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Regional Anesthesia and Acute Pain: Original Article
Impact of Video Technology for Improving Success of Medial Canthus Episcleral Anesthesia in Ophthalmology
  1. Gilles Guerrier, MD, PhD*,†,
  2. Pierre-Raphaël Rothschild, MD, PhD‡,
  3. Mathieu Lehmann, MD‡,
  4. Frédéric Azan, MD‡ and
  5. Christophe Baillard, MD, PhD*
  1. *Service d'Anesthésie-Réanimation, Hôpital Cochin Hôtel-Dieu, †Département de Simulation en santé iLumens, and ‡Service d'Ophtalmologie, Hôpital Cochin Hôtel-Dieu, Université Paris Descartes, Paris, France
  1. correspondence: Gilles Guerrier, MD, PhD, Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France (e-mail: guerriergilles{at}gmail.com).

Abstract

Background and Objectives Efficient learning of regional anesthesia in ophthalmology remains challenging because trainees are afforded limited opportunity to practice ocular anesthesia. The aim of this prospective, randomized, blinded study was to determine whether teaching with video improves regional anesthesia skills of residents in ophthalmology.

Methods From January to October 2016, 32 novice anesthesiology residents were evaluated while performing medial canthus episcleral procedures during a 5-day rotation. Residents were randomly assigned to either receive or not receive a video review of their performance at day 3. The primary outcome was a comparison of akinesia using a 12-point scale before incision assessed by the blinded surgeon.

Results A total of 288 blocks were performed by 32 residents and were assessed by 3 surgeons before the intervention (144 blocks) and after the intervention (144 blocks). Residents in the review group improved to a greater degree compared with residents in the no-review group. The median overall akinesia scores for the review and no-review groups were similarly low (6; interquartile range [IQR], 2–11; and 6 [IQR, 2–9], respectively) on day 1 of the rotation, whereas anesthesia performed by residents in the video group provided a better akinesia score (12 [IQR, 10–12] vs 8 [IQR, 6–10]; P < 0.001) on day 5 of the rotation.

Conclusions Video-assisted teaching significantly improves performance of medial canthus episcleral anesthesia performed by novice trainees.

https://doi.org/10.1097/AAP.0000000000000658

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    Footnotes

    • No funding was received to perform the study.

      The authors declare no conflict of interest.

      Authors' Contributions: G.G. and C.B. conceived and designed the experiments and wrote the paper. G.G., P.-R.R., M.L., and F.A. performed the experiments. G.G. analyzed the data.