Przkora Rene, McGrady William, Vasilopoulos Terrie, Gravenstein Nikolaus, Solanki Daneshvari
Department of Anesthesiology, University of Florida, Gainesville, Florida.
Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas.
Pain Med. 2015 Nov;16(11):2192-4. doi: 10.1111/pme.12765. Epub 2015 Apr 30.
Anesthesiologists performing peripheral nerve blocks under ultrasound guidance look frequently back and forth between the patient and the ultrasound screen during the procedure. These head movements add time and complexity to the procedure. The head-mounted display (HMD) device is a commercially available head-mounted video display that is connected to the ultrasound machine and projects the ultrasound image onto the HMD glasses, enabling the anesthesiologist to monitor the screen without ever needing to look away from the patient. We hypothesized that the use of the HMD device would decrease the total procedure time as well as operator head and ultrasound probe movements during a simulated nerve block.
The Blue Phantom was used to simulate a nerve block target. After IRB approval, verbal consent was obtained. Twenty participants, at different levels of training/experience, were asked to perform a simulated nerve block under ultrasound guidance with and without the HMD. The number of ultrasound probe and head movements and the time required to place the needle with and without the HMD were recorded. Results were analyzed using a paired t-test and significance was accepted with P < 0.05.
Participants were significantly faster (7.1 vs 10.9 seconds) performing the simulated block with the HMD than without. Additionally, the HMD significantly decreased the number of operator head and ultrasound probe movements.
Use of a HMD improved efficiency and human factors during simulated nerve blocks. This suggests that a clinical study to see if this observation translates into a clinical setting is warranted.
在超声引导下实施周围神经阻滞的麻醉医生在操作过程中经常在患者和超声屏幕之间来回看。这些头部动作增加了操作的时间和复杂性。头戴式显示器（HMD）设备是一种商用的头戴式视频显示器，它与超声机器相连，并将超声图像投射到头戴式眼镜上，使麻醉医生无需将目光从患者身上移开就能监测屏幕。我们假设在模拟神经阻滞过程中使用HMD设备会减少总操作时间以及操作者头部和超声探头的移动。
使用蓝色人体模型模拟神经阻滞靶点。经机构审查委员会（IRB）批准后，获得了口头同意。20名不同培训/经验水平的参与者被要求在有和没有HMD的情况下，在超声引导下进行模拟神经阻滞。记录使用和不使用HMD时超声探头和头部的移动次数以及进针所需时间。结果采用配对t检验进行分析，P < 0.05时认为具有显著性。
参与者使用HMD进行模拟阻滞的速度明显更快（7.1秒对10.9秒）。此外，HMD显著减少了操作者头部和超声探头的移动次数。
在模拟神经阻滞过程中使用HMD提高了效率并改善了人为因素。这表明有必要进行一项临床研究，以确定这一观察结果是否能转化到临床环境中。
