The effect of an ultrasound‐activated needle tip tracker needle on the performance of sciatic nerve block on a soft embalmed Thiel cadaver

Abstract

Summary In this study, we measured the performance of medical students and anaesthetists using a new tracker needle during simulated sciatic nerve block on soft embalmed cadavers. The tracker needle incorporates a piezo element near its tip that generates an electrical signal in response to insonation. A circle, superimposed on the ultrasound image surrounding the needle tip, changes size and colour according to the position of the piezo element within the ultrasound beam. Our primary objective was to compare sciatic block performance with the tracker switched on and off. Our secondary objectives were to record psychometrics, procedure efficiency, participant self‐regulation and focused attention using eye‐tracking technology. Our primary outcome measures were the number of steps successfully performed and the number of errors committed during each block. Videos were scored by trained experts using validated checklists. Sequential tracker activation and deactivation was randomised equally within subjects. With needle activation, steps improved in 10 (25%) subjects and errors reduced in six (15%) subjects. The most important steps were: needle tip identification before injection, OR (95%CI) 2.12 (1.61–2.80; p < 0.001); and needle tip identification before advance of the needle, 1.80 (1.36–2.39; p < 0.001). The most important errors were: failure to identify the needle tip before injection, 2.40 (1.78–3.24; p < 0.001); and failure to quickly regain needle tip position when tip visibility was lost, 2.03 (1.5–2.75; p < 0.001). In conclusion, needle‐tracking technology improved performance in a quarter of subjects.

The use of artificial intelligence and robotics in regional anaesthesia

“…The steeper learning curve likely reflected the novelty of the technology as performance times were considerably longer in the earlier trials. This phenomenon was also witnessed during testing of a regional block needle tip tracking system [21] and underlines the need for thorough training when adopting new technology. Moreover, there is a potential danger of overreliance on robotic‐assistance during training.…”

Intelligent Three-Dimensional Reconstruction Algorithm-Based Ultrasound-Guided Nerve Block in Intraoperative Anesthesia and Postoperative Analgesia of Orthopedic Surgery

“…Elderly patients have poor body tolerance; the function of various organs declines and often accompanied by a variety of underlying diseases. In this case, clinical lower extremity fracture surgery is performed, so there is a higher requirement for intraoperative anesthesia [16]. Traditional orthopedic surgery anesthesia mostly uses general anesthesia, which is convenient for ventilation and management, so it is widely used in clinical practice.…”

Patterns of Skills Acquisition in Anesthesiologists During Simulated Interscalene Block Training on a Soft Embalmed Thiel Cadaver: Cohort Study

“…Cadaver-based training courses are common but unstructured, and only basic skills are taught. Trainee:trainer ratios are high, and skills are acquired at different rates [5]. Thus, clinical educational outcomes prescribed by the Royal College of Anaesthetists training curriculum 2021 may be difficult to reach within short time frames [6,7].…”

“…To date, our work has validated the physical and functional alignment of the Thiel embalmed cadaver simulator [10], developed and validated checklist and eye tracking metrics that reflect skills performance [11], introduced mastery learning and dedicated 1:1 training to regional anesthesia [5], measured learning curves using new needle technology [5], and showed translation of skills from cadavers to patients 3 weeks after training. We also used eye tracking to measure the performance of the simulators and patients [4].…”