Improving needle visualization by novice residents during an in-plane ultrasound nerve block simulation using an in-plane multiangle needle guide

Pain Med. 2013 Oct;14(10):1600-7. doi: 10.1111/pme.12160. Epub 2013 Jun 11.

Abstract

Objective: Ultrasound-guided regional anesthesia with in-plane needle approaches can be challenging due to difficult needle visualization. We hypothesized that an in-plane, multiangle needle guide can help reduce the time it takes novice regional anesthesiologists to perform a simulated ultrasound-guided nerve-targeting procedure and enhance the visualization of the needle.

Design: Crossover simulation study.

Setting: Simulation environment at an academic institution.

Subjects: Volunteer trainees in their postgraduate years 1 and 2.

Methods: Sixteen subjects were randomized to repeat a single nerve targeting simulation task four times with and four times without a needle guide. End points were time to complete the nerve targeting, needle visualization, number of passes, and needle approximation to the target.

Results: The needle guide reduced median time to complete the task by 27% (95% confidence interval: 4-44%) and increased the odds of an acceptable needle visualization by 355% (95% confidence interval: 171-737%). A learning benefit for the time outcome was also noted, with multiple attempts regardless of whether the needle guide was used or not.

Conclusions: A needle guide can help reduce the time needed to complete a simulated nerve targeting procedure and enhance needle visualization for the novice sonographer in a phantom gel simulation. There was no significant reduction in the number of needle passes or in improvement of target approximation noted.

Keywords: Education; Regional Anesthesia; Regional Anesthesia Techniques; Ultrasound.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthesiology / education
  • Female
  • Humans
  • Internship and Residency
  • Male
  • Needles*
  • Nerve Block / instrumentation*
  • Ultrasonography, Interventional / methods*