Loss of Resistance: A Randomized Controlled Trial Assessing 4 Low-fidelity Epidural Puncture Simulators

Abstract

(Eur J Anaesthesiol 2017;34:602–608) Placing an epidural catheter for administration of regional anesthesia is considered to be a difficult skill for anesthesia residents to master. In one study, first-year residents had only an 80% success rate after 90 attempts at epidural catheter placement. With such a steep learning curve, it would be beneficial to have significant simulated experiences before performing the procedure on patients. Several simulators are commercially available for practicing identification of the epidural space using a loss of resistance (LOR) technique. However, these simulators can be quite expensive, ranging in price between €1500 and 3000. The use of various fruits have been studied to simulate the feel of LOR during epidural procedures with the banana found to best simulate the sensation. In this single-blinded, randomized, controlled study the investigators compared 3 commercially available simulators and a banana for their ability to simulate the LOR feel essential to successful epidural placement.

A homemade simulation model improves the impact of e‐learning for the practical administration of dental anaesthesia

“…The strategy of using fruit to simulate a puncture has been reported in other studies. 24,25 We explored that strategy for G1 because the absence of any practice for the participants in that group would put them at a clear disadvantage in comparison with G2 participants.…”

“…The Styrofoam head was fine for practising the BIT because it did not involve a specific dental anaesthesia technique but only the experience of practising puncture, aspiration and injection. The strategy of using fruit to simulate a puncture has been reported in other studies 24,25 . We explored that strategy for G1 because the absence of any practice for the participants in that group would put them at a clear disadvantage in comparison with G2 participants.…”

“…We also evaluated the students' perception of confidence in performing the BIT. Confidence is defined as ‘a feeling or belief that you can do something well or succeed at something’ 25 . To evaluate that variable, first the participants practised the BIT with a lemon (G1) or with the HMDASM (G2) at Stages 2 and 3 of the online learning course and then completed the questionnaire exploring the variable.…”

“…Confidence is defined as 'a feeling or belief that you can do something well or succeed at something'. 25 To evaluate that variable, first the participants practised the BIT with a lemon (G1)…”