TITLE:
A Structured Method of Teaching Epidural Block reduces the incidence of accidental dural puncture in inexperienced trainees.
AUTHORS:
Marco Scorzoni, Gianluigi Gonnella, Emanuele Capogna, Marina Campione, Gaetano Draisci, Matteo Velardo, Giorgio Capogna
KEYWORDS:
teaching, epidural Anesthesia, obstetrical Anesthesia, Anesthesia
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.14 No.4,
April
24,
2024
ABSTRACT: Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the construction of a 3D epidural module by trainees and practical training by using an epidural simulator with and without the CompuFlo™ Epidural instrument.
In this study we report the retrospective analysis of the accidental dural puncture rate of inexperienced trainees during their 6 months clinical practice rotation in obstetrics before and after the introduction of the SETM in our Institution.
Method: We evaluated the incidence of accidental dural puncture before the introduction of the SETM methodology and afterwards by analyzing our departmental database from February 2019 to January 2023. All epidural blocks were executed by trainees who had never previously performed an epidural block and were about to begin their obstetrics rotation.
Results: We analyzed 7415 epidurals: 3703 were performed before the introduction of the SETM methodology (control group) and 3712 afterwards (study group). The incidence of accidental dural puncture was 0.37% for the control group and 0.13% for the study group (pConclusions: After the introduction of the structured teaching method, we observed a significant reduction of accidental dural puncture during the training period. We hope that our observation will encourage a constructive discussion among experts about the need to use standardized and validated tools as a valuable aid in teaching epidural anesthesia.