Mission Statement

To promote the excellence in practice and teaching of regional anesthesia and Peripheral nerve blockade.

NYSORA stands for New York School of Regional Anesthesia. As opposed to a traditionally static format of textbooks and atlases of regional anesthesia, NYSORA has a continuous, dynamic character that changes in pace with new developments in the field.

New York - because NYSORA was born in Manhattan, NY and because featured material on this site is specific to the authors' practice of regional anesthesia at St. Luke's-Roosevelt Hospital Center, a Columbia University affiliate at New York NY.

School of Regional Anesthesia - because most of the presented material is based on original contributions. The featured techniques have developed on our concept of Functional Regional Anesthesia Anatomy and often depart from the traditional teaching. Consequently, this site features ONLY the proven techniques which are used with great success in our everyday practice.

The NYSORA debuted in the fall of 1996 under the name www.idamedical.simplenet.com. This was a true pioneering project since at that time this was one of the first web sites that focussed on peripheral nerve blockade. Early on, only a series of techniques that had been developed or refined by the authors were featured. The decision was made to limit the content of the site to original contributions and techniques specific to the authors' practices rather than reproduce work that had already been published elsewhere. This principle has been followed throughout the further development of the site. As a result, the information from the basic (anatomy) and clinical research is combined the details of the techniques are continuously assessed and evaluated.

The testimony to NYSORA's educational value came at the authors' scientific exhibits on peripheral nerve blocks at the 1997 ASA, IARS and PGA meetings [1,2,3] were the website received enormous attention which proved the success of this pioneering project. The rapidly growing website soon demanded a commitment to another reorganization and more flexible ISP (Internet Service Provider) hosting. The second generation of NYSORA emerged as a much-expanded version in December of 1997 under the name www.anesthesiaregional.com on a Yahoo server. The rising number of daily visits and continuous work on the concept of "Functional Regional Anesthesia" as well as the establishment of the regional anesthesia fellowship and the Center of Excellence in Regional Anesthesia at St. Luke's-Roosevelt paralleled and fostered the further development of the web-based school project. The current, third edition of the website, now located at www.NYSORA.com and hosted on a newer dedicated server, has been redesigned in order to service these demands and offers a bold frills-free tutorial on the principles and practice of peripheral nerve blocks to the ever growing Internet-enabled Anesthesia community. The site has been substantially expanded to include more techniques, discussions on principles of regional nerve blocks, local anesthetics, equipment and focused videos on techniques and responses to nerve stimulation.

The NYSORA web site is currently organized into 12 sections. These sections present the necessary information for successful implementation of practice of nerve blocks in a logical, user-friendly format. The "What's New?" section features information on upcoming meetings and recently released teaching material. Information about past meetings is also stored in a database. "New Concepts" contains discussions on various aspects of regional anesthesia practice, including discussions on equipment and tips for their successful use. It also includes discussions on various controversial issues as well as the upcoming additions to NYSORA. The "Equipment" section deals with the organization of regional anesthesia carts, the selection of local anesthetics, and discussions on the selection and use of nerve stimulators and nerve block needles. The "Techniques" section is the heart of the site. It contains a free concise manual on nerve block techniques. Of note, many of these techniques have been developed or substantially modified by the authors to fit the needs of modern anesthesia and surgery practices. We have richly illustrated this section in order to convey the nuances of techniques and their anatomical correlation, and feature video demonstrations of block techniques and responses to nerve stimulation. "Clinical Applications" focuses on practical discussions on the use of regional anesthesia for inpatient and out-patient surgery. "Training Opportunities" offers some insight into what is available at St. Luke's-Roosevelt to those interested in pursing a career in regional anesthesia. Especially appealing are the regional anesthesia fellowship and the two-day crash course in regional anesthesia (sponsored by ASTRA-Zeneca through the Centers of Excellence in Regional Anesthesia Program) that utilize a well-structured teaching program in specific peripheral nerve blocks. "Our Surgeons" is a growing section featuring surgeons who almost exclusively operate on patients anesthetized using regional anesthesia. This sections offers a surgical view on implications of regional anesthesia. The "Guest Contributors" section attempts to strike a balance between the specifics of the techniques taught and practiced by the authors (New York School of Regional Anesthesia) and those of other prominent regional anesthesia practices throughout the world. This page remains open to all authorities in the field wishing to contribute. Finally, a "Forum" section was established in the latest site design to foster discussion on various subjects of interest and controversy in regional anesthesia. The site also includes standard features such as a site map, related links, and information about the authors.

It is almost universally accepted that peripheral nerve blocks offer numerous advantages over the general and spinal/epidural anesthesia. When performed judiciously and skillfully, nerve blocks can facilitate fast-tracking, allow early mobilization, decrease hospital stay, reduce unanticipated hospital admission, and reduce health care costs at large. Similarly, with the rapidly expanding scope of ambulatory surgery, emergence of better nerve block techniques and equipment, and imminently pending development of substantially more flexible local anesthetics, nerve blocks are also rapidly becoming the anesthetic of choice for majority of patients undergoing ambulatory surgery. Because of these trends, it is imperative that the organized anesthesia societies continue to emphasize the teaching of peripheral nerve blocks [4]. As the Internet makes its way into homes and operating rooms worldwide, advances in video, telecommunication and computing technologies offer an unprecedented possibility for online education in regional anesthesia. Numerous medical educational web sites are emerging as powerful online tools for a rapid access to needed medical information. Our own site monitoring tools have confirmed that the NYSORA website has already developed a group of regular visitors that browse our materials at length. We feel our site will continue to grow and educate as long we continue to routinely review, refocus, and redesign it utilizing current technologies. Our experience so far has taught us to embrace change in order to establish and maintain an effective robust educational environment on the Internet.

1. Hadzic A, Vloka JD. Practical approach to peripheral nerve blocks of the lower extremity. New techniques and concepts. Scientific exhibition at the 1997, International Anesthesia Research Society (IARS) meeting, San Francisco, Ca, March 23, 1997.
2. Vloka JD, Hadzic A. Lower extremity nerve blocks. New techniques and compli. Scientific exhibition at the American Society of Anesthesiologists Annual Meeting, San Diego, Ca, October 20-22, 1997.
3. Vloka JD, Hadzic A. Lower extremity nerve blocks. New techniques and compli. Scientific exhibition at the New York State Society of Anesthesiologists Annual Meeting (PGA), December 14-16, 1997.
4. Hadzic A,Vloka JD, Kuroda MM, Koorn R, Birnbach DJ. The practice of peripheral nerve blocks in the United States. A national survey. Reg Anesth Pain Med 1998:23:241-246.