Evaluation of M43B Lumbar puncture simulator‐II as a training tool for identification of the epidural space and lumbar puncture*

Abstract

SummaryThe identification of the epidural space, insertion of an epidural catheter and lumbar puncture are advanced technical skills that can be challenging to teach to novice anaesthetists. The M43B Lumbar puncture simulator-II (Limbs & Things Ltd., Sussex Street, Bristol, UK) is a teaching aid designed for epidural and spinal insertion. The aim of this study was to determine if experienced anaesthetists thought this simulator may be a useful tool for training novice anaesthetists in these procedures. Experienced anaesthetists performed an epidural insertion followed by a lumbar puncture procedure on the simulator model. Various aspects of both epidural and lumbar puncture insertions were scored by the anaesthetists for likeness to a real patient using a Likert scale (0 -strongly disagree; 1 -disagree; 2 -neither agree nor disagree; 3 -agree; 4 -strongly agree). The simulator was found to be life-like for most aspects of epidural insertion. -4]). However, the overall impression was that the simulator could be a useful tool for training of both epidurals (score 3.0 (3.0-4.0 [3-4])) and spinals (score 3.0 (3.0-3.5 [2-4])).

Comparison of Ultrasound‐guided vs. Standard Landmark Techniques for Training Novice Operators in Placing Needles Into the Lumbar Subarachnoid Space of Canine Cadavers

“…The traditional landmark‐based technique does not require specific equipment and it is easily available and inexpensive. However, its application requires training and is compromised if the bony landmarks are not successfully palpated . The ultrasound‐guided technique (as the blind technique) does not produce ionizing radiation, but requires a more expensive and less available equipment.…”

07 / Objective evaluation of a new epidural simulator with CompuFlo® Epidural Instrument

“…In particular, the major problems with epidural simulator assessment is that they are usually evaluated by subjective Likert like scales reported by physicians, and this kind of scales may have some disadvantages and are subjected to a large variability of ratings [1][2][3]. Due to the nature of this subjective evaluation, results of previous studies on epidural simulators are controversial.…”

“…One major limitation of these models is that they do not reproduce the anatomical features of all the layers the needle must pass (skin, subcutaneous fat, supraspinous and interspinous ligament, and ligamenta flava) and sometimes the solid plastic structure to represent the vertebare do not accurately reproduce the vertebral arch and the other possible bony parts which may be encountetred during needle insertion. e average impression of the users of the commercially available simulators, based on subjective scales, has been reported to be largely variable, usually achieving medium or low scores [1,2].…”

Nuevo simulador híbrido cadavérico/sintético para la enseñanza de técnicas intervencionistas para tratamiento del dolor refractario

“…La medición de la eficacia de la educación médica debe considerar los nuevos recursos que se suceden en los últi-mos años incorporando modernas tecnologías que, a través de la simulación, como se mencionó previamente, buscan atenuar el gap entre la teoría y la práctica (50)(51)(52)(53). La historia contemporánea de la Medicina del Dolor ha evolucionado con los cambios de la Anestesiología, y se pueden considerar como principales referencias en la primera mitad del siglo xx la clínica del dolor de John Lundy, las enseñanzas de John Bonica de bloqueos diagnósticos y terapéuticos en la residencia de anestesiología y, en las últimas décadas, los talleres en cadáveres frescos de Gabor Racz y Prithvi Raj, entre otros.…”