ESRA Academy. du Plessis M. Sep 8, 2016; 138368; 0206 Topic: GENERAL PRINCIPLES OF REGIONAL ANAESTHESIA (RA)
Dr. Murray du Plessis
Dr. Murray du Plessis

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Background and Aims:

Local orbital blocks should be administered by a suitably trained anaesthetist or ophthalmologist1. Trainee exposure to ophthalmic lists is variable and formal training in practical skills for ophthalmic blocks may be difficult without adequate exposure.

Simulation is a tool used often in anaesthesia and while its use has not been specifically evaluated in ophthalmic anaesthesia we believe that it will help improve confidence and skills in those who wish to learn ophthalmic blocks.


We created an interactive model that could be used for learning peribulbar and sub-tenon blocks. This model allows the user to simulate administration of the block and contains elements to give feedback in the form of LEDs when the needle tip is in correct areas.

This model was tested and evaluated by a group of consultant anaesthetists.

If the clinician accidentally hits the muscle cone a buzzer and red LED light is shown. When angled correctly towards the nasal bone or infero-medial aspect a green LED is lit


Of the 17 anaesthetists surveyed 12% perform peribulbar blocks yearly with only 1 respondent using them routinely. Simulation training for novices was felt “somewhat important” (59%); “very important” (35%). Our model was deemed “somewhat useful” (41%); “very useful” (47%).


Simulation using models is one way of mitigating lack of trainee exposure to a given specialty. It allows practice in a non-clinical environment and allows skills to be honed prior to attempts on patients.

Simulated sessions should of course be accompanied by background knowledge of the anatomy of the eye and potential risks and benefits of procedures learnt.
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