From the Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
the Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Daejeon, Republic of Korea.
Anesthesiology. 2021 Oct 1;135(4):612-620. doi: 10.1097/ALN.0000000000003914.
Hand-eye coordination and ergonomics are important for the success of delicate ultrasound-guided medical procedures. These can be improved using smart glasses (head-mounted display) by decreasing the head movement on the ultrasound screen. The hypothesis was that the smart glasses could improve the success rate of ultrasound-guided pediatric radial arterial catheterization.
This prospective, single-blinded, randomized controlled, single-center study enrolled pediatric patients (n = 116, age less than 2 yr) requiring radial artery cannulation during general anesthesia. The participants were randomized into the ultrasound screen group (control) or the smart glasses group. After inducing general anesthesia, ultrasound-guided radial artery catheterization was performed. The primary outcome was the first-attempt success rate. The secondary outcomes included the first-attempt procedure time, the overall complication rate, and operators' ergonomic satisfaction (5-point scale).
In total, 116 children were included in the analysis. The smart glasses group had a higher first-attempt success rate than the control group (87.9% [51/58] vs. 72.4% [42/58]; P = 0.036; odds ratio, 2.78; 95% CI, 1.04 to 7.4; absolute risk reduction, -15.5%; 95% CI, -29.8 to -12.8%). The smart glasses group had a shorter first-attempt procedure time (median, 33 s; interquartile range, 23 to 47 s; range, 10 to 141 s) than the control group (median, 43 s; interquartile range, 31 to 67 s; range, 17 to 248 s; P = 0.007). The overall complication rate was lower in the smart glasses group than in the control group (5.2% [3/58] vs. 29.3% [17/58]; P = 0.001; odds ratio, 0.132; 95% CI, 0.036 to 0.48; absolute risk reduction, 24.1%; 95% CI, 11.1 to 37.2%). The proportion of positive ergonomic satisfaction (4 = good or 5 = best) was higher in the smart glasses group than in the control group (65.5% [38/58] vs. 20.7% [12/58]; P <0.001; odds ratio, 7.3; 95% CI, 3.16 to 16.8; absolute risk reduction, -44.8%; 95% CI, -60.9% to -28.8%).
Smart glasses-assisted ultrasound-guided radial artery catheterization improved the first-attempt success rate and ergonomic satisfaction while reducing the first-attempt procedure time and overall complication rates in small pediatric patients.
手眼协调和人体工程学对于成功进行精细的超声引导医疗程序至关重要。通过使用智能眼镜（头戴式显示器）减少在超声屏幕上的头部运动，可以改善这些方面。假设智能眼镜可以提高超声引导儿科桡动脉置管术的成功率。
这是一项前瞻性、单盲、随机对照、单中心研究，纳入了需要在全身麻醉下进行桡动脉插管的儿科患者（n=116，年龄小于 2 岁）。参与者被随机分为超声屏幕组（对照组）或智能眼镜组。在诱导全身麻醉后，进行超声引导下桡动脉置管术。主要结局是首次尝试的成功率。次要结局包括首次尝试的操作时间、总并发症发生率和操作人员的人体工程学满意度（5 分制）。
共有 116 名儿童纳入分析。智能眼镜组的首次尝试成功率高于对照组（87.9%[51/58]比 72.4%[42/58]；P=0.036；优势比，2.78；95%CI，1.04 至 7.4；绝对风险降低，-15.5%；95%CI，-29.8 至-12.8%）。智能眼镜组的首次尝试操作时间更短（中位数 33 秒；四分位距 23 至 47 秒；范围 10 至 141 秒），而对照组的操作时间更长（中位数 43 秒；四分位距 31 至 67 秒；范围 17 至 248 秒；P=0.007）。智能眼镜组的总并发症发生率低于对照组（5.2%[3/58]比 29.3%[17/58]；P=0.001；优势比，0.132；95%CI，0.036 至 0.48；绝对风险降低，24.1%；95%CI，11.1 至 37.2%）。智能眼镜组的人体工程学满意度评分较高（4=好或 5=最佳）的比例高于对照组（65.5%[38/58]比 20.7%[12/58]；P<0.001；优势比，7.3；95%CI，3.16 至 16.8；绝对风险降低，-44.8%；95%CI，-60.9%至-28.8%）。
在小型儿科患者中，智能眼镜辅助超声引导桡动脉置管术可提高首次尝试成功率和人体工程学满意度，同时缩短首次尝试操作时间并降低总并发症发生率。
