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Background In this study, we describe a custom-made new epidural simulator, created by modifying the inner structure of a commercially available one, in the attempt to make it adequately realistic. To validate and evaluate the realism of our device, we used the Computerized Epidural Instrument CompuFlo. Method The Compuflo CompuFlo curves obtained from 64 experiments on the epidural simulator were compared to 64 curves obtained from a previous human study, from consecutive laboring parturients requesting epidural analgesia. Results Epidural simulator and human pressure curves were very similar. There was a significant difference between the drop of pressure due to false and true loss of resistance (LOR) in both the groups. Discussion Our simulator can realistically reproduce the anatomical layers the needle must pass as demonstrated by the similarity between the simulator and human pressure curves and the small differences of pressure values recorded. CompuFlo may be used as an objective tool to create and assess and compare objectively the epidural task trainers.

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The ability of recognizing the ligamentum flavum is the first, crucial, important skill to teach novices when they are learning the epidural technique. The aim of this preliminary prospective study was to evaluate whether the Compuflo® Epidural instrument may help inexperienced trainees to better identify the ligamentum flavum during an epidural simulator training session. Compuflo® reduced the total number of attempts to identify the ligamentum flavum and increased three fold the chance to identify it at the first attempt during a simulator-assisted training module, making this identification easier for inexperienced trainees. This trial is registered with NCT03812926.