Department of Anaesthesia, Royal Melbourne Hospital, Victoria, Australia.
Reg Anesth Pain Med. 2013 Jul-Aug;38(4):350-2. doi: 10.1097/AAP.0b013e3182926d6b.
Needle guidance under ultrasound is an acquired skill requiring fine motor control. Maintaining the image of an advancing needle in the plane of an ultrasound beam may be performed with the probe and needle orientated along the visual axis (AL) or across the visual axis (AC). This study was undertaken to determine if orientation affected task performance.
Twenty-four relative novices were tasked to perform guided punctures to a target in a pork phantom using each technique 5 times. The technique first used was randomly chosen from a sealed envelope. The time taken to guide the needle to target and the accuracy of needle imaging were recorded.
The mean time to locate the target was significantly faster for the AL technique, compared with the AC technique (group AL, 35.7, vs group AC, 58.6 seconds; P < 0.0001, Wilcoxon matched-pairs signed rank test). The mean imaging quality score was also significantly better when needle advancement was along the visual axis (group AL, 1.37, vs group AC, 1.64; P = 0.05).
Advancing the needle along the visual axis was associated with improved task completion speed and quality of needle imaging. This ergonomic pattern, therefore, may be the more appropriate choice for novices learning ultrasound-guided in-plane needle imaging.
超声引导下的进针需要精细的运动控制，这是一种需要掌握的技能。将进针的图像保持在超声束的平面内，可以通过将探头和针沿着视觉轴（AL）或穿过视觉轴（AC）来实现。本研究旨在确定进针的方向是否会影响任务的完成。
24 名相对新手使用每种技术进行 5 次导向穿刺，以在猪模型中的靶标上进行穿刺。使用密封信封随机选择首先使用的技术。记录引导针到达靶标所需的时间和针成像的准确性。
与 AC 技术相比，AL 技术定位目标的平均时间明显更快（AL 组 35.7 秒，AC 组 58.6 秒；P < 0.0001，Wilcoxon 配对符号秩检验）。当针沿视觉轴推进时，平均成像质量评分也明显更好（AL 组 1.37，AC 组 1.64；P = 0.05）。
将针沿着视觉轴推进与提高任务完成速度和针成像质量有关。因此，对于学习超声引导平面内针成像的新手来说，这种符合人体工程学的模式可能是更合适的选择。
