Regional Anesthesia in Intensive Care: An Overview in Tunisia

Abstract

Regional anesthesia (RA) is increasingly used in intensive care in Tunisia, but challenges persist to ensure optimal practice. We conducted a multicenter study involving post-operative and polyvalent intensive care units, both private and public. Resident physicians(44.7%) are sensitized to quality of care, but gaps remain. Attending physicians (63.3%) often report the absence of pain management committees (PMCs) and written protocols for RA. The majority express a need for continuous training, particularly on RA. High-fidelity simulation is the preferred format for learning. RA is commonly used in intensive care (97.2%), mainly epidural (76.4%) and femoral nerve blocks (54.9%). Ultrasound is widely preferred for guiding procedures (77.5%). The main areas of RA application are thoracic (94.4%) and limb trauma (64.8%). The ANI is the preferred pain monitoring tool (49.3%). Improving training and infrastructure is necessary for optimal RA practice in intensive care in Tunisia.