Kasuya Yusuke, Moriwaki Shota, Inano Chiaki, Fukada Tomoko, Komatsu Ryu, Ozaki Makoto
Department of Anesthesiology, Tokyo Women's Medical University, 8-1 Kawadacho Shinjuku-ku, Tokyo, 162-8666, Japan.
Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Room H3580 MC 5640 Department of Anesthesia, Stanford, CA, 94305, USA.
J Anesth. 2017 Oct;31(5):782-784. doi: 10.1007/s00540-017-2371-x. Epub 2017 May 5.
The head-mounted display (HMD) has the potential to improve the quality of ultrasound-guided procedures. The aim of this non-clinical crossover designed study is to evaluate the feasibility of the HMD for ultrasound-guided nerve block. Eight experienced anesthesiologists performed ultrasound-guided peripheral nerve blocks on a training simulator with a standard approach and with an upside-down approach. Each approach was performed with a control conventional method and with an HMD. The ultrasound image and operating field were recorded by video camera. The procedure time and fractional percentage of time with the needle visible on the ultrasound image were determined. The needle insertion times were 10.4 ± 7.2 s with the control method and 6.8 ± 5.3 s with the HMD method for the standard approach (p = 0.03), and 18.1 ± 10.1 with the control method and 11.8 ± 9.5 s with the HMD method for the upside-down approach (p = 0.002). The fractional percentages of time with the needle visible on the ultrasound image were 34.1 ± 20.9 with the control method and 56.5 ± 13.6% with the HMD method for the standard approach (p < 0.001), and 20.1 ± 13.4 with the control method and 38.2 ± 21.2% with the HMD method for the upside-down approach (p = 0.001). In conclusion, this pilot study using a simulation model indicated that the use of an HMD shortened the procedure time and improved the needle visibility on ultrasound.
头戴式显示器（HMD）有潜力提高超声引导操作的质量。这项非临床交叉设计研究的目的是评估HMD用于超声引导神经阻滞的可行性。八位经验丰富的麻醉医生在训练模拟器上采用标准方法和倒置方法进行超声引导的外周神经阻滞。每种方法都分别采用传统对照方法和HMD进行。用摄像机记录超声图像和手术视野。确定操作时间以及针在超声图像上可见的时间占比。标准方法中，对照方法的进针时间为10.4±7.2秒，HMD方法为6.8±5.3秒（p = 0.03）；倒置方法中，对照方法的进针时间为18.1±10.1秒，HMD方法为11.8±9.5秒（p = 0.002）。标准方法中，对照方法针在超声图像上可见的时间占比为34.1±20.9，HMD方法为56.5±13.6%（p < 0.001）；倒置方法中，对照方法为20.1±13.4，HMD方法为38.2±21.2%（p = 0.001）。总之，这项使用模拟模型的初步研究表明，使用HMD可缩短操作时间并提高超声下针的可见性。
