Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942009000300008
Brazilian Journal of Anesthesiology
Scientific Article

Atitudes de anestesiologistas e médicos em especialização em anestesiologia dos CET/SBA em relação aos bloqueios nervosos dos membros superior e inferior

The attitude of anesthesiologists and anesthesiology residents of the CET/SBA regarding upper and lower limb nerve blocks

Pablo Escovedo Helayel; Diogo Brüggemann da Conceição; Mario José da Conceição; Gustavo Luchi Boos; Gustavo Bertoni de Toledo; Getúlio Rodrigues de Oliveira Filho

Downloads: 0
Views: 1015

Resumo

JUSTIFICATIVA E OBJETIVOS: O emprego da anestesia regional, em especial dos bloqueios nervosos periféricos (BNP) tem aumentado na prática anestesiológica devido à menor necessidade de instrumentação de vias aéreas, menor custo e excelente analgesia pós-operatória. Entretanto, sua utilização sofre restrições causadas pela falta de treinamento, maior tempo de realização, temor de complicações neurológicas e toxicidade sistêmica. O objetivo desse estudo foi medir as atitudes de anestesiologistas e médicos em especialização nos Centros de Ensino e Treinamento (CET/SBA) em relação aos BNP. MÉTODO: Foi construído um questionário com 25 itens sendo disponibilizado eletronicamente e por correio aos responsáveis de 80 CET, seus instrutores e médicos em especialização. RESULTADOS: Quarenta e dois CET (52,5%) devolveram 188 questionários, sendo 62 (32%) médicos em especialização (ME) e 126 (68%) anestesiologistas. O coeficiente de confiabilidade de Cronbach do questionário foi 0,79. A análise fatorial revelou seis fatores, que explicaram 53% da variância dos escores: fator 1 - atitudes positivas, responsável por 18,34 % da variância; fator 2 - treinamento/aplicação, responsável por 11,73 % da variância; fator 3 - aspectos negativos, responsável por 7,11 % da variância; fator 4 - fatores limitantes, responsável por 6,39 % da variância; fator 5 - anestesia regional como diferencial de competência, responsável por 5,79% da variância; e fator 6 - respeito pelo paciente, responsável por 5,4 % da variância. CONCLUSÕES: O questionário mostrou-se uma ferramenta fidedigna para medida de atitudes com relação à anestesia regional. Os anestesiologistas demonstraram maior interesse nos aspectos relacionados aos pacientes enquanto os ME tiveram como foco principal a aquisição de habilidades técnicas.

Palavras-chave

ANESTESIOLOGIA, Ensino, METODOLOGIA, TÉCNICAS ANESTÉSICAS, Regional

Abstract

BACKGROUND AND OBJECTIVES: The use of regional blocks especially peripheral nerve blocks (PNB) has been increasing in anesthesiology due to the reduced need to manage the airways, lower cost, and excellent postoperative analgesia. However, its use has restrictions due to the lack of training, that it takes longer to be done, fear of neurological complications, and systemic toxicity. The objective of this study was to measure the attitude of anesthesiologists and anesthesiology residents at Teaching and Training Centers (CET/SBA) regarding PNBs. METHODS: A 25-item questionnaire was developed and it was available, via the Internet and by mail, to those responsible for the 80 CETs, their instructors and residents. RESULTS: Forty-two CETs (52.5%) returned 188 questionnaires, 62 (32%) from anesthesiology residents and 126 (68%) from anesthesiologists. The Cronbach's alpha coefficient of the questionnaire was 0.79. Factor analysis revealed six factors that explain 53% of scores variance: factor 1 - positive attitude, responsible for 18.34% of the variance; factor 2 - training/use, responsible for 11.73% of the variance; factor 3 - negative aspects, responsible for 7.11% of the variance; factor 4 - limiting factors, responsible for 6.39% of the variance; and factor 5 - regional block as a competence differential, responsible for 5.79% of the variance; and factor 6 - respect for the patient, responsible for 5.4% of the variance. CONCLUSIONS: The questionnaire proved to be a reliable tool to measure the attitude regarding regional blocks. Anesthesiologists demonstrated greater interest for patient-related aspects, while the main focus of residents was the acquisition of technical abilities.

Keywords

ANESTHESIOLOGY, Teaching, ANESTHETIC TECHNIOQUES, Regional, METHODOLOGY

References

Horlocker TT. Peripheral nerve blocks: regional anesthesia for the new millennium. Reg Anesth Pain Med. 1998;23:237-240.

Oldman M, McCartney CJ, Leung A. A survey of orthopedic surgeons attitudes and knowledge regarding regional anesthesia. Anesth Analg. 2004;98:1486-1490.

Hadzic A, Vloka JD, Kuroda MM. The practice of peripheral nerve blocks in the United States: a national survey. Reg Anesth Pain Med. 1998;23:241-246.

Clergue F, Auroy Y, Pequignot F. French survey of anesthesia in 1996. Anesthesiology. 1999;91:1509-1520.

Smith MP, Sprung J, Zura A. A survey of exposure to regional anesthesia techniques in American anesthesia residency training programs. Reg Anesth Pain Med. 1999;24:11-16.

Kopacz DJ, Bridenbaugh LD. Are anesthesia residency programs failing regional anesthesia?: The past, present, and future. Reg Anesth. 1993;18:84-87.

Hasson F, Keeney S, McKenna HP. Research guidelines for the Delphi survey. J Adv Nurs. 2000;32:1008-1015.

Cronbach LJ, Warrington WG. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297-334.

VanDenKerkhof EG, Parlow JL, Goldstein DH. In Canada, anesthesiologists are less likely to respond to an electronic, compared to a paper questionnaire. Can J Anaesth. 2004;51:449-454.

Braithwaite D, Emery J, De Lusignan S. Using the Internet to conduct surveys of health professionals: a valid alternative?. Fam Pract. 2003;20:545-551.

Nora FS, Aguzzoli M, de Oliveira Filho GR. Atitudes atuais de anestesiologistas e médicos em especialização com relação à anestesia venosa total. Rev Bras Anestesiol. 2006;56:362-369.

Hadzic A, Vloka JD, Koenigsamen J. Training requirements for peripheral nerve blocks. Curr Opin Anaesthesiol. 2002;15:669-673.

Matthey PW, Finegan BA, Finucane BT. The publics fears about and perceptions of regional anesthesia. Reg Anesth Pain Med. 2004;29:96-101.

Helayel PE, da Conceição DB, Pavei P. Ultrasound-guided obturator nerve block: a preliminary report of a case series. Reg Anesth Pain Med. 2007;32:221-226.

Koscielniak-Nielsen ZJ. Ultrasound-guided peripheral nerve blocks: what are the benefits?. Acta Anaesthesiol. 2008;52:727-737.

Helayel PE, da Conceição DB, de Oliveira Filho GR. Bloqueios nervosos guiados por ultrassom. Rev Bras Anestesiol. 2007;57:106-123.

Hargett MJ, Beckman JD, Liguori GA. Guidelines for regional anesthesia fellowship training. Reg Anesth Pain Med. 2005;30:218-225.

Kopacz DJ, Neal JM. Regional anesthesia and pain medicine: residency training - the year 2000. Reg Anesth Pain Med. 2002;27:9-14.

Kopacz DJ. Regional anesthesia training: do we have the confidence to go on?. Reg Anesth Pain Med. 1999;24:1-4.

5dd67eec0e8825c82ec8fca7 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections