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BMJ Publishing Group, Regional Anesthesia & Pain Medicine, p. rapm-2023-104884, 2023

DOI: 10.1136/rapm-2023-104884

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Standardizing nomenclature in regional anesthesia: an ASRA-ESRA Delphi consensus study of upper and lower limb nerve blocks

Journal article published in 2023 by Kariem El-Boghdadly ORCID, Eric Albrecht ORCID, Morné Wolmarans ORCID, Edward R. Mariano ORCID, Sandra Kopp ORCID, Anahi Perlas ORCID, Athmaja Thottungal, Jeff Gadsden, Serkan Tulgar ORCID, Sanjib Adhikary ORCID, Jose Aguirre, Anne M. R. Agur, Başak Altıparmak ORCID, Michael J. Barrington, Nigel Bedforth and other authors.
This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

BackgroundInconsistent nomenclature and anatomical descriptions of regional anesthetic techniques hinder scientific communication and engender confusion; this in turn has implications for research, education and clinical implementation of regional anesthesia. Having produced standardized nomenclature for abdominal wall, paraspinal and chest wall regional anesthetic techniques, we aimed to similarly do so for upper and lower limb peripheral nerve blocks.MethodsWe performed a three-round Delphi international consensus study to generate standardized names and anatomical descriptions of upper and lower limb regional anesthetic techniques. A long list of names and anatomical description of blocks of upper and lower extremities was produced by the members of the steering committee. Subsequently, two rounds of anonymized voting and commenting were followed by a third virtual round table to secure consensus for items that remained outstanding after the first and second rounds. As with previous methodology, strong consensus was defined as ≥75% agreement and weak consensus as 50%–74% agreement.ResultsA total of 94, 91 and 65 collaborators participated in the first, second and third rounds, respectively. We achieved strong consensus for 38 names and 33 anatomical descriptions, and weak consensus for five anatomical descriptions. We agreed on a template for naming peripheral nerve blocks based on the name of the nerve and the anatomical location of the blockade and identified several areas for future research.ConclusionsWe achieved consensus on nomenclature and anatomical descriptions of regional anesthetic techniques for upper and lower limb nerve blocks, and recommend using this framework in clinical and academic practice. This should improve research, teaching and learning of regional anesthesia to eventually improve patient care.