Single and Double Operator Techniques in Ultrasound-guided Peripheral Nerve Block Learning Curve
Study Details
Study Description
Brief Summary
Aim of this study is to compare learning curves of single(1- Jedi grip: Pappin and Christie/ 2- Bedforth/ 3- on lock: Gupta and Berrill) and double operator ultrasound-guided peripheric nerve block techniques on a home-made gelatin-based phantom model.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Ultrasound-guided peripheral blocks are conventionaly performed by double operators. One operator controls both the ultrasound probe and peripheric block needle. Another assistant operator aspirate or injects local anesthetic. In this technique operator do not sense resistance in the syringe. Also this technique requires a well-done communication and coordination between operators.
In order to eliminate disadvantages of this technique several single-operator grip techniques of the needle and syringe have been described(1- Jedi grip: Pappin and Christie/ 2- Bedforth/ 3- on lock: Gupta and Berrill). Single operator techniques allow the provider to perform independently.
Aim of this study is to compare learning curves of single and double operator ultrasound-guided peripheric nerve block techniques on a home-made gelatin-based phantom model.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Double Operator Ultrasound-Guided Regional Anesthesia resident control block needle and ultrasound probe and asistant operator inject the solution. resident reach the target area created in the phantom model using a block needle with ultrasound guidance |
Other: reaching targeted area on the phantom model
resident reach the targeted area on the phantom model using ultrasoun guidance and independently or with asistance inject the solution
|
| Active Comparator: Jedi Grip resident control block needle, ultrasound probe and syringe independently with jedi grip; reach the target area created in the phantom model using a block needle with ultrasound guidance; inject and aspirate the solution. |
Other: reaching targeted area on the phantom model
resident reach the targeted area on the phantom model using ultrasoun guidance and independently or with asistance inject the solution
|
| Active Comparator: On-lock grip resident control block needle, ultrasound probe and syringe independently with on-lock grip; reach the target area created in the phantom model using a block needle with ultrasound guidance; inject the solution. |
Other: reaching targeted area on the phantom model
resident reach the targeted area on the phantom model using ultrasoun guidance and independently or with asistance inject the solution
|
| Active Comparator: Bedforth alternative grip resident control block needle, ultrasound probe and syringe independently with bedforth's alternative grip; reach the target area created in the phantom model using a block needle with ultrasound guidance; inject the solution. |
Other: reaching targeted area on the phantom model
resident reach the targeted area on the phantom model using ultrasoun guidance and independently or with asistance inject the solution
|
Outcome Measures
Primary Outcome Measures
- Time to correct grip1 [during implementation of procedure on phantom model(first session)]
Time(sec) from start command to correct grip of the probe, needle and syringe for each technique
- image quality1 [during implementation of procedure on phantom model(first session)]
provided image quality by resident for each technique which is assessed by investigator by four point Liker Scale( 1- much worse 2- worse 3- better 4- much better)
- number of attempts1 [during implementation of procedure on phantom model(first session)]
number of attempts until correct needling to target area
- needling time 1 [during implementation of procedure on phantom model(first session)]
time to reach target area with block needle
- success of injection1 [during implementation of procedure on phantom model(first session)]
successful if injected water flows from hose of model/ unsuccessful if solution do not flow
- Time to correct grip2 [during implementation of procedure on phantom model(second session)]
Time(sec) from start command to correct grip of the probe, needle and syringe for each technique
- Time to correct grip3 [during implementation of procedure on phantom model(third session)]
Time(sec) from start command to correct grip of the probe, needle and syringe for each technique
- image quality2 [during implementation of procedure on phantom model(second session)]
provided image quality by resident for each technique which is assessed by investigator by four point Liker Scale( 1- much worse 2- worse 3- better 4- much better)
- image quality3 [during implementation of procedure on phantom model(third session)]
provided image quality by resident for each technique which is assessed by investigator by four point Liker Scale( 1- much worse 2- worse 3- better 4- much better)
- number of attempts2 [during implementation of procedure on phantom model(second session)]
number of attempts until correct needling to target area
- number of attempts3 [during implementation of procedure on phantom model(third session)]
number of attempts until correct needling to target area
- needling time 2 [during implementation of procedure on phantom model(second session)]
time to reach target area with block needle
- needling time 3 [during implementation of procedure on phantom model(third session)]
time to reach target area with block needle
- success of injection2 [during implementation of procedure on phantom model(second session)]
successful if injected water flows from hose of model/ unsuccessful if solution do not flow
- success of injection3 [during implementation of procedure on phantom model(third session)]
successful if injected water flows from hose of model/ unsuccessful if solution do not flow
Secondary Outcome Measures
- NASA-TLX (NASA Task Load Index) [during implementation of procedure on phantom model(third session)]
Resident assessment of each techniques for Mental Demand ,Physical Demand, Temporal Demand, Performance, Effort and Frustration
- Assesment of education [during education of techniques]
Residents assesment of pre-procedural education with a questtionarie. "Education was sufficient enough to safely perform peripheral block": I absolutely agree I approve I am indecisive I do not approve Absolutely Disagree
Eligibility Criteria
Criteria
Inclusion Criteria:
- To be a junior resident of anesthesiology(< 2 years )
Exclusion Criteria:
- Refusal of resident
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Ankara City Hospital | Ankara | Turkey | 06600 |
Sponsors and Collaborators
- Ankara City Hospital Bilkent
Investigators
- Principal Investigator: İsmail Aytac, Ankara City Hospital Anesthesiology Department
Study Documents (Full-Text)
None provided.More Information
Publications
- Bedforth N, Townsley P, Maybin J, Eisenberg E. Single-handed ultrasound-guided regional anaesthesia. Anaesthesia. 2011 Sep;66(9):846. doi: 10.1111/j.1365-2044.2011.06864.x.
- Gupta P, Berrill A. 'On lock' - a further single-operator ultrasound-guided regional anaesthesia grip. Anaesthesia. 2017 Oct;72(10):1289. doi: 10.1111/anae.14050.
- Miyake S. Factors influencing mental workload indexes. J UOEH. 1997 Dec 1;19(4):313-25. Review.
- Pappin D, Christie I. The Jedi Grip: a novel technique for administering local anaesthetic in ultrasound-guided regional anaesthesia. Anaesthesia. 2011 Sep;66(9):845. doi: 10.1111/j.1365-2044.2011.06845.x.
- E1/20-804