The practice of peripheral nerve blocks in the United States: a national survey [p2e comments].

Objective: A nationwide survey was conducted in order to describe practice patterns surrounding the use of peripheral nerve blocks (PNBs).

Methods: Questionnaires were mailed to 805 anesthesiologists selected systematically from the 1995 ASA and ASRA membership directories. Responses from 409 attending anesthesiologists (response rate 56.5%) were analyzed.

Results: While almost all respondents (97.8%) regularly use at least some regional anesthesia techniques in their practices, significantly fewer use PNBs, with most anesthesiologists (59.7%) performing less than five PNBs monthly. Peripheral nerve blocks of the lower extremity (femoral 32 %, sciatic 22 %, popliteal 11%) were less frequently used than PNB of the upper extremity (axillary 88%, interscalene 61%) (McNemar chi-square test = 215.2; P < .001). Anesthesiologists who rated their training in PNBs as adequate (50.8%) devoted a larger percentage of their practice to PNBs than anesthesiologists who rated their training as inadequate (P = .02). Despite the infrequent use of PNBs, 176 respondents (42.6%) predicted that their use of PNBs would increase in the future.

Conclusions: Although this survey indicates that regional anesthesia is frequently practiced in the United States, PNBs and particularly PNBs of the lower extremities remain underutilized.