Evaluation of the learning curve of residents in localizing a phantom target with ultrasonography

被引:14
作者
Dessieux, T. [1 ]
Estebe, J. -P. [1 ]
Bloc, S. [2 ]
Mercadal, L. [2 ]
Ecoffey, C. [1 ]
机构
[1] CHU Rennes, Hop Pontchaillou, Serv Anesthesie Reanimat Chirurg 2, F-35033 Rennes 9, France
[2] Ctr Hosp Prive Claude Galien, F-91480 Quincy Sous Senart, France
来源
ANNALES FRANCAISES D ANESTHESIE ET DE REANIMATION | 2008年 / 27卷 / 10期
关键词
Regional anesthesia; Ultrasonography; Hydrolocalization; Training program; Learning curve;
D O I
10.1016/j.annfar.2008.08.008
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Introduction. - Few information are available regarding the learning curve in ultrasonography and even less for ultrasound-guided regional anesthesia. This study aimed to evaluate in a training program the learning curve on a phantom of 12 residents novice in ultrasonography. Material and methods. - Twelve trainees inexperienced in ultrasonography were given introductory training consisting of didactic formation on the various components of the portable ultrasound machine (i.e. on/off button, gain, depth, resolution, and image storage). Then, students performed three trials, in two sets of increased difficulty, at executing these predefined tasks: adjustments of the machine, then localization of a small plastic piece introduced into roasting pork (3 cm below the surface). At the end of the evaluation, the residents were asked to insert a 22 G needle into an exact predetermined target (i.e. point of fascia intersection). The progression of the needle was continuously controlled by ultrasound visualization using injection of a small volume of water (needle perpendicular to the longitudinal plane of the ultrasound beam). Two groups of two different examiners evaluated for each three trials the skill of the residents (quality, time to perform the machine adjustments, to localize the plastic target, and to hydrolocalize, and volume used for hydrolocalization). After each trial, residents evaluated their performance using a difficulty scale (0: easy to 10: difficult). Results. - All residents performed the adjustments from the last trial of each set, with a learning curve observed in terms of duration. Localization of the plastic piece was achieved by all residents at the 6th trial, with a shorter duration of localization. Hydrolocalization was achieved after the 4th trial by all subjects. Difficulty scale was correlated to the number of trials. All these results were independent of the experience of residents in regional anesthesia. Discussion. - Four trials were necessary to adjust correctly the machine, to localize a target, and to complete hydrolocalization. Ultrasonography in regional anesthesia seems to be a fast-learning technique, using this kind of practical training. (c) 2008 Elsevier Masson SAS.
引用
收藏
页码:797 / 801
页数:5
相关论文
共 18 条
[1]   USE OF DOPPLER FOR DIFFICULT AXILLARY BLOCK [J].
ABRAMOWITZ, HB ;
COHEN, C .
ANESTHESIOLOGY, 1981, 55 (05) :603-603
[2]   Use of a nerve stimulator does not improve the efficacy of ultrasound-guided supraclavicular nerve blocks [J].
Beach, Michael L. ;
Sites, Brian D. ;
Gallagher, John D. .
JOURNAL OF CLINICAL ANESTHESIA, 2006, 18 (08) :580-584
[3]  
BLOC S, 2007, ANN FR ANESTH S, V26, pS13
[4]   A prospective, randomized comparison between ultrasound and nerve stimulation guidance for multiple injection axillary brachial plexus block [J].
Casati, Andrea ;
Danelli, Giorgio ;
Baciarello, Marco ;
Corradi, Maurizio ;
Leone, Stefania ;
Di Cianni, Simone ;
Fanelli, Guido .
ANESTHESIOLOGY, 2007, 106 (05) :992-996
[5]   Ultrasound examination and localization of the sciatic nerve - A volunteer study [J].
Chan, VWS ;
Nova, H ;
Abbas, S ;
McCartney, CJL ;
Perlas, A ;
Xu, DQ .
ANESTHESIOLOGY, 2006, 104 (02) :309-314
[6]   Ultrasound-guided regional anesthesia - Current state of the art [J].
Gray, AT .
ANESTHESIOLOGY, 2006, 104 (02) :368-373
[7]  
LAGRANGE PDP, 1978, BRIT J ANAESTH, V50, P965
[8]   Ultrasound guidance in regional anaesthesia [J].
Marhofer, P ;
Greher, M ;
Kapral, S .
BRITISH JOURNAL OF ANAESTHESIA, 2005, 94 (01) :7-17
[9]   Ultrasonographic guidance improves sensory block and onset time of three-in-one blocks [J].
Marhofer, P ;
Schrogendorfer, K ;
Koinig, H ;
Kapral, S ;
Weinstabl, C ;
Mayer, N .
ANESTHESIA AND ANALGESIA, 1997, 85 (04) :854-857
[10]   Ultrasonographic guidance reduces the amount of local anesthetic for 3-in-1 blocks [J].
Marhofer, P ;
Schrogendorfer, K ;
Wallner, T ;
Koinig, H ;
Mayer, N ;
Kapral, S .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 1998, 23 (06) :584-588