ESRA 2011
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ESRA 2011 - Regional Anaesthesia Conference

Preliminary List of sessions 

  1. Refresher Courses
  2. Symposia
  3. Expert Panel Discussions 
  4. Ask the Expert
  5. Pro-Con Debates
  6. Luncheon Discussions
  7. Lecture Workshops
  8. Hands-On Workshops: Landmark, Cadaver, and Ultrasound Workshops*

*These workshops count toward application for an ESRA Diploma

  Regional Anaesthesia Sessions
  Acute & Chronic Pain Sessions

REFRESHER COURSES

Regional AnAesthesia                                                                          

  • Peripheral Blocks and Anticoagulation                                                                             
  • What Does it Take to get Started US-Guided Nerve Blocks                                             
  • Role of Ultrasonography in Neuraxial and Truncal Techniques                              
  • Role of Ultrasonography in Lower Limb Blocks                                                            
  • Preeclampsia Revisited                                                                                                               
  • Which is the Best Analgesic Solution for Labour Analgesia?                                          
  • Future Directions for Regional Anaesthesia in Fast-Track Surgery                              
  • Bariatric Surgical Techniques and its Implications Under RA                                          
  • Adjunct Drugs for Central and Peripheral Nerve Blocks in Paediatric Patient     
  • Safety of Epidural Anaesthesia
  • Optimal Thoracic Epidural Analgesia                                                   
  • Nerve Damage after RA: Incidence, Diagnosis and Management                            
  • Non Anaesthetic Effects of Local Anaesthetics                                                                    
  • Regional Anaesthesia and Organ Protection                                                   
Acute & Chronic Pain
  • Role of Ultrasonography in Pain Therapy                              
  • Musculoskeletal Pain: Basic Central Mechanisms                                                                   
  • Current knowledge of Complex Regional Pain Syndrome                                  
  • Persistent Postoperative Pain: Pathogenic Mechanisms and Treatment Strategies 
  • Low Back Pain: Assessment and Management                                                               
  • Integrating Mechanism of Neuromodulation with Mechanism of Pain                         
  • Management of Acute Pain in Acute Tolerant Patient                                                    
  • Can We Predict Which Patients will Suffer from Pain after Operation?                         

SYMPOSIA 

REGIONAL ANAESTHESIA 

S1. ASRA/ESRA Joint Session: 

Ambulatory Anaesthesia Practice

  • Patients selection guidelines and decissions
  • Anaesthesia techniques application
  • Selection of Local Anaesthetic and Adjuvants
  • Postoperative pain management
  • Panel Discussion

S2.Peripheral nerve blocks revisited

  • Upper limb Double Block in two shots                                                                
  • Phrenic nerve sparing brachial plexus blocks                                                   
  • Peripheral nerve block proposals for outpatient knee arthroscopy               
  • How many sciatic approaches? , US has the answer.                                          
  • Discussion

S3.Cancer surgery and implications of anaesthesia

  • Perioperative risk factor for cancer recurrence                                                       
  • Anticancer Chemotherapy and it's Anaesthetic Implications                                
  • Effect of anaesthetic technique on cancer recurrence                                           
  • Inflammation and cancer: a common pathway                                                        
  • Discussion

S4. How much ultrasonography has changed the practice of Regional anaesthesia?

  • Ultrasound for follow up after nerve damage                                                   
  • Intercostal block– Paravertebral block                                                                            
  • Infraclavicular brachial Plexus Approach?                                                                
  • Peripheral nerve catheter                                                                                           
  • Discussion                                                                                                             

S5. Quality management in regional anaesthesia

  • Education in regional anaesthesia                                                                                                   
  • Paths of medical innovation, discovery and translation                                          
  • Complication management in regional anaesthesia                                                         
  • A German network for safety in regional anaesthesia                                                    
  • Discussion

S6.Complications in regional anaesthesia                                                                          

  • Critical incident reports involving regional anaesthesia                                         
  • Wrong sided blocks                                                                                                                               
  • Incidence of falls/injuries after lower limb blocks                                                           
  • Poor aftercare/lack of staff                                                                                                              
  • Discussion

S7. C-Section revisited

  • Unplanned C-section in labour: how to proceed ?                                                          
  • Low dose spinal anaesthesia for C-section: techniques, advantages and risks 
  • Modern forms of postoperative analgesia after C-section                                     
  • Chronic pain after C-section: myth or fact ?                                                                         

S8. Complications in OB anaesthesia:

  • Major Obstetric hemorrhage                                                                                                         
  • Cardiac arrest in pregnancy                                                                                                               
  • Failed intubation: prophylaxis and management                                                           
  • PDPH, anything new in OB patients                                                                                         

S9.Labour analgesia

  • CSE or epidural analgesia for labour                                                                                       
  • Alternatives to regional analgesia for labour pain relief                                         
  • Patient controlled epidural analgesia for labour, the modern way                      
  • Postpartum neuropathy: how to handle      

> Top

                                                                          

PAIN ACUTE/CHRONIC

S1. Discogenic low back pain (DLBP)

  • Standard Criteria for diagnosing discogenic pain                                              
  • Is Provocation Discography a Measure of Intradiscal Mechanical Hyperalgesia?
  • Outcome predictors of thermal annuloplasty for DLBP                                   
  • Discussion

S2. Geriatric pain management

  • Pharmacokinetic and pharmacodynamic changes                                            
  • Drugs used in the management of acute pain in older people                         
  • Intrathecal opioid analgesia delivery                                                                   
  • Epiduroscopy and treatment of adhesions in the epidural space                  

S3. Current developments in neuromodulation techniques for chronic pain management

  • Neuronavigation                                                                                                      
  • Role of paresthesia perception in outcome                                                       
  • Role of spinal anatomical structures for neuromodulation
  • Ultrasound-guided permanent implantation of peripheral nerve
  • Stimulation (PNS) system                                                                                              
  • Discussion

S4. Radiofrequency for chronic pain management

  • Is there a reason for Diagnostic medial branch blocks before lumbar radiofrequency zygapophysial
    (facet) joint denervation?                    
  • US for facet detection and lysis with RF better than fluoroscopy?                 
  • What are the limits for targets in radiofrequency neurotomy                                
  • Outcome and measures in RF treatments                                                                 
  • Discussion

> Top

EXPERT PANEL DISCUSSIONS

REGIONAL ANAESTHESIA 

PD1. Improving clinical practice. Lesson taken from the anatomy

  • Looking for the development of paresthesias in the subarachnoid and epidural anaesthesia: A clinical and anatomical analysis                                                             
  • Understanding topographical anatomy                                                                      
  • Lesson from human cadaver worshops                                                                     
  • Discussion

PD2. Ultrasonography: Basic Facts.

  • 3 D ultrasonography correlation with anatomy                                                                
  • 3 D ultrasonography for peripheral nerve blocks is this the future?                          
  • Needle visibility in US is not the only important factor for US-guided
    nerve blocks                                                                                                          
  • Discussion

PD3. Epidural Anaesthesia

  • Alternatives for thoracic epidural anaesthesia and analgesia                                      
  • Are there still indications for lumbar neuraxial techniques in orthopaedics?          
  • Does the combination of neuraxial regional techniques and general anaesthesia improve the outcome?    

PD4. Pediatric Regional anaesthesia – what is new?

  • Ultrasound and  blocks in children: an advanced update                                     
  • Regional blocks and ambulatory children                                                                        
  • Regional anaesthesia and intensive care                                                                           
  • Complications of regional anaesthesia in paediatrics                                                        
  • Discussion

PD5. Controversies in regional anaesthesia                                                                     

  • Regional anaesthesia for awake thoracic surgery                                                                          
  • Epidural anaesthesia for minimal invasive spinal surgery                                             
  • Discussion

PD6. Centennial of intravenous regional anaesthesia (1908-2008). Still a place in Regional anaesthesia Practice for Bier's Block ?

  • Current indications and clinical place for Intravenous regional anaesthesia /analgesia
  • Additives to IVRA: Should we use them?                                                                           
  • Tourniquet pain and its management: still many unanswered questions  
  • Discussion

PD7. Dramatization of a regional anaesthesia complication scenario – a mock trial

  • Master of ceremonies                                  
  • Judge                                                               
  • Prosecutor                         
  • Lawyer

PD8. Regional anaesthesia application outside the operating room

  • In the Intensive Care Unit                                                                                                         
  • In the Emergency Department                                                                                                
  • In the field during natural catastrophies                                                                   
  • Discussion

PD9. Procedure specific regional anaesthesia techniques:

  • Hip surgery: epidural, spinal or general combined with peripheral nerve block?  
  • Knee surgery: epidural, spinal or general combined with femoral nerve block or combination of blocks?
  • How do nerve blocks affect peripheral blood flow and the outcome of microvascular surgery?                           
  • Discussion

PD. 10 Regional anaesthesia techniques and coagulation disorders

  • Thrombosis prevention and regional anaesthesia, new data                                         
  • Monitoring of the new antithrombotics                                                                           
  • UK guidelines for regional anaesthesia and anticoagulant therapy                      

> Top

PAIN ACUTE/CHRONIC

PD1. Update in Pharmacology for pain management

  • Ketamine in opioid dependent or tolerant patients  
  • Current practice of Patient-controlled epidural analgesia
  • Risks of acute postoperative neuropathic pain  
  • Discussion

PD2. Cancer Patient and pain management on acute and chronic settings

  • Potential influence of the postoperative analgesia regimens on cancer-related outcome.
  • Intrathecal drug delivery specific approach                                                                         
  • Radiofrequency techniques in the management of cancer pain                                
  • Discussion

PD3. Disease specific pain assessment and management

  • Neuropathic Pain                                                                                                     
  • Headaches and trigeminocervial complex                                                          
  • Peripheral vascular disease                                                                   

PD4. Peripheral nerve stimulation

  • Field or nerve stimulation, what is the approach?                                                   
  • Transforaminal or retrograde sacral stimulation is there a difference?                
  • Combinations of SCS and PNS: when and how to measure effectiveness?   

PD5. Intrathecal drug delivery: Criteria for drug selection

  • The taxonomy of pain                                                                                                   
  • The age as main variable                                                                                              
  • Risks and benefits of combinations in IDD

> Top

ASK THE EXPERT

  • Labour analgesia: CSE or epidural?
  • What is an intraneural injection?
  • Acute phantom limb pain: What is the best neural blockade?
  • Questions for an anatomist you would always wanted to ask but never dared to do it
  • How to monitor during a block procedure, storing ultrasound images?
  • Documenting nerve stimulator settings and thresholds, measuring injection pressures?
  • Documenting paresthesias?
  • Other findings by ultrasound during us-guided block, what to do as anaesthesiologist?
  • Which opioid is ideal for using in the epidural space?
  • Catheters in regional anaesthesia, how can we determine the optimal position in epidural and peripheral regional anaesthesia?
  • Paresthesias, what does it mean during neuraxial blocks and peripheral nerve blocks and what should I do?
  • Materials for peripheral nerve blocks or in ultrasound guided regional anaesthesia
  • Controversies in lipid emulsion therapy   
  • How to manage the postoperative care after regional anaesthesia
  • Is the ultrasonography a safe alternative in the performance of Sacral Plexus block?

> Top

PRO-CON DEBATES

REGIONAL ANAESTHESIA

  • Paravertebral Blockade is an alternative for thoracic epidural anaesthesia and analgesia
  • Combination of ultrasonography and nervestimulation improves safety of regional anaesthesia
  • Regional anaesthesia in the febrile patient
  • Compartment syndrome and regional anaesthesia
  • All obese patients in labour should receive an epidural catheter:
  • General anaesthesia for C-section should include an opioid prior to delivery of the fetus:
  • Which nerve block for subumbilical surgery in paediatric patient?"
  • Adult Patient: US-guided neuroaxial blocks
  • Paediatric Patient: Ultrasound and central blocks     
PAIN ACUTE/CHRONIC
  • Intradiscal therapies discography has a role
  • Epidural steroids by transforaminal route

> Top

LUNCHEON DISCUSSIONS

  • Failed regional block for C-section                                          
  • US and children                                                                                                                          
  • Serious neurological injury after leg surgery under GA and epidural anaesthesia: possible mechanisms and diagnostic follow-up.                                                                       
  • Regional anaesthesia in the trauma patient                             
  • Resuscitation science: does anything works?
  • Low dose spinal anaesthesia for C-section: practical implications                          
  • Rapid sequence induction for C-section under GA: new ideas!
  • PCEA or peripheral nerve blocks for lower limb surgery
  • Local anaesthetic dose, how low must we go?
  • Short surgical procedures on the arm, do we use IVRA or peripheral nerve blocks?
  • Management of neurologic complications after regional anaesthesia 

> Top

LECTURE WORKSHOPS

  • Ultrasound for spine imaging                                                                                             
  • Anaesthesia/sedation and regional anaesthesia in children: a solved problem? 
  • Continuous infusions in children                                                                                                         
  • Local infiltration techniques are they as effective as peripheral nerve blocks?
  • Hygiene in peripheral regional anaesthesia (solutions, preparation, disinfection, clothing)                                   
  • Bilateral dual TAP block                                                                                                                       
  • Why does a US-guided TAP-block not work?                                                                          
  • Phantoms for teaching US-guided blocks                                                                          
  • Needle placement by nerve stimulation or ultrasound and the associated risk of intraneural injection
  • How to start regional anaesthesia with US                                                              
  • Paravertebral block - Gold standard for post-mastectomy analgesia                   
  • New developments in ultrasound-guided regional anaesthesia: retrobulbar blockade, new catheters
  • Surgical regional anaesthesia of the hip joint with ultrasound-guided lumbar plexus and sacral plexus block      

> Top

HANDS – ON WORKSHOPS*

1- Animal (Pigs) Workshops
A special workshop with anaesthetized pigs for a limited number of participants using US and performence of the blocks.

2- Human Special Cadaver Diploma Workshops
Proposed as ESRA deal for promoting education and support candidates of DEA

3- Human Cadaver Workshops
Cadavers  showing interscalene region/anatomy and after that station the participants will perform ultrasound at a model in the interscalene region

4- Human Models: Anatomical Landmarks
STATIONS:              

  • Upper extremity blocks around clavicle (interscalene, infraclavicular, axillary
  • Upper extremity blocks at elbow and wrist level (ulnar, radial and median)
  • Lower extremity blocks at the hip level (sciatic- various approaches, femoral)
  • Lower extremity blocks at knee and ankle level (popliteal block-dorsal and lateral approach, saphenous, ankle block)

5- Human Models: Ultrasound Adults

  • Pain: Basics
  • Pain:paravertebral, upper limb , lower limb
  • Upper limb / lower limb
  • Neuraxial /paravertebral
  • Abdominal wall

5.1 Introductory
Basic physics / Machine Knobology / Image optimization and acquisition using models - needling with phantoms - hands on

5.2. Upper Limb 
Interscalene / supraclavicular / infraclavicular / axillary and peripheral nerves

5.3. Lower Limb 
Sciatic, femoral, popliteal, saphenous, obturator and ankle

5.4. Neuraxial & Abdominal Wall  
Epidural, paravertebral, lumbar plexus, rectus sheath, TAP blocks

5.5. Chronic pain
Stellate ganglion, cervical medial branch/roots, suprascapular, Lumbar facets, pudendal nerve and lateral cutaneous nerve of thigh.

6. Human Models: Ultrasound Paediatrics

  • Limbs Peripheral blocks
  • Trunk and paravertebral blocks
  • Central blocks - anatomy and landmarks

 > Top