survey of the practice of regional anesthesia in Saudi Arabia

This survey aimed to assess both the extent of practice and need for training in regional anesthesia among anesthesiologists in Saudi Arabia in 2012. We distributed an electronic survey among 382 anesthesiologists attending the bi-annual meetings of the Saudi Anesthetic Association, enquiring about their practice in regional anesthesia. Questions concerned the practice of regional anesthesia, use of ultrasound guidance, and the need for training workshops. The response rate of anesthetists was 55.2% with most of them were males and had mean age of 25-50 years. Most anesthesiologists [88.2%] were practicing regional anesthesia frequently in the operating rooms [75.3%] rather than designated block room. From the respondents, only 14.2% did fellowship in regional anesthesia, 21.8% and 18.5% were using ultrasound and nerve stimulation guidance, respectively, 11.4% received formal training, and 86.3% were willing to attend training workshops on regional anesthesia. There was a significant negative correlation between the ultrasound users and their institutional positions [r=-0.191] [P=0.026]. We believe that more could be done to improve the practice of regional anesthesia in the Kingdom of Saudi Arabia, including the implementation of formal training and conduction of more frequent specialized courses/workshops in the field of regional anesthesia with special reference to ultrasound regional anesthesia blockade techniques

influence of bilateral superficial cervical plexuses block [BSCBs] as pre-emptive analgesia on patient satisfaction after thyroid surgery

Superficial cervical nerve block may reduce post-thyroidectomy pain. The aim of this study was to evaluate the influence of BSCBs as pre-emptive analgesia on patient satisfaction post- thyroidectomy surgery. Fifty adult patients were randomly allocated to one of the two groups, to receive either 20 mL isotonic sodium chloride solution [Saline group] or 20 mL bupivacaine 0.25% [Bupivacaine group] as BSCBs before induction of general anesthesia. Thyroid surgery was performed according to a standardized procedure by the same surgeon. Patients were transferred to the PACU where they stayed for 2 h, then were transferred to the ward. Morphine was administered in PACU following a standardized protocol [1-2 mg repeated every 10 minutes until the pain was controlled] if the VAS score was >/= 40 mm. Postoperative pain: was assessed by visual analogue scale [VAS], with 100 being the worst pain and 0 being no pain, by a nurse trained in pain assessment when patient is fully awake and extubated [H0], before discharge from the PACU [H+2], and every 4 h until 24 h after the end of surgery. Was evaluated the day after surgery by the anaesthetist using a 5- point verbal score [0: poor; 1: moderate; 2 good; 3: very good; 4 excellent. Total amount of morphine used in PACU and after 24hours. All adverse effects were recorded. There were no significant statistical differences between both groups as regard demographic data, duration of anesthesia and duration of surgery. The main outcome variables were pain scores [VAS], the proportion of patients given morphine at PACU and 24-h after surgery as well as the amount of morphine required. The Bupivacaine group had a smaller proportion of patients given morphine [24% vs. 72%; P = 0.0016] and [40% vs. 84%] in PACU and 24 hour after surgery respectively. Patients given BSCBs had significantly lower VAS with excellent satisfaction. We conclude that bilateral superficial cervical plexus blocks significantly reduce pain intensity and Opioids requirement in the postoperative period after thyroid surgery with excellent patient satisfaction