Validation of the soft-embalmed Thiel cadaver as a high-fidelity simulator of pressure during targeted nerve injection
| Autor: | Shengli Zihang, Amy Sadler, A. Chandra, Christine Demore, Zhihong Huang, Graeme McLeod, Panpan Qiao |
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| Rok vydání: | 2021 |
| Předmět: |
Coronavirus disease 2019 (COVID-19)
03 medical and health sciences Nerve injection 0302 clinical medicine 030202 anesthesiology Cadaver Epineurium Animals Humans Medicine 030212 general & internal medicine Pandemics Simulation Embalming SARS-CoV-2 business.industry Epimysium COVID-19 Reproducibility of Results General Medicine Patient Simulation Anesthesiology and Pain Medicine medicine.anatomical_structure Regional anesthesia Bolus (digestion) business Perineural Tissue |
| Zdroj: | Regional Anesthesia & Pain Medicine. 46:540-548 |
| ISSN: | 1532-8651 1098-7339 |
| Popis: | IntroductionAlthough administration of regional anesthesia nerve blocks has increased during the COVID-19 pandemic, training opportunities in regional anesthesia have reduced. Simulation training may enhance skills, but simulators must be accurate enough for trainees to engage in a realistic way—for example, detection of excessive injection pressure. The soft-embalmed Thiel cadaver is a life-like, durable simulator that is used for dedicated practice and mastery learning training in regional anesthesia. We hypothesized that injection opening pressure in perineural tissue, at epineurium and in subepineurium were similar to opening pressures measured in experimental animals, fresh frozen cadavers, glycol soft-fix cadavers and patients.MethodsWe systematically reviewed historical data, then conducted three validation studies delivering a 0.5 mL hydrolocation bolus of embalming fluid and recording injection pressure. First, we delivered the bolus at 12 mL/min at epimysium, perineural tissue, epineurium and in subepineurium at 48 peripheral nerve sites on three cadavers. Second, we delivered the bolus at using three infusion rates: 1 mL/min, 6 mL/min and 12 mL/min on epineurium at 70 peripheral nerve sites on five cadavers. Third, we repeated three injections (12 mL/min) at 24 epineural sites over the median and sciatic nerves of three cadavers.ResultsMean (95%) injection pressure was greater at epineurium compared with subepineurium (geometric ratio 1.2 (95% CI: 0.9 to 1.6)), p=0.04, and perineural tissue (geometric ratio 5.1 (95% CI: 3.7 to 7.0)), p0.05 for all comparisons).DiscussionWe conclude that the soft-embalmed Thiel cadaver is a realistic simulator of injection opening pressure. |
| Databáze: | OpenAIRE |
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