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超声引导下周围神经阻滞的模拟:麻醉科住院医师在CET-SMA/HSL方面的学习曲线

Simulation of ultrasound-guided peripheral nerve block: learning curve of CET-SMA/HSL Anesthesiology residents.

作者信息

Baranauskas Marilia Bonifácio, Margarido Clarita Bandeira, Panossian Cláudia, Silva Enis Donizetti, Campanella Murilo Awada, Kimachi Pedro Paulo

机构信息

Instituto de Ensino e Pesquisa (IEP), localizado no Hospital Sírio Libanês (HSL), São Paulo, SP.

出版信息

Rev Bras Anestesiol. 2008 Mar-Apr;58(2):106-11. doi: 10.1590/s0034-70942008000200003.

DOI:10.1590/s0034-70942008000200003
PMID:19378529
Abstract

BACKGROUND AND OBJECTIVES

The use of ultrasound imaging in peripheral nerve block has been increasing. However, there are few reports in the literature on the learning curve of the ultrasound technique. The objective of this report was to evaluate the learning curve of CET-SMA/HSL Anesthesiology residents of ultrasound-guided peripheral block using an experimental agar model.

METHODS

An experimental model was developed by filling a bowl with agar and olives. Nine residents were randomly divided in three groups (G1, G2, and G3), each one with a R1, a R2, and a R3. All three groups received theoretical explanation. G1 also had two hours of practical training, G2 had one hour, and G3 had no training. Residents were then asked to place a needle at the middle of the olive wall, near the transducer and then reposition the needle between the olive and the bottom of the bowl, simulating the epidural injection of anesthetic. The speed and efficacy of the tasks, as well as technical flaws, were evaluated.

RESULTS

The mean length of time to perform the tasks was 37.63 seconds for G1, without technical flaws; 64.40 seconds for G2, with two technical flaws; and 93.83 seconds for G3, with 12 technical flaws.

CONCLUSIONS

This study allows us to conclude that the longer training of ultrasound-guided peripheral nerve block in an experimental model improved the learning curve of the technique.

摘要

背景与目的

超声成像在外周神经阻滞中的应用日益增多。然而,文献中关于超声技术学习曲线的报道较少。本报告的目的是使用实验性琼脂模型评估某麻醉科住院医师超声引导外周阻滞的学习曲线。

方法

通过在碗中填充琼脂和橄榄建立实验模型。9名住院医师被随机分为三组(G1、G2和G3),每组各有R1、R2和R3三名医师。所有三组均接受理论讲解。G1组还接受了两小时的实践培训,G2组接受了一小时培训,G3组未接受培训。然后要求住院医师将针置于靠近换能器的橄榄壁中部,接着将针重新定位到橄榄与碗底部之间,模拟硬膜外注射麻醉剂。对任务的速度和效果以及技术缺陷进行评估。

结果

G1组完成任务的平均时长为37.63秒,无技术缺陷;G2组为64.40秒,有两个技术缺陷;G3组为93.83秒,有12个技术缺陷。

结论

本研究使我们得出结论,在实验模型中对外周神经阻滞进行更长时间的超声引导培训可改善该技术的学习曲线。

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