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Department of Anesthesiology
Duke University Medical Center
Box 3094
Durham, NC 27710

Office of Medical Education
Duke University Medical Center
Box 3005
Durham, NC 27710

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Within the clinical specialty of anesthesiology a strong interest in regional anesthesia (peripheral nerve blocks) has continued to develop over the last decade. Within the last few years this interest has been further assisted by the introduction of handheld ultrasound devices. This is evidenced by the increasing number of dedicated ultrasound-guided regional anesthesia workshops offered by the two largest anesthesia societies, namely the American Society of Anesthesiologists (ASA) and the American Society of Regional Anesthesia (ASRA). Members of the Regional Division, Department of Anesthesiology at Duke have regularly participated as the faculty of these courses as well as the Duke ultrasound course, now in its fifth year. The location of the venues (typically hotel conference rooms) precludes the use of cadaveric tissue with which to demonstrate at close hand the relation of the pertinent nerves to adjacent tissues. It has been well recognized that this “hands-on” cadaveric teaching helps to emphasize the participants’ understanding of anatomy that can be readily transferred to the improvement of clinical skills of nerve block placement.

The opportunity for both anesthesia residents and practicing physicians to encounter cadaveric dissections is very limited as the majority of residency programs do not offer any anatomy education in the gross anatomy lab and, likewise, many practicing physicians rarely have access to anatomy labs.

The Human Fresh Tissue Lab at Duke University is a dedicated facility using fresh tissue specimens, in contrast to formalin-preserved cadavers. The color and texture of the tissue is far better preserved. This permits clear identification of anatomical structures and the differentiation of nerves from adjacent tissues.

TARGET AUDIENCE

This activity is designed to educate or refresh the knowledge of practicing anesthesiologists, critical care specialists, anesthesiology residents and students.

LEARNING OBJECTIVES

At the end of the workshop, the registrant will be able to:

1. Describe the anatomy of the peripheral nervous system (brachial, lumbar and sacral plexuses and their terminal branches).
2. Correlate the neuroanatomy with techniques to provide nerve blocks of the upper and lower extremities.
3. Use an ultrasound device to visualize nerves at common sites for nerve blockade.
4. Discuss the side effects and complications of nerve block techniques related to the proximity of adjacent anatomical structures.
5. Recognize the signs and symptoms of local anesthetic toxicity and describe the appropriate clinical management of this complication.

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