The most effective way of delivering regional anaesthesia training and the best means of demonstrating competency have not been established. Clinical competency, based on the Dreyfus and Dreyfus lexicon, appears unachievable using current training approaches. Lessons should be taken from the worlds of music, chess, and sports. Modern skills training programmes should be built on an explicit and detailed understanding with measurement of a variety of factors such as perception, attention, psychomotor and visuospatial function, and kinesthetics, coupled with quantitative, accurate, and reliable measurement of performance.
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http://dx.doi.org/10.1016/j.bja.2024.06.003 | DOI Listing |
JAMA Intern Med
January 2025
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Importance: There are no validated decision rules for terminating resuscitation during in-hospital cardiac arrest. Decision rules may guide termination and prevent inappropriate early termination of resuscitation.
Objective: To develop and validate termination of resuscitation rules for in-hospital cardiac arrest.
J Pain Res
January 2025
School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada.
Purpose: Complex regional pain syndrome (CRPS) is a debilitating chronic pain condition characterized by sensory, motor, and autonomic dysfunction with a world-wide prevalence of 26.2 per 100,000 people per year and is 3 to 4 times more prevalent in females. Repetitive transcranial magnetic stimulation (rTMS) has shown to be beneficial for pain relief in neuropathic pain and initial evidence in CRPS is promising, but studies are limited.
View Article and Find Full Text PDFJ Pain Res
January 2025
Department of General Surgery, The 955th Hospital of Chinese People's Liberation Army, Tibet, 854000, People's Republic of China.
Fracture surgeries are frequently accompanied by severe pain, necessitating efficacious pain management strategies to enhance postoperative recovery. Nerve block techniques, which are critical in mitigating pain, involve the targeted administration of local anesthetics to disrupt nerve signal transmission, thereby achieving significant analgesia. Traditionally, these techniques rely on anatomical landmarks and the clinician's expertise, which can introduce variability and potential risks.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
December 2024
Department of Anesthesiology, Missoula Anesthesiology and The International Heart Institute of Montana, Missoula, MT.
Patients after thoracic surgery experience significant pain that can disrupt normal respiratory mechanics, increase the risk of respiratory complications, and impair recovery. Poorly controlled postoperative pain can develop into persistent postoperative pain. In addition, using opioids for pain control in the thoracic surgical population makes them more susceptible to opioid-related side effects due to their pre-existing comorbidities.
View Article and Find Full Text PDFBr J Anaesth
January 2025
Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.
Background: Moderate-to-severe pain is common after cardiac surgery, peaking during the first and second postoperative days. Several nerve blocks for sternotomy have been described; however, the optimal location for continuous catheters has not been established. This study assessed the feasibility of a larger trial evaluating the efficacy of serratus anterior plane (SAP) catheter analgesia for sternotomy pain.
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