OP74 Impact of a structured training programme on technical challenges in epidural catheter placement by trainees in parturients

<h3>Background and Aims</h3> In teaching hospitals, epidural analgesia in parturients is commonly performed by anesthesiology trainees. Given that epidural catheter placement is a blind technique, adequate training is essential to reduce technical difficulties and improve outcomes. This study evaluates the impact of a structured training programme on the incidence of technical challenges during epidural catheter placement by trainees in parturients. <h3>Methods</h3> Obstetric epidural procedural reports between March 2024 and February 2025 were analyzed. Provided by the anesthesiology department, all trainees received theoretical and simulation training, followed by a mandatory exam. After passing the exam, trainees performed their first five epidural catheter placements under direct supervision. Procedural documentation included technical challenges, bone contact, the number of attempts, and patient characteristics. As per institutional protocol, patients were evaluated the day after the puncture by the acute pain team for procedural satisfaction and screened for complications, such as post-dural puncture headache. <h3>Results</h3> A total of 1,280 epidurals were performed by 85 trainees, with 156 cases (12%) reported as difficult. Deep bone contact was noted in 266 cases (21%), and 277 procedures (22%) required two or more attempts; of these 51 (4%) needed three or more attempts. Dural punctures occurred in 10 cases (0.8%). The median patient-reported procedural satisfaction score was 9 (8–10), while the maximum NRS pain score during epidural placement had a median of 1 (0–3). Technical challenges were not influenced by the trainees’ experience level. <h3>Conclusions</h3> Our data suggest that the trainee teaching model provides adequate safety, efficacy, and a comparable number of attempts regardless of the trainee’s experience level, supporting its continued use in anesthesiology training.

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Published
2025-09-01
DOI
https://doi.org/10.1136/rapm-2025-esra.74
Primary Topic
Cardiac, Anesthesia and Surgical Outcomes
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article
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article

OP74 Impact of a structured training programme on technical challenges in epidural catheter placement by trainees in parturients

Admir Hadžić, Imré Van Herreweghe, Florence Polfliet, Eline Ghysels et al.
1 links
Cardiac, Anesthesia and Surgical Outcomes
article

OP74 Impact of a structured training programme on technical challenges in epidural catheter placement by trainees in parturients

Admir Hadžić, Imré Van Herreweghe, Florence Polfliet, Eline Ghysels, Sterre Warson, Eline Soors
article en

Abstract

<h3>Background and Aims</h3> In teaching hospitals, epidural analgesia in parturients is commonly performed by anesthesiology trainees. Given that epidural catheter placement is a blind technique, adequate training is essential to reduce technical difficulties and improve outcomes. This study evaluates the impact of a structured training programme on the incidence of technical challenges during epidural catheter placement by trainees in parturients. <h3>Methods</h3> Obstetric epidural procedural reports between March 2024 and February 2025 were analyzed. Provided by the anesthesiology department, all trainees received theoretical and simulation training, followed by a mandatory exam. After passing the exam, trainees performed their first five epidural catheter placements under direct supervision. Procedural documentation included technical challenges, bone contact, the number of attempts, and patient characteristics. As per institutional protocol, patients were evaluated the day after the puncture by the acute pain team for procedural satisfaction and screened for complications, such as post-dural puncture headache. <h3>Results</h3> A total of 1,280 epidurals were performed by 85 trainees, with 156 cases (12%) reported as difficult. Deep bone contact was noted in 266 cases (21%), and 277 procedures (22%) required two or more attempts; of these 51 (4%) needed three or more attempts. Dural punctures occurred in 10 cases (0.8%). The median patient-reported procedural satisfaction score was 9 (8–10), while the maximum NRS pain score during epidural placement had a median of 1 (0–3). Technical challenges were not influenced by the trainees’ experience level. <h3>Conclusions</h3> Our data suggest that the trainee teaching model provides adequate safety, efficacy, and a comparable number of attempts regardless of the trainee’s experience level, supporting its continued use in anesthesiology training.

Ziekenhuis Oost-Limburg (BE), New York School of Regional Anesthesia (US), Hasselt University (BE)
Openalex Percentile: Top 63%
Cardiac, Anesthesia and Surgical Outcomes
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