Regional anesthesia and pain medicine: residency training--the year 2000

Abstract

Background and objectives: A survey of anesthesiology training programs in 1980 reported the use of a regional anesthetic technique in 21.3% of cases. A similar survey of anesthesiology training programs in 1990 reported that the use of regional anesthetic techniques had increased to 29.8%. Over the ensuing 10 years, additional changes have occurred in the field of anesthesiology and its United States residency training programs. This manuscript reports the impact these changes have had on the use of regional anesthesia techniques in residency training programs in the year 2000.

Methods: Blinded cumulative data about regional anesthetic techniques performed by anesthesiology residents were obtained from all annual training report forms submitted to the Residency Review Committee for Anesthesiology. Exposure to obstetric (OB) anesthesia, pain management, and a resident's year-in-training were analyzed as independent factors expected to influence the use of regional anesthesia.

Results: Anesthesiology trainees used a regional anesthesia technique in 30.2% of cases in the year 2000. This represents an insignificant change from 1990 and a marked slowing in the growth of regional anesthesia techniques compared with the 1980 to 1990 period. The use of regional anesthesia remains strongly correlated with a resident's exposure to OB anesthesia and pain consultations. Variability in exposure to regional anesthesia techniques among individual residents has decreased.

Conclusions: Anesthesiology training programs now appear to provide a satisfactory exposure to regional anesthesia for a majority of resident trainees, although 40% of residents may still be deficient in nerve block anesthesia. The growth in the use of regional anesthesia during residency has plateaued over the past decade, but the discrepancy between individual resident experience has improved.