Online vs In-Person Education for Regional Anesthesia Training

Overseen by Hermann dos Santos Fernandes, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: University of Toronto

No Placebo Group

Trial Summary

What is the purpose of this trial?

This trial tests whether medical students can learn to perform an ultrasound-guided nerve block using online materials instead of traditional in-person classes. The study focuses on students who are new to this technique. The online resources include videos and images that teach students how to use ultrasound to find the right spot for a nerve block.

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications. It seems unlikely, as the trial focuses on educational methods for medical students.

What data supports the idea that Online vs In-Person Education for Regional Anesthesia Training is an effective treatment?

The available research shows that using ultrasound guidance for supraclavicular brachial plexus block is effective because it reduces complications and increases success rates. While the studies focus on the use of ultrasound in performing the block, they highlight the importance of learning these techniques, which can be done through both online and in-person education. The research suggests that ultrasound guidance makes the procedure safer and more efficient, which supports the idea that learning these skills, whether online or in-person, is beneficial. ^{1 2 3 4 5}

What safety data exists for supraclavicular brachial plexus block training methods?

The safety of supraclavicular brachial plexus block, particularly when guided by ultrasound, is well-documented. Studies show a low complication rate, with one large study reporting only 0.6% adverse events in 713 cases, none of which were clinically significant. Ultrasound guidance significantly reduces the risk of major complications like pneumothorax and nerve damage, making it a safe and efficient procedure. This technique is also considered safe for use in children, although there is limited data for those under six years old. ^{2 6 7 8 9}

Is learning about supraclavicular brachial plexus block online a promising treatment?

Yes, learning about supraclavicular brachial plexus block online is promising because it allows students to access a wide range of resources at their own pace, potentially leading to a better understanding of the procedure. Online resources can provide detailed visual guides and explanations, which can be especially helpful for understanding complex techniques like ultrasound-guided blocks. ^{3 4 5 10 11}

Research Team

Hermann dos Santos Fernandes, PhD

Principal Investigator

University of Toronto

Eligibility Criteria

This trial is for medical students who have done less than two ultrasound-guided supraclavicular blocks and are open to learning either through in-person teaching or by studying online materials independently. They must be willing to participate in an anonymous assessment of their skills.

Inclusion Criteria

I am a medical student willing to attend in-person teaching or study online.

Willing to undergo an anonymous skill acquisition assessment

I have had 2 or fewer ultrasound-guided blocks near my collarbone.

Exclusion Criteria

I have had ultrasound-guided nerve block near my collarbone more than twice.

I have chosen not to participate in this study.

Treatment Details

Interventions

• Conventional in-person teaching on supraclavicular brachial plexus block (Behavioural Intervention)
• Self exploring of available online material on supraclavicular brachial plexus block (Behavioural Intervention)

Trial Overview The study aims to compare the effectiveness of self-study using online resources from NYSORA and USRA with traditional, in-person teaching methods for performing ultrasound-guided supraclavicular brachial plexus block, a regional anesthesia technique.

Participant Groups

Group I: Online group Experimental Treatment 1 Intervention

Independent learning with online educational material

Group II: In-person group Active Control 1 Intervention

Conventional in-person standardized teaching

Who Is Running the Clinical Trial?

University of Toronto

Lead Sponsor

Trials

739

Recruited

1,125,000+

Findings from Research

A study analyzing 175 YouTube videos on ultrasound-guided brachial plexus blocks found that academic, manufacturer, and educational videos had significantly better accuracy and reliability compared to individual videos, indicating that source matters for effective learning.

Manufacturer and educational videos also scored higher in educational quality, suggesting that these types of videos are more beneficial for teaching the procedure, while all sources showed weaknesses in addressing equipment preparation and post-procedure care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reliability and Quality of YouTube Videos on Ultrasound-Guided Brachial Plexus Block: A Programmatical Review. Cho, NR., Cha, JH., Park, JJ., et al.[2021]

Ultrasound-guided supraclavicular brachial plexus block significantly reduces the risk of major complications, such as pneumothorax, compared to traditional methods.

The review highlights the effectiveness of ultrasonography in enhancing the safety and efficiency of regional anesthesia techniques, making it a valuable tool in modern medical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Renaissance of supraclavicular brachial plexus block. Sadowski, M., Tułaza, B., Lysenko, L.[2019]

In a study of 120 patients undergoing ultrasound-guided supraclavicular blocks, using 30 ml of 1% mepivacaine achieved a 90% success rate, making it the recommended volume for optimal results.

Lower volumes of local anesthetic (20 ml) resulted in a significantly lower success rate (66.7%), while the highest volume (35 ml) was associated with a higher incidence of Horner's syndrome, indicating a trade-off between efficacy and safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of ultrasound-guided supraclavicular block according to the various volumes of local anesthetic. Jeon, DG., Kim, SK., Kang, BJ., et al.[2021]

Ultrasound-guided supraclavicular brachial plexus blocks can be safely performed in pediatric patients, allowing for direct visualization of nerves and monitoring of local anesthetic distribution.

This technique helps reduce the risk of complications, such as pneumothorax and inadvertent intravascular injection, making it a valuable approach for upper limb surgeries in children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultrasound-guided supraclavicular brachial plexus block in pediatric patients -A report of four cases-. Yang, CW., Cho, CK., Kwon, HU., et al.[2021]

Ultrasound-guided regional anaesthesia, particularly the supraclavicular block, has gained popularity due to its enhanced safety profile compared to traditional methods.

The review emphasizes that ultrasound guidance allows for more precise placement of the block, potentially leading to better outcomes and reduced complications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultrasound guided supraclavicular block. Hanumanthaiah, D., Vaidiyanathan, S., Garstka, M., et al.[2019]

In a study of 713 patients undergoing hand surgery with ultrasound-guided supraclavicular nerve blocks, only 4 adverse events (0.6%) were reported, indicating a very low complication rate.

The study found no significant pulmonary or neurovascular complications, supporting the safety and efficacy of using ultrasound-guided supraclavicular blocks in an outpatient surgery center setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Evaluation of Complications Following Ultrasound-Guided Regional Block Anesthesia in Outpatient Hand Surgery. Voskeridjian, AC., Calem, D., Rivlin, M., et al.[2022]

In a study of 80 participants undergoing angioplasty for dysfunctional arteriovenous access, the ultrasound-guided supraclavicular brachial plexus block (BPB) significantly reduced pain levels compared to the control group, with average pain scores of 0.9 versus 6.4 on a 10-point scale.

Participant satisfaction was also higher in the BPB group, indicating a better overall experience, while the long-term patency rates of arteriovenous access were similar between both groups, suggesting that BPB is effective and safe without increasing complications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy and Safety of Ultrasound-Guided Supraclavicular Brachial Plexus Block during Angioplasty of Dysfunctional Arteriovenous Access: A Prospective, Randomized Single-Center Clinical Trial. Heo, S., Won, JH., Kim, J., et al.[2020]

The study reviewed four methods of brachial plexus block using the supraclavicular approach, highlighting that while the effectiveness of these techniques is similar, newer methods have fewer side effects.

Among the techniques analyzed—Kulenkampff's, Winnie's, Brown's, and Alemanno's—the latest methods showed a significant reduction in potential side effects, making them safer options for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Sopraclavicular techniques for brachial plexus block]. Alemanno, F.[2006]

The study involved 17 pediatric patients aged 6 months to 6 years and demonstrated that ultrasound-guided supraclavicular brachial plexus block is both effective and safe for upper extremity surgeries, with no reported complications.

The procedure had a mean establishment time of 89.59 seconds and provided analgesia lasting an average of 9.76 hours, indicating that ultrasound guidance can enhance the accuracy and reliability of this anesthetic technique in young children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Upper extremity surgery in younger children under ultrasound-guided supraclavicular brachial plexus block: a case series. Amiri, HR., Espandar, R.[2021]

Supraclavicular block has been a key technique in upper limb surgeries since its introduction in 1911, and its application has evolved with advancements in technology like peripheral nerve stimulators and ultrasound.

This case report highlights the effective use of supraclavicular block in a patient with multiple health conditions, suggesting its potential to safely extend the use of regional anesthesia during challenging times, such as the COVID-19 pandemic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Low-volume ultrasound-guided supraclavicular block in a multicomorbid patient for emergency vascular surgery - In COVID-19 era. Lonikar, AV., Diwan, SM., Sancheti, PK.[2022]

The infraclavicular brachial plexus block is quicker to perform than the supraclavicular block, taking an average of 9.57 minutes compared to 11.53 minutes, while both methods have similar success rates of 93.3%.

The infraclavicular block also leads to a faster onset of sensory blockade (6.43 minutes) compared to the supraclavicular block (8.45 minutes), and it has fewer complications, making it the preferred choice for upper limb surgeries.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomised comparative evaluation of supraclavicular and infraclavicular approaches to brachial plexus block for upper limb surgeries using both ultrasound and nerve stimulator. Abhinaya, RJ., Venkatraman, R., Matheswaran, P., et al.[2020]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Reliability and Quality of YouTube Videos on Ultrasound-Guided Brachial Plexus Block: A Programmatical Review. [2021]

2. Poland pubmed.ncbi.nlm.nih.gov

Renaissance of supraclavicular brachial plexus block. [2019]

3. Korea (South) pubmed.ncbi.nlm.nih.gov

Comparison of ultrasound-guided supraclavicular block according to the various volumes of local anesthetic. [2021]

4. Korea (South) pubmed.ncbi.nlm.nih.gov

Ultrasound-guided supraclavicular brachial plexus block in pediatric patients -A report of four cases-. [2021]

5. Romania pubmed.ncbi.nlm.nih.gov

Ultrasound guided supraclavicular block. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

An Evaluation of Complications Following Ultrasound-Guided Regional Block Anesthesia in Outpatient Hand Surgery. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Efficacy and Safety of Ultrasound-Guided Supraclavicular Brachial Plexus Block during Angioplasty of Dysfunctional Arteriovenous Access: A Prospective, Randomized Single-Center Clinical Trial. [2020]

8. Italy pubmed.ncbi.nlm.nih.gov

[Sopraclavicular techniques for brachial plexus block]. [2006]

9. England pubmed.ncbi.nlm.nih.gov

Upper extremity surgery in younger children under ultrasound-guided supraclavicular brachial plexus block: a case series. [2021]

10. India pubmed.ncbi.nlm.nih.gov

Low-volume ultrasound-guided supraclavicular block in a multicomorbid patient for emergency vascular surgery - In COVID-19 era. [2022]

11. India pubmed.ncbi.nlm.nih.gov

A randomised comparative evaluation of supraclavicular and infraclavicular approaches to brachial plexus block for upper limb surgeries using both ultrasound and nerve stimulator. [2020]