Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
Canadian Advances in Neuro-Orthopedics for Spasticity Congress (CANOSC), Kingston, ON K7K 1Z6, Canada.
Toxins (Basel). 2024 Jul 2;16(7):304. doi: 10.3390/toxins16070304.
Ultrasound guidance can enhance existing landmark-based injection methods, even through a brief and single exposure during a cadaveric training course. A total of twelve participants were enrolled in this training program, comprising nine physical medicine and rehabilitation specialists, one pediatrician, and two physician assistants. For each participant, one upper-limb muscle and one lower-limb muscle were randomly chosen from the preselected muscle group. Subsequently, participants were tasked with injecting both of their chosen cadaveric muscles with 1 mL of acrylic paint using a manual needle palpation technique, relying solely on their knowledge of anatomic landmarks. Participants then underwent a personalized, one-to-one ultrasound teaching session, lasting approximately five minutes, conducted by two highly experienced instructors. Following this instructive phase, participants were tasked with a second round of injections, targeting the same two muscles in the lower and upper limbs. However, this time, the injections were performed using anatomical landmarks and ultrasound guidance. To facilitate differentiation from the initial injections, a distinct color of acrylic paint was employed. When employing the anatomical landmark-based approach, the overall success rate for injections was 67%, with 16 out of 24 targeted muscles accurately injected. With the incorporation of ultrasound guidance, the success rate was 92%, precisely targeting 22 out of the 24 muscles under examination. There was an improvement in injection accuracy achievable through the integration of ultrasound guidance, even with minimal training exposure. Our single cadaveric ultra-sound training program contributes valuable insights to the utilization of ultrasound for anatomy training to help optimize the targeting of BoNT-A.
超声引导可以增强现有的基于体表标志的注射方法，即使在尸体培训课程中仅进行短暂的单次暴露也是如此。共有 12 名参与者参加了该培训计划，其中包括 9 名物理医学和康复专家、1 名儿科医生和 2 名医师助理。对于每个参与者，从预选的肌肉群中随机选择一块上肢肌肉和一块下肢肌肉。随后，参与者使用手动针触诊技术，仅依靠对解剖标志的了解，将 1 mL 丙烯颜料注入他们选择的两个尸体肌肉中。然后，参与者接受了由两位经验丰富的讲师进行的个性化一对一超声教学课程，大约持续五分钟。在这个教学阶段之后，参与者被要求进行第二轮注射，针对上肢和下肢的相同两块肌肉。然而，这次使用解剖标志和超声引导进行注射。为了便于与初始注射区分开来，使用了不同颜色的丙烯颜料。在使用基于解剖标志的方法时，注射的总体成功率为 67%，24 个目标肌肉中有 16 个被准确注射。使用超声引导时，成功率为 92%，在检查的 24 块肌肉中准确地定位了 22 块。即使仅接受了少量的培训，通过整合超声引导也可以提高注射的准确性。我们的单次尸体超声培训计划为超声在解剖学培训中的应用提供了有价值的见解，有助于优化 BoNT-A 的靶向性。
