Plexus and peripheral nerve block Questionnaire

Dear Anaesthesiologist,
You are requested to take part in the survey for “Epidemiology, diversities and differences in Plexus and Peripheral nerve blocks: A multi-national Survey” which will help us to study the usage and practices of various blocks across the globe. Your consent is voluntary and this would take 10-15 mins. Collected data will be used for the analysis while maintaining anonymity. We appreciate your time & knowledge sharing. Thank you for taking up the survey.

DEMOGRAPHICS


1 Age

2 What is your professional experience in anaesthesia? (For the purpose of study, 3 years in anaesthesia is considered as training. Post training- PT)

  • Trainee (Upto 3yrs)
  • 3-5 years PT
  • >5-10 yrs PT
  • >10-20 yrs PT
  • >20 yrs PT

3 What is the current nature of your anaesthesia setting? (Can consider multiple options)

  • Government/ Public Hospital
  • Private Hospital
  • Teaching Hospital
  • Corporate Hospital
  • Private Practitioner/Freelancer

4 How frequently are you using Plexus/ peripheral nerve Blocks (PNBs) for perioperative care?

  • Everyday
  • Twice weekly
  • Weekly
  • Fortnightly
  • Monthly

5 If a procedure can be done safely under either plexus or PNBs /General Anaesthesia (GA), what will be your preferred choice?

  • GA
  • PNB for surgical anaesthesia - No sedation
  • PNB with conscious sedation
  • GA with PNB for analgesia
  • Surgery dependent choice

6 How frequently do you discuss the PNB plan with your patients?

  • Always
  • > 70%
  • >50-70%
  • 20-50%
  • < 20%

7 What is the most appropriate reason according to you for using plexus/ PNBs?

  • Safety
  • Improved outcome and Pain relief
  • Patient's Choice
  • Surgeon's Choice
  • Others

8 Where do you perform the blocks mostly?

  • Operating room
  • Preoperative holding area
  • Induction room
  • Regional anesthesia block area (RABA)/Dedicated procedure room
  • Recovery area

9 What are the barriers to practice PNBs in your set-up? (Can consider multiple options)

  • Surgeon factors
  • Equipment Issues
  • Time factor
  • Knowledge/ Experience
  • Cost factor
  • Patient refusal
  • Others

10 How do you chiefly achieve training in plexus and PNBs?

  • Self-taught
  • Fellowship
  • Courses and workshops
  • Residency Training
  • Peer-assisted learning
  • Others

11 What is your preferred resource for Plexus & PNBs when in doubt, or to teach on a day-to-day basis?

  • Internet websites
  • YouTube videos
  • Mobile Apps
  • Textbooks
  • RA teachers/ Seniors
  • Others

BLOCK PERFORMANCE

12 What is the preferred method of skin preparation and asepsis for plexus/ PNBs?

  • Povidone iodine
  • 0.5% Chlorhexidine with alcohol
  • 2% Chlorhexidine with alcohol
  • Alcohol
  • Combination of Povidone iodine and Chlorhexidine with alcohol
  • Cetrimide
  • Others

13 What is your preferred practice for USG Probe asepsis?

  • Sterile gloves
  • Probe cover/Camera cover
  • Transparent adhesive dressing
  • Chlorhexidine with alcohol rubs
  • Sterile Cling drapes
  • None
  • Others

14 How do you mostly localize plexus/ nerves before blocks?

  • Landmark technique
  • PNS guided
  • USG Guided
  • USG with PNS guided

15 What monitoring is/are applied in your context while performing a nerve block? (Can consider multiple options)

  • ECG
  • Pulse-oximeter/ peripheral oxygen saturation
  • NIBP
  • End Tidal CO2
  • All of the above
  • Others

16What monitoring is/are applied in your context after performing a nerve block? (Can consider multiple options)

  • ECG
  • Pulse-oximeter/ peripheral oxygen saturation
  • NIBP
  • End Tidal CO2
  • All of the above
  • Others

17 What percentage of paediatric patients in your setting receive PNBs (Not caudal/ central neuraxial blocks)?

  • > 70%
  • > 50-70%
  • 20-50%
  • < 20%
  • None

18 Do you use sedation/ conscious sedation for your patients before blocks?

  • Always
  • Apprehensive patients only
  • Only paediatric patients
  • Both Apprehensive and paediatric patients
  • Never

19 What is the preferred mode of plexus/ nerve block at your place?

  • Single injection
  • Catheter for infusion in adults only
  • Catheter for infusion in paediatric patients only
  • Both single injection/catheter

20 What is your preferred local anaesthetic drug used for plexus and nerve blocks:

  • Bupivacaine
  • Ropivacaine
  • Lignocaine
  • Bupivacaine with lignocaine
  • Ropivacaine with Lignocaine
  • Others

21 What is your preferred adjuvant for PNBs?

  • Clonidine
  • Dexamethasone
  • Dexmedetomidine
  • Fentanyl
  • Sodium bicarbonate
  • Others
  • None

22 What kind of needles are mostly used for Plexus/ PNBs in your context?

  • Hypodermic needles
  • Spinal needle
  • Tuohy Needle
  • Short bevel Needles
  • Stimulating nerve block needle
  • Echogenic Needles
  • Other

23 Does the cost of Regional anaesthesia equipment (Needles, USG etc) restrict its usage in your practice?

  • Always
  • Often
  • Rarely
  • Never

24 Can you specify the chief modality of documentations of plexus/ PNBs in your setting?

  • As part of Anaesthesia chart
  • e-logbook
  • Separate RA form/ audit form
  • Separately in the patient file/ progress note
  • No documentation

25 What are the perceived limitations of PNBs in your context? (Can consider multiple options)

  • Low success rate
  • Time constraints
  • Poor patient acceptability
  • Risk of adverse events
  • No limitations
  • Others

26 What is/are the most common complication(s) that you have encountered during/after PNBs performance: (Can consider multiple options)

  • LA toxicity
  • Neurological deficits
  • Wrong side block
  • Pneumothorax
  • Respiratory Depression
  • Cardiac Arrest
  • None
  • Others

27 Do you have easy access to Lipid Emulsion (Eg Intralipid) in the location of RA block performance?

  • Yes
  • No

28 Are there any practice changes done after witnessing the complication? (Can consider multiple options)

  • Effort to improve skills and knowledge
  • Changed to PNS guided
  • Changed to USG guided
  • Changed drug concentration
  • Changed drug volume
  • Stopped RA practice
  • Not Applicable
  • No change was implemented
  • Others

29 What is the most common Upper limb block performed by you?

  • Interscalene
  • Supraclavicular BPB
  • Infraclavicular
  • Costoclavicular
  • Axillary approach
  • Isolated Nerve blocks
  • Others
  • None performed

30 What is the most common Lower limb block performed by you?

  • Femoral Nerve block
  • Fascia Iliaca Block
  • Adductor canal Block
  • Sciatic Nerve block (above popliteal)
  • Popliteal Sciatic Block
  • Ankle Block
  • Lumbar plexus block
  • Sacral Plexus Block
  • Others
  • None performed

31 Most common Thoracic wall Block performed by you?

  • Pectoserratus Plane block
  • Serratus anterior plane block
  • Erector spinae plane block
  • Paravertebral Block
  • Intercostal Nerve Block
  • Others
  • None performed

32 Most common Abdominal wall Block performed by you?

  • Transversus abdominis plane block
  • Rectus sheath block
  • Ilio-inguinal and ilio-hypogastric nerve block
  • Quadratus lumborum block
  • Others
  • None performed

33 What is the postoperative follow-up duration of the patients who received plexus/PNBs?

  • Less than 6 hours
  • 6-12 hours
  • 13-24 hours
  • Till full sensory-motor recovery
  • Till discharge from hospital
  • Till catheter removal (if placed)
  • Others

34 What type of patients are followed up after a plexus/ PNBs?

  • All
  • Only those who had paraesthesia while performing nerve block
  • Patients with prolonged sensory motor deficit/ delayed recovery
  • Others

35 Are you a member of any regional anaesthesia society?

  • Yes, National
  • Yes, International
  • Both National & International
  • None