC) program?

A. 100 epidurals, 50 spinals, and 40 peripheral nerve blocks

B. 50 epidurals, 50 spinals, and 40 peripheral nerve blocks

C. 50 epidurals, 75 spinals, and 50 peripheral nerve blocks

D. 50 epidurals, 100 spinals, and 50 peripheral nerve blocks

B is correct. The current RRC program requirement state that residents must perform 50 epidural, 50 spinal, and 40 peripheral nerve blocks plus an additional 25 nerve blocks for pain management.1

How many epidural blocks are required for residents to achieve clinical competence with an 80% success rate?

A. 15–30

B. 30–45

C. 45–60

D. 60–90

D is correct. Studies of clinical competence show it takes between 60 and 90 epidural blocks to reach at least 80% success.2-4

Which type of block is the most frequently performed in residency training programs?

A. Spinal

B. Combined spinal-epidural

C. Epidural

D. Peripheral nerve

C is correct. See Figure 73–1.

Figure 73–1

Distribution of types of regional anesthesia in residency training programs did not change significantly between 1990 and 2000 (P = .75).

According to Neal, to what extent is ultrasound guidance used in comparison to peripheral nerve stimulation?

A. Less by a wide margin

B. Less by a short margin

C. More by a short margin

D. More by a wide margin

D is correct. According to Neal, ultrasound-guidance as a nerve localization tool now surpasses by a wide margin peripheral nerve stimulation.

The worst consequence of inadequate training for residents in regional anesthesia is:

A. Reluctance to attempt a block when clinically indicated

B. Attempting a block without the appropriate skills


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