Objective

To evaluate two transducer and needle handling methods, along the visual axis (AL) and across the visual axis (AC), in non-skilled and skilled clinicians.

Study design

Prospective randomized crossover study.

Method

A total of 26 students with no ultrasound locoregional anaesthesia experience (non-skilled group) and six clinicians experienced and familiar with ultrasound locoregional anaesthesia (skilled group) were enrolled. The non-skilled group was asked to perform two tasks: the first on a phantom and the second on canine cadavers, whilst the skilled group performed only the second task. The tasks consisted of guiding the tip of the needle to a target point (simulated nerve on the jelly phantom and sciatic nerve on the cadavers) using two different methods of needle handling—AL or AC. All operators performed each task three times for each method. The time to drive the needle to the target for the two methods was analysed with a paired Student t test, and the number of times the needle was not visualized on the screen between the groups was compared using an unpaired Student t test. Data are presented as mean ± standard deviation. Value of p < 0.05 was considered significant.

Results

The AL method, compared with the AC method, resulted in shorter performance time in both skilled (9 ± 5 versus 20 ± 8 seconds for the second task) and non-skilled groups (9 ± 8 versus 17 ± 15 seconds for the first task and 18 ± 11 versus 32 ± 26 seconds for the second task).

Conclusion and clinical relevance

In both groups, the AL method significantly reduced the time to complete the task. Results from this study indicate that the AL method should be the preferred method for learning/teaching ultrasound-guided regional anaesthesia.

中文翻译：

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沿或跨视轴：两种超声屏幕、针头和换能器定向技术的比较

客观的

评估非熟练和熟练临床医生沿视轴 (AL) 和跨视轴 (AC) 的两种换能器和针头操作方法。

学习规划

前瞻性随机交叉研究。

方法

共招募了 26 名没有超声局部麻醉经验的学生（非技术组）和 6 名经验丰富且熟悉超声局部麻醉的临床医生（技术组）。非技术组被要求执行两项任务：第一项是在幽灵上，第二项是在犬类尸体上，而技术组只执行第二项任务。任务包括使用两种不同的针处理方法 - AL 或 AC，将针尖引导到目标点（果冻模型上的模拟神经和尸体上的坐骨神经）。所有操作员对每种方法执行每个任务 3 次。使用配对的 Student t分析了两种方法将针驱动到目标的时间测试，并且使用未配对的学生t检验比较各组之间屏幕上未显示针的次数。数据表示为平均值±标准偏差。p < 0.05 的值被认为是显着的。

结果

与 AC 方法相比，AL 方法在熟练组（第二个任务的9 ± 5秒对20 ± 8 秒）和非熟练组（第一个任务的9 ± 8秒对17 ± 15 秒）中的执行时间更短和 18 ± 11对第二个任务的 32 ± 26 秒）。

结论和临床相关性

在两组中，AL 方法都显着减少了完成任务的时间。这项研究的结果表明，AL 方法应该是学习/教授超声引导区域麻醉的首选方法。