New York School of Regional Anesthesia URL: http://www.nysora.com Authors: Admir Hadzic and Jerry Vloka
John Oyston, M.B., B.S., F.R.C.P.(C.) Department of Anesthesia The Scarborough Hospital, Toronto, Ontario, Canada email@example.com Temporarily firstname.lastname@example.org
Drs. Hadzic and Vloka have produced one of the best regional anesthesia Web sites, without sponsorship from any equipment or pharmaceutical company. They have assembled an impressive team of assistants to produce a site that has quality content and an elegant, professional appearance.
The site was established in 1996 and has had three different addresses and several major revisions, the last of which (December 2000) occurred during the drafting of this review. It describes their practice of regional anesthesia at St. Luke’s–Roosevelt Hospital Center in New York City. It has all the usual features, such as links to other sites, details of meetings, information about anesthesia training at St. Luke’s, backgrounds of the authors, and a bulletin board. One nice touch is a collection of tributes from some of the surgeons at St. Luke’s–Roosevelt, who obviously appreciate the advantages of regional anesthesia.
Information about Nerve Blocks
The main feature of the site is detailed information about how to perform a variety of peripheral nerve blocks. The descriptions are based on the authors’ practice and research. In many cases, useful, practical tips are offered. Some blocks are not referenced; others have many references. There are sections about setting up equipment, with details of their cart and block trays, which are well-illustrated. There is also a guide to choosing local anesthetics.
The nerve blocks described include infraclavicular and interscalene blocks, thoracic paravertebral blocks, combined epidural–spinal blocks, and a wide variety of lower extremity blocks. The descriptions are clear and concise and are accompanied by excellent detailed photographs, including, in many cases, dissections of cadavers to display the relevant anatomy.
The authors have prepared a number of short video clips, which are used to display information that could not be represented in any other way, such as a needle being inserted or a muscle twitching. The clips are not narrated but are documented clearly in the adjacent text. They are available in Real Video and QuickTime formats, in versions for different connection speeds. The authors are commended for attempting to use streaming video as a teaching aid, for producing excellent quality video images, and for resisting the temptation to use “talking heads.” However, I felt the clips could have been a little longer.
Quality of Material
The descriptions of the blocks are all written by the authors, except for two guest contributions.
The authors have considerable practical experience related to regional anesthesia at a major academic center and have published many articles in established journals. The site expresses the authors’ experience and, like a conventional textbook, it is not peer reviewed. One assumes that no one would go to the effort of publishing a textbook unless he or she had useful and accurate information to propagate. There are a few typographical errors that have escaped spell checking but that might have been caught by an editor. Although the site offers excellent educational material, there is no method of testing one’s knowledge or of gaining continuing medical education credits.
Navigation and Searching
Navigation can be confusing. For example, a list of meetings is given in the What’s New section, although information about past meetings is included. Information about a specific nerve block could be available under Concepts, Techniques, or Guest Contributors. There is a site map, which reduces the confusion somewhat, and an efficient search engine.
This is an excellent Web site, with a wealth of practical and research information about regional anesthesia.
It shows how useful the Web can be as a teaching medium. It is especially good regarding peripheral blocks of the lower extremities, a rather neglected aspect of regional anesthesia.