Editorial - ESRA

ESRA Updates

Peter Merjavy (Craigavon Area University Teaching Hospital, Northern Ireland, UK) @PeterMerjavy
Clara Lobo (Editor of ESRA Updates; Cleveland Clinic Abu Dhabi, UAE) @claralexlobo

CoViD-19 presents big challenges for healthcare across all countries in the world. The pandemic is far from over and there is a real concern, that it might stay with us for months or even for years to come. Since the start of pandemic, we have seen increased interest in using regional anaesthesia techniques in order to minimise the AGPs (aerosol generating procedures), reduce the use of opioids for peri and postoperative pain management, reduce the resources and costs of PPE, earlier discharge and preservation of immune system when compared with general anaesthesia. Those benefits serves both patients as well as healthcare providers.

Similar to the recommendations for airway management, where the most experienced practitioner should perform the endotracheal intubation, some argue that regional anaesthesia should be performed by the most skilled and experienced person to maximise success, reduce complications and minimise the direct interaction time with the patient.

These challenges can have a negative impact on teaching and exposure of trainees to regional anaesthesia procedures. Trainees are not only facing reduced opportunities, but they are also redeployed to Intensive Care Units, Emergency Departments , Respiratory wards etc by the hospital management team to provide acute care whenever is mostly needed. Svetlana Galitzine (Oxford, UK) and Steve Coppens (Leuven, Belgium) bring us their experience how the CoViD impacted on their well-established regional anaesthesia fellowship programmes.
Many of us have changed our habits of communication from personal to some form of virtual meetings. Even prior to pandemic ESRA has been promoting the online educational activities – eESRA online congress from Paris as well as partially online programme of ESRA European Day organised simultaneously in multiple cities/centres across Europe. Webinars with several hot topics were recorded and are available for replay in ESRA Academy including the second recordings for Q&A. This year the ESRA team under the leadership of past president and Chair of Scientific Committee Alain Delbos will organise full online Annual Scientific meeting.
Virtual education is experiencing a massive boom especially on the social media (SoMe) platforms. There are many advantages of SoMe, especially Twitter when used appropriately for engaging people to virtual learning, communication and cooperation with top leaders in RA, discussing the newly published papers (mostly ahead-of-print). Ed Mariano (Palo Alto, USA) is one of the top influencers in regional anaesthesia in SoMe and real life and we are grateful of his contribution for our Newsletter. Ki Jinn Chin (Toronto, Canada) is another extremely popular author of various educational videos and he presents the role of YouTube in regional anaesthesia education not only for CoViD pandemic but also for the years ahead.

I’m sure we would agree that ultrasound is very useful tool for a variety of invasive procedures like regional anaesthesia or vascular access, but there is also huge potential for it’s use in diagnostic procedures. Point of Care Ultrasound (POCUS) techniques are performed at patient’s bedside, they are not invasive, there is no radiation, the results are immediately available (for trained practitioner) and can be repeated several times a day according the clinical situation. Thomas Bendtsen (Aarhus, Denmark) presents his project of USabcd online interactive e-learning, which the ESRA members can access for free since 2018. There are range of POCUS topics: cardiac, lung, airway, gastric, central and peripheral vascular access, nerve blocks, emergency ultrasound, FAST as well as a dedicated course for medical students. Everybody can therefore find the course which will satisfy their clinical needs.

Teaching is only one component of the education process. Another one is examination. EDRA Board has been working extremely hard during last 12 months to adapt to the new situation. Jose Aguirre (Zurich, Switzerland) – EDRA Chair presents the introduction of fully online EDRA Part 1 (written) exam with exam dates in July and September 2021 and also the changes to EDRA Part 2 exam, which will be divided to online and practical (face to face). Candidates who would consider to sit any part of the EDRA exam will find lots of practical information in this article. The criteria for workshops required for EDRA exam are also changing and we will bring you the details in next issue of ESRA Updates.

Cadaveric workshops were traditionally connected to the core training of future regionalists. Whilst we would generally agree, that anatomy is still extremely relevant for regional anaesthesia, the question is, are the cadaveric workshops still necessary and fit for purpose in 2021 and for the years ahead? We will try to find out the answers for this and few other questions from the three experts with close connection to regional anaesthesia and anatomy Paul Kessler (Frankfurt, Germany), Graeme McLeod (Dundee, UK) and Mario Fajardo Perez (Madrid, Spain).

PROSPECT group under leadership of Marc Van de Velde (Leuven, Belguim) has been very efficient during last 2 years and brought us seven recommendations for postoperative pain management. Caesarean section, Laminectomy, Complex spine surgery, Open liver resection, Tonsilectomy and two updates Total hip replacement and Inguinal hernia repair. All recommendations are published in English, German, French, Spanish, Portuguese, Chinese, Japanese and Turkish languages. There are another 7 recommendations in progress. If you are as curious to know more about PROSPECT do not hesitate to read their article.

Many articles published in peer reviewed journals are of great quality. We are grateful for Brian O’Donnel (Cork, Ireland) to share his view which of recently published papers have influenced his clinical practice. If you want to know more, read our Journal Club with Brian O’Donnel.

We hope that you’ll enjoy your summer ESRA Updates edition and we are looking forward to see you all soon in person in Annual Congress in Thessaloniki 2022.

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