Comparison of the Learning Curves of Ultrasound-Guided In-Plane Needle Placement Among Four Different Puncture Modes: A Randomized, Crossover, Simulation Study.
Yingjie Hu, Jing Xiao, Xiao He, Tingting Qin, Li Wan, Wenlong Yao
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引用次数: 0
Abstract
Background: The effects of different positional relationships between the probe, needle, and puncture model on in-plane puncture performance have not been fully evaluated. In this simulation study, we used a 4-period crossover design to compare the learning curves of ultrasound-guided in-plane needle placement among 4 different puncture modes by novices.
Methods: Forty residents were randomly assigned to receive training in one of 4 puncture modes according to the placement of the puncture model and the orientation of the probe to the operator: horizontal phantom-parallel probe (HP), horizontal phantom-vertical probe (HV), vertical phantom-parallel probe (VP), and vertical phantom-vertical probe (VV). They were allowed 10 trials on each mode and then received the other 3 trainings following the predefined sequences based on a Williams design. Puncture time was recorded from needle entry until successful in-plane puncture under ultrasound guidance.
Results: Linear and generalized linear models indicated significant effects of puncture mode and trial number on puncture time (P < .001 for all models). The mean (standard deviation [SD]) puncture times for 10 trials were 44 (44) s for HP, 37 (34) s for HV, 80 (57) s for VP, and 46 (48) s for VV. HV had the shortest puncture time, while VP had the longest. No significant difference was observed in puncture time between VV and HP modes (P = .330). Within each mode, puncture time significantly decreased from the first to the tenth trial (P = .001 for HP, P < .001 for HV, P < .001 for VP, and P = .002 for VV). VP showed the steepest learning curve; however, even after 10 trials, its puncture time remained significantly higher than that of the other 3 modes (P < .001 for all comparisons).
Conclusions: Ultrasound-guided in-plane puncture difficulty follows the order VP > HP = VV > HV.
期刊介绍：
Anesthesia & Analgesia exists for the benefit of patients under the care of health care professionals engaged in the disciplines broadly related to anesthesiology, perioperative medicine, critical care medicine, and pain medicine. The Journal furthers the care of these patients by reporting the fundamental advances in the science of these clinical disciplines and by documenting the clinical, laboratory, and administrative advances that guide therapy. Anesthesia & Analgesia seeks a balance between definitive clinical and management investigations and outstanding basic scientific reports. The Journal welcomes original manuscripts containing rigorous design and analysis, even if unusual in their approach.
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