Current trends in Regional Anesthesia: a survey on Portuguese Anesthesiologists motivation and practice

Background and Goal of Study: 
The use of Regional Anesthesia (RA) techniques, particularly peripheral nerve blocks, has gained increasing popularity as part of Anesthesia and Pain management. Little is known about Anesthesiologists individual predisposition for RA. The purpose of this study was to determine the factors affecting the practice of regional blocks among the Portuguese Anesthesiologists.

Materials and Methods: 
A 41-item questionnaire named “The Practice of Regional Anesthesia Questionnaire” (PRAQ) was designed through a focus group event followed by a Delphi process. The PRAQ is composed of 4 scores: motivation, advantages, training and barriers. Each score includes 8, 10, 5 and 9 questions and the questions were rated on a 5 point Likert scale.  The questionnaire was sent by email to Anesthesiologists of 25 Portuguese Hospitals. Statistical analysis was performed with SPSS22.0 and Epi Info (significant level α=0.05).

Results and Discussion: 
173 Anesthesiologists answered the questionnaire. 70 (41.5%) were specialists in Anesthesia for less than 10 years. When compared with Anesthesiologists working for 10 or more years, the younger achieved higher scores on motivation and advantages (p<0.05). 43.4% of Anesthesiologists were members of a RA Society which denote a special interest in this area. Comparatively to the non-members group, members were more motivated and exhibit more versatility in RA (p<0.05). This group considered that experience in RA is determinant in the choice of type of anesthesia.  52% of responders didn’t execute regional blocks in children due to inadequate training. The opinion about the barriers to RA didn’t differ between the Anesthesiologists. 64% didn’t believe that RA delays the starting times of surgeries or the time for discharge from a post-anesthesia care unit. For 32 Anesthesiologists the pressure employed by other professionals influenced the choice of anesthetic technique. 91.9% considered ultrasound guidance increased the safety of RA and 56.6% prefer the application of ultrasound to regional blocks.

Conclusion:
Most Portuguese Anesthesiologists were motivated and interested in RA. Training programs must be implemented to turn RA in a competency of every Anesthesiologist. The questionnaire responders considered that the acquisition of competencies in advanced RA techniques added value to the Anesthesiology Department.

Current trends in regional anesthesia: a survey on Portuguese anesthesiologists motivation and practice