|
|
October 16-20, 2010 San Diego, CA Home Abstract Archive Search Abstracts 2010 Session Grid 2010 Meeting Website Policy Statements ASA Website Feedback 
Visit Anesthesiology.org |
| Previous Abstract | Next Abstract |
| Printable Version |
|
A1707
October 16, 2007 2:00 PM - 4:00 PM Room Hall D, Area L, |
| Estimation of Ultrasound-Guided Puncture Skills with a Novel Needle |
|
Kazuto Takakuwa, M.D., Masanori Yamauchi, M.D., Ph.D., Yasuyuki Susa, M.D., Ph.D., Toshiya Kawagishi, M.D., Akiyoshi Namiki, M.D., Ph.D. Anesthesiology, Sapporo Medical University, Sapporo, Hokkaido, Japan |
|
Introduction: Ultrasound-guided nerve block and blood access have widely distributed around the world, and the technical procedure and the equipment has also developed. Ultrasound (US) imaging can identify nerves, vessels and a needle tips in-plane approach (IP). Therefore, a novel unique needle for ultrasound-guided nerve block (CCR needle, Hakko Co, Tokyo, Japan) has the tip that could be identify clearer in the US imaging by diffused reflection is recently appeared. This needle is expected smoother hand-eye coordination than usual needle. In this study we estimated the US-guided puncture ability comparing the normal needle with the CCR needle, and IP with out-of-plane approach (OOP) by medical students, residents and senior anesthesiologists using an US training phantom. Methods: The protocol of the present study had been approved by the Ethics Committee of our institution. The study examinees consisted of 90 medical associates in 3 groups; 30 anesthesia specialists, 30 residents and 30 final term medical students. Ultrasound hands-on training model (Blue PhantomTM, Advanced Medical Technologies, LLC, WA) which has a front hazardous circle and a deeper target circle was used to examine the US-guided puncture ability. Each examinee attempted training US-guided puncture; a needle tip would touch the side edge of the target in 4 times randomly (2 types of needle; CCR needle and usual needle, and 2 approaches; OOP and IP). The puncture time and the number of miss-puncture to a hazard circle were counted. The accuracy and utility of the puncture was also compared between needles and between approaches. Data were analyzed using the Mann-Whitney U-test, paired t-test and the χ2 test. P<0.05 was considered statistically significant. Results: Puncture time by IP (9.2sec) or CCR needle (8.9sec) in medical students and resident group is significantly shorter than in OP (19.5sec) or usual needle (20.3sec), simultaneously (p<0.01). In anesthesia specialists group, there was no significant difference in the puncture time between CCR and usual needle. IP caused less miss puncture than OOP (p<0.05). Utility was more superior in IP and CCR (90%) needle than that in OOP and usual needle (10%) (p<0.05). There was no significant difference in puncture time between medical students and residents. Therefore, in using CCR needle in IP, there was no significant difference among the groups. Conclusion: A novel needle for ultrasound-guided puncture could be useful for accurate puncture, especially in IP. These results suggested that ultrasound-guided puncture technique is still not familiar to even anesthesia specialists, and equipments, needles and optimum approach would be more important than experience of the performer for accurate puncture. Anesthesiology 2007; 107: A1707 |