Single and Double Operator Techniques in Ultrasound-guided Peripheral Nerve Block Learning Curve

Not Applicable

• Conditions: Single-handed Ultrasound-guided Regional Anaesthesia Grip; Single-operator Ultrasound-guided Peripheric Nerve Block; Anesthesiology Training; Jedi Grip
• Interventions: Other: reaching targeted area on the phantom model

• Registration Number: NCT04487366
• Lead Sponsor: Ankara City Hospital Bilkent

Brief Summary

Aim of this study is to compare learning curves of single(1- Jedi grip: Pappin and Christie/ 2- Bedforth/ 3- on lock: Gupta and Berrill) and double operator ultrasound-guided peripheric nerve block techniques on a home-made gelatin-based phantom model.

Detailed Description

Ultrasound-guided peripheral blocks are conventionaly performed by double operators. One operator controls both the ultrasound probe and peripheric block needle. Another assistant operator aspirate or injects local anesthetic. In this technique operator do not sense resistance in the syringe. Also this technique requires a well-done communication and coordination between operators.

In order to eliminate disadvantages of this technique several single-operator grip techniques of the needle and syringe have been described(1- Jedi grip: Pappin and Christie/ 2- Bedforth/ 3- on lock: Gupta and Berrill). Single operator techniques allow the provider to perform independently.

Aim of this study is to compare learning curves of single and double operator ultrasound-guided peripheric nerve block techniques on a home-made gelatin-based phantom model.

Study Timeline

• Status Verified: 2020-07
• Study Start: 2020-07-01
• Study First Submitted: 2020-07-17
• Study First Submitted QC: 2020-07-22
• Last Update Submitted: 2020-07-22
• Study First Posted: 2020-07-27
• Last Update Posted: 2020-07-27
• Primary Completion: 2020-09-15
• Study Completion: 2020-10-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• To be a junior resident of anesthesiology(< 2 years )

Exclusion Criteria

• Refusal of resident

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Double Operator Ultrasound-Guided Regional Anesthesia	reaching targeted area on the phantom model	resident control block needle and ultrasound probe and asistant operator inject the solution. resident reach the target area created in the phantom model using a block needle with ultrasound guidance
Jedi Grip	reaching targeted area on the phantom model	resident control block needle, ultrasound probe and syringe independently with jedi grip; reach the target area created in the phantom model using a block needle with ultrasound guidance; inject and aspirate the solution.
Bedforth alternative grip	reaching targeted area on the phantom model	resident control block needle, ultrasound probe and syringe independently with bedforth's alternative grip; reach the target area created in the phantom model using a block needle with ultrasound guidance; inject the solution.
On-lock grip	reaching targeted area on the phantom model	resident control block needle, ultrasound probe and syringe independently with on-lock grip; reach the target area created in the phantom model using a block needle with ultrasound guidance; inject the solution.

Primary Outcome Measures

Name	Time	Method
Time to correct grip2	during implementation of procedure on phantom model(second session)	Time(sec) from start command to correct grip of the probe, needle and syringe for each technique
Time to correct grip1	during implementation of procedure on phantom model(first session)	Time(sec) from start command to correct grip of the probe, needle and syringe for each technique
needling time 2	during implementation of procedure on phantom model(second session)	time to reach target area with block needle
needling time 3	during implementation of procedure on phantom model(third session)	time to reach target area with block needle
number of attempts1	during implementation of procedure on phantom model(first session)	number of attempts until correct needling to target area
image quality3	during implementation of procedure on phantom model(third session)	provided image quality by resident for each technique which is assessed by investigator by four point Liker Scale( 1- much worse 2- worse 3- better 4- much better)
image quality1	during implementation of procedure on phantom model(first session)	provided image quality by resident for each technique which is assessed by investigator by four point Liker Scale( 1- much worse 2- worse 3- better 4- much better)
needling time 1	during implementation of procedure on phantom model(first session)	time to reach target area with block needle
image quality2	during implementation of procedure on phantom model(second session)	provided image quality by resident for each technique which is assessed by investigator by four point Liker Scale( 1- much worse 2- worse 3- better 4- much better)
number of attempts2	during implementation of procedure on phantom model(second session)	number of attempts until correct needling to target area
number of attempts3	during implementation of procedure on phantom model(third session)	number of attempts until correct needling to target area
success of injection2	during implementation of procedure on phantom model(second session)	successful if injected water flows from hose of model/ unsuccessful if solution do not flow
success of injection3	during implementation of procedure on phantom model(third session)	successful if injected water flows from hose of model/ unsuccessful if solution do not flow
success of injection1	during implementation of procedure on phantom model(first session)	successful if injected water flows from hose of model/ unsuccessful if solution do not flow
Time to correct grip3	during implementation of procedure on phantom model(third session)	Time(sec) from start command to correct grip of the probe, needle and syringe for each technique

Secondary Outcome Measures

Name	Time	Method
NASA-TLX (NASA Task Load Index)	during implementation of procedure on phantom model(third session)	Resident assessment of each techniques for Mental Demand ,Physical Demand, Temporal Demand, Performance, Effort and Frustration
Assesment of education	during education of techniques	Residents assesment of pre-procedural education with a questtionarie. "Education was sufficient enough to safely perform peripheral block": 1. I absolutely agree; 2. I approve; 3. I am indecisive; 4. I do not approve; 5. Absolutely Disagree

Trial Locations

Locations (1)

Ankara City Hospital; 🇹🇷 Ankara, Turkey