16th ESRA Winter Week

The 16th ESRA Winter week was again organised by Jens Børglum from Denmark and Geert Jan van Geffen from the Netherlands. They are two of the best regional anaesthetists that I know and feel privileged to call them friends. And this is exactly what the ESRA Winter week is all about! Making friends in perfect Austrian surroundings, with a fantastic balance of excellent regional anaesthesia (RA) education, the superb Aqua Dome Spa hotel in Långenfeld, the nearby ski slopes of Solden and the very informal gatherings sharing ideas amongst RA friends.

The two remarkable aspects of this meeting is firstly the exceptionally high standard of RA education. Most of the delegates are proficient RA practitioners, so the level of detail and enthusiasm for teaching and learning is outstanding, but participants of all levels of RA ability is definitely catered for. The sharing of different practices, tips and tricks between faculty and delegates, ensures that the best level of safe RA practice is justified, discussed and challenged. This year 120 delegates from all over the world gathered for this 5 day meeting and discussed best practice that works for them in their country and hospital environment. We certainly learn from each other.

The second aspect that I love about this meeting, is the how the format and venue creates so many opportunities for informal discussion about RA. This could be during breakfast, coffee breaks, pre dinner aperitifs or the ski bus to Solden. You could be in the 007 restaurant (Ice Q) at 3048 meters, discussing the use of Dexamethasone with Eric Albrecht and Matthias Desmet while comparing which Schnitzel is the best in Europe. Or get opinions on types of infraclavicular blocks from Steve Coppens in the spa, while Vladimir, the masseuse beats you with eucalyptus tree branches. Or drinking a Monkey 47 gin with Jens Børglum and comparing which Quadrates Lumborum Block is really the best and how shall we name it? Or standing in a hotel lift in wet swimming trunks and sandals, wishing you still had abdominal muscles like a six pack, discussing the benefits of fascial plane blocks with Vincent Chan. Yes! The Vincent Chan!! My point is that this meeting creates interactions with RA enthusiasts like non other and this is why more than 50% of the delegates return on an annual basis. So book early for next year!

The usual format is for each day of the week is an early breakfast and then a 2  hour session of short, detailed lectures from passionate experts. Jens and Geert-Jan’s programme was delivered  by internationally renowned speakers to cover a variety of topics including Chronic pain, RA, Obstetric anaesthesia and relevant interesting clinical topics.

So spoke David Fertleman, geriatrician about the mechanisms involved in the development of postoperative delirium. He gave details with humour and experience about the perioperative multidisciplinary care for the geriatric orthopaedic patient. Including how in  daily practice we cope with the anaesthetic problems we might face with the growing amount of octarians presenting for orthopaedic surgery. Athmaja Thottungal spoke about the role fascia’s may play as an important source of nociceptive input in different pain syndromes and discussed several interventional therapies. In another lecture she discussed the developments in ultrasound guided pain interventions.

Sarah Armstrong, obstetric anaesthesiologist updated the audience about labour analgesia, and how to provide effective analgesia after cesarean section. She provided tips and tricks how to approach and treat the obese parturient, an increasing group of patients in the obstetric practice. In Steve Coppens lecture, he discussed the options and benefits of providing regional anaesthesia for thoracic surgery.

Vincent Chan who has regularly supported this meeting and after a gruelling travel schedule, accompanied by his wife Ann, gave a though provoking lecture on minimal clinically differences in pain and reviewed the current evidence for fascial plane blocks. Geert Jan van Geffen spoke about and demonstrated POCUS skills.

And there was also fantastic contributions from Jens Borglum, Eric Albrecht, Steve Coppens and Matthias Desmet, covering  topics like ERAS protocols, RA education, block additives and RA for vascular surgery.

The middle of the day is dedicated to recreational activities which for the majority of participants included donning ski gear and hopping onto a ski bus to local ski resorts like Solden and Obergurgl. There are enough ESRA friends to find a ski group that suits your fitness, ability and lunch requirements. If the ski slope is not your forte, you had the fantastic spa facilities located in the Aqua Dome hotel, which included indoor and outdoor heated pools, gyms, saunas and steam rooms etc.

The afternoon sessions included hands-on ultrasound workshops and a variety of problem based learning (PBL) discussions. All delegalises rotated through all the sessions which ensured that the group sizes were small enough for an interactive learning experience.

All the members of faculty shared their expertise during the workshop sessions, like Eric Albrecht, a fantastic skier who not only showed his ski-skills on the slopes but also his ultrasound skills in the workshops. He also presented an update on intralipid for LAST, brachial plexus blocks and discussed whether it is safe to apply regional anaesthesia in diabetes patients. Matthias Desmet and I, who are regular faculty members for ESRA winter week, discussed the latest literature regarding regional anaesthesia and how to measure competency in regional anaesthesia training. We also provided PBL’s about conflict management in the OR and how to prepare for the EDRA examination.

The remainder of the evenings were spend in the hotel restaurant and bars, which delivered set courses of mouth watering dishes that caters for all tastes. The hotel also has many different lounges and a library available. ESRA arranged networking sessions that provided even more informal interactive time for all participants.

Jens and Geert-Jan provided a perfect venue, invited enthusiastic world expert faculty with a great programme and the participants were eager to learn, discuss and share knowledge, but the smooth running of this conference was due to the hard work of Vivienne Penning, the local course manager.

She kept the show on the road, sorted out technical hitches and was the liaison between delegates, faculty, hotel and ESRA. She did a fantastic job keeping the faculty on time and organised.

The ESRA winter week will again be organised for the 17-22 January 2021 and I would whole heartedly recommend that you register early for this truly unique RA conference.

Best wishes and stay safe!