Question 15 from the second paper of 2002 asked to compare PCA and thoracic epidural in the setting of rib fractures. Question 20 from the second paper of 2005 asked more broadly about the role of regional anaesthesia in the critically ill.
The college comments, "Many candidates provided long lists of regional techniques, but did address the issues of when to use and when not to use a technique. Consider asking “why don’t we perform more epidurals in our patients?”"
Epidural |
Peripheral nerve block |
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Disadvantages |
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Karmakar, Manoj K., and Anthony M-H. Ho. "Acute pain management of patients with multiple fractured ribs." Journal of Trauma-Injury, Infection, and Critical Care 54.3 (2003): 615-625.
Janossy, K. M., et al. "The effect of pilot balloon design on estimation of safe tracheal tube cuff pressure." Anaesthesia 65.8 (2010): 785-791.
Hoffman, Robert J., Vivek Parwani, and In-Hei Hahn. "Experienced emergency medicine physicians cannot safely inflate or estimate endotracheal tube cuff pressure using standard techniques." The American journal of emergency medicine 24.2 (2006): 139-143.
Parwani, Vivek, et al. "Practicing paramedics cannot generate or estimate safe endotracheal tube cuff pressure using standard techniques." Prehospital Emergency Care 11.3 (2007): 307-311.