Objective Evaluation of a New Epidural Simulator by the CompuFlo®Epidural Instrument

Coccoluto, Alessandra; Capogna, Giorgio; Vecchio, Angelica Del

doi:10.1155/2018/4710263

Cited by 11 publications

(10 citation statements)

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“…Previous studies have reported the ability and reliability of the CompuFlo ® instrument to detect the epidural space and thereafter to obtain the analgesic success of the epidural block [1] [2] [3]. This instrument is also reported to be very useful in helping the anesthesiologist correctly differentiate the false from true losses of resistances encountered as an epidural needle advances during the epidural procedure [5] and in being used as a teaching simulation tool [6]. Accidental dural puncture 0 0% Figure 1.…”

Section: Discussionmentioning

confidence: 99%

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Epidural Space Identification Using Continuous Real-Time Pressure Sensing Technology (CompuFlo&reg;): A Report of 600 Consecutive Cases

Hidalgo¹

2019

OJAnes

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Introduction. The aim of this open, prospective, single operator study was to report the clinical experience with the CompuFlo® Epidural Instrument. Method. Epidural block was performed with the CompuFlo® Epidural Instrument in all consecutive patients undergoing an epidural or thoracic block under the author's care over a two years period. The epidural needle was considered to have reached the epidural space when an increase in pressure (accompanied by an increase of the pitch of the audible tone) was followed by a sudden and sustained drop in pressure of more than 5 seconds accompanied by a sudden decrease of the pitch of the audible tone, resulting in the formation of a low and stable pressure plateau on the instrument's visual display. The following outcomes were evaluated: incidence of accidental dural puncture, success of anesthesia, procedure time, volume of saline used for the epidural procedure, number of epidural attempts to reach the epidural space, number of needle redirections, and the operator's agreement with his tactile sensation of loss of resistance and the CompuFlo® pattern. Results. A total of 600 cases were studied. All the epidural blocks were successful and no accidental dural punctures were noted. Epidural space was correctly identified on the first attempt in 91% of cases, in 95% of cases the operator judged as a perfect correlation between his tactile sensations and the CompuFlo® recordings. Conclusion. The major finding of this paper is the very high success rate of the epidural blocks, no matter in what clinical setting (obstetrical, surgical or blood patch intervention) or at which vertebral level (thoracic or epidural) were done. Most importantly, the reporting of zero incidence of any accidental dural puncture.

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, this has been further reduced using the CompuFlo® Epidural Instrument. While this study is not a controlled, randomized trial, and therefore a statistical comparison cannot be made with historical controls, a large number of patients scale provides a sufficient sample to make a comparison [6].…”

Section: Discussionmentioning

confidence: 99%

Epidural Space Identification Using Continuous Real-Time Pressure Sensing Technology (CompuFlo&reg;): A Report of 600 Consecutive Cases

Hidalgo¹

2019

OJAnes

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“…For the purpose of the study, we used a validated, modified version of a commercially available epidural simulator (P61, 3B Scientific) which can realistically reproduce the anatomical features of the layers the needle must pass through to reach the epidural space. 4 The total duration of the procedure was defined as the length of time between the insertion of the epidural needle into the skin of the simulator and the introduction of the catheter into the epidural space.…”

Section: Methodsmentioning

confidence: 99%

Novice and Expert Anesthesiologists’ Eye-Tracking Metrics During Simulated Epidural Block: A Preliminary, Brief Observational Report

Capogna¹,

Salvi²,

Delvino³

et al. 2020

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Introduction: Eye tracking is the process of measuring an individual's eye movements to register their attentional behavior by using a device called an eye-tracker. Studies conducted using eye-tracking techniques have demonstrated a number of differences in eye movement parameters and patterns between experts and novices. The aim of this preliminary study was to evaluate if there are any differences in eye-tracking metrics between novice and expert anesthesiologists during the performance of an epidural block using an epidural simulator. Methods: Seven experts and seven novices who gave their consent to this preliminary study were asked to perform an epidural technique using an epidural simulator while wearing a pair of Tobii Pro glasses. Number of fixations, fixation duration, heat maps and scan-paths were examined by Tobii Pro Lab Software. Duration of the procedure was also recorded. Results: The observation of the attentional heat map and gaze plot showed different gaze dispersion between experts and novices. The mean total duration of fixations during needle insertion and advancement and catheter introduction was lower in experts than trainees (respectively, 0.18 vs 3.56 sec; P<0.05 and 0.73 vs 2.48 sec; P<0.05). The mean fixation count was greater in experts vs trainees (5 vs 2; P<0.05). The mean duration of the epidural procedure was 104.16 (41) (trainees) vs 65.3 (32.6) seconds (experts) (P<0.05). Expert anesthesiologists spent more time fixating a more specific target location (eg, the point of the epidural needle rather than the syringe's barrel) whilst novices split their attention between tracking their tools and the target location. Discussion: Eye tracking may have interesting implications for the creation of assessment programs, which distinguish skill level through the use of gaze behavior, and may be a promising tool for monitoring training progress towards the development of expertise.

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“…In human medicine, simulators are used to improve training in anesthesia [7][8][9] . Most try to simulate the sensation of penetration of ligamentum flavum and loss of resistance of the syringe plunger during injection of the anesthetic.…”

Section: ■ Introductionmentioning

confidence: 99%

3D anatomical model for teaching canine lumbosacral epidural anesthesia

et al. 2020

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To develop a 3D anatomical model for teaching canine epidural anesthesia (3DMEA) and to assess its efficacy for teaching and learning prior to the use of live animals. Methods: The creation of 3DMEA was based on 3D optical scanning and 3D printing of canine bone pieces of the fifth to the seventh lumbar vertebrae, sacrum and pelvis. A total of 20 male dogs were scheduled for castration. 20 veterinary students watched a video showing epidural anesthesia in dogs before the clinical attempt and were assigned to control or 3DMEA groups. Students in the 3DMEA group trained in the model after the video. For the clinical trial, the epidural procedure was performed by students under the veterinary supervision. When observed the absence of response to nociceptive stimuli, the epidural was considered successful. Then, all students answered a questionnaire evaluating the main difficulty founded in the technique and its degree of difficulty. Results: The 3DMEA group reported a lower degree of difficulty to perform the epidural anesthesia technique when compared with the control group (p=0.0037). The 3DMEA reproduced the anatomical structures, allowing the perception of the distance of needle in relation to the iliac prominences during epidural anesthesia. Its mobility allowed simulation of the animal in standing position and sternal recumbency. Conclusion: The use of 3DMEA demonstrated greater efficacy in the execution of the technique, being effective in the teaching and learning process before the epidural anesthesia in live animals.

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Objective Evaluation of a New Epidural Simulator by the CompuFlo^®Epidural Instrument

Cited by 11 publications

References 9 publications

Epidural Space Identification Using Continuous Real-Time Pressure Sensing Technology (CompuFlo<sup>&reg;</sup>): A Report of 600 Consecutive Cases

Epidural Space Identification Using Continuous Real-Time Pressure Sensing Technology (CompuFlo<sup>&reg;</sup>): A Report of 600 Consecutive Cases

<p>Novice and Expert Anesthesiologists’ Eye-Tracking Metrics During Simulated Epidural Block: A Preliminary, Brief Observational Report</p>

3D anatomical model for teaching canine lumbosacral epidural anesthesia

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Objective Evaluation of a New Epidural Simulator by the CompuFlo®Epidural Instrument

Cited by 11 publications

References 9 publications

Epidural Space Identification Using Continuous Real-Time Pressure Sensing Technology (CompuFlo&lt;sup&gt;&amp;reg;&lt;/sup&gt;): A Report of 600 Consecutive Cases

Epidural Space Identification Using Continuous Real-Time Pressure Sensing Technology (CompuFlo&lt;sup&gt;&amp;reg;&lt;/sup&gt;): A Report of 600 Consecutive Cases

<p>Novice and Expert Anesthesiologists’ Eye-Tracking Metrics During Simulated Epidural Block: A Preliminary, Brief Observational Report</p>

3D anatomical model for teaching canine lumbosacral epidural anesthesia

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Product

Resources

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Objective Evaluation of a New Epidural Simulator by the CompuFlo^®Epidural Instrument

Epidural Space Identification Using Continuous Real-Time Pressure Sensing Technology (CompuFlo<sup>®</sup>): A Report of 600 Consecutive Cases

Epidural Space Identification Using Continuous Real-Time Pressure Sensing Technology (CompuFlo<sup>®</sup>): A Report of 600 Consecutive Cases