Barriers to the routine use of peripheral nerve blocks in some tertiary hospitals in Nigeria

Background: Regional anaesthesia is rapidly becoming a viable alternative to general anaesthesia in the care of the surgical patient. However, there appears to be limited use of regional anaesthesia for surgery and pain management. This study determined the scope and barriers to the use of regional anaesthesia in the practice of anaesthetists in Nigeria. Methods: This survey using a structured questionnaire, addressed participants’ demographic features, proficiency in regional anaesthesia (central neuraxial and peripheral nerve block practices), type of equipment available in the hospital for regional anaesthesia, and level of education and training. All physician anaesthetists were required to complete the questionnaire except the nurse anaesthetists. All categorical data were expressed as frequencies and percentages. Results: A total of 120 questionnaires were distributed to the participating institutions and 109 were returned with a response rate of 90.8%. The majority (71.6%) were males with a male-to-female ratio of 2.52: 1. Performances of upper or lower limb blocks show 71(65.1%) had experience with upper or lower limb block. The performance of central neuraxial blocks was very high; subarachnoid blocks (100%), epidural blocks (85%), and caudal blocks (78.1%) respectively. Lack of required skills accounted for the leading reason why peripheral nerve blocks were not performed in the upper limb (81.5%), as against the least reason which is the non-availability of an ultrasound machine (7.4%) for lower limb blocks. Conclusion: Anaesthetists in Nigeria are interested in performing various regional techniques. Poor workforce development and access to appropriate technology are limitations to the routine performance of peripheral nerve blocks.