Ultrasound-guided lumbar puncture with a needle-guidance system: A prospective and controlled study to evaluate the learnability and feasibility of a newly developed approach

Abstract

ObjectiveTo evaluate the learnability and feasibility of a new technique comprising a needle-guidance-system (NGS) for ultrasound-assisted lumbar puncture.MethodUsing a randomized crossover study design, 24 medical students were asked to perform an ultrasound-assisted lumbar puncture on a gel phantom using two different techniques that each included a paramedian insertion site. Procedure 1 (P1) used a pre-procedural ultrasound scan to predetermine the ideal insertion point. Procedure 2 (P2) applied a new technique comprising an NGS for performing real-time ultrasound-guided lumbar puncture. Success rates and performance times for both procedures were compared. Participants were also asked to complete a post-study questionnaire, both to quantitatively assess the workload involved and state their personal preferences.ResultsIn comparison to the pre-procedural scan (P1), the NGS (P2) was associated with a significant increase in the number of successful punctures per participant (5 (P2) [interquartile range: 3.3–5.0] vs. 3 (P1) [interquartile range: 1.3–4.0], p = 0.005), and led to a significant reduction in performance time (118 seconds vs. 80.6 seconds, p < 0.001). In terms of workload perception, NGS use was associated with significantly better performances and lower frustration levels, as rated by students in the post-study questionnaire. Finally, 23/24 participants stated their preference for P2.ConclusionOur newly-developed technique for real-time ultrasound-guided lumbar puncture proved to be learnable and feasible for novices, and only required a small amount of training. The use of an NGS therefore has the potential to serve as a key feature of the ultrasound-assisted lumbar puncture.

A novel electromagnetic guidance ultrasound system on radial artery cannulation: a prospective randomized controlled trial

“…The predicted trajectory and actual position of the needle are also shown in the ultrasound view. In previous studies, the electromagnetic guidance system resulted in favourable outcomes when performing ultrasound-guided procedures using the phantom model [ 11 – 13 ]. However, the clinical advantages of the electromagnetic guidance system have not been previously validated.…”

“…It also shows the expected route and tip of the needle. In several studies using a gel phantom model, the novel electromagnetic guidance system appears capable of reducing the incidence of complications and improving the success rate of invasive procedures among providers with or without sufficient experience with radial artery cannulation under ultrasound guidance [ 11 – 13 ]. However, no clinical in vivo studies have been conducted on the efficacy of the electromagnetic ultrasound guidance system during invasive procedures such as central venous catheterization or radial artery cannulation.…”

Can simulation-based education and precision teaching improve paediatric trainees’ behavioural fluency in performing lumbar puncture? A pilot study

“…Future research should further evaluate the potential for this type of intervention to contribute to improvements in procedural skills that may directly impact patient outcomes. Studies that consider how incorporating technological innovations (e.g., ultrasound guided lumbar puncture [22]) may expedite the achievement of behavioural fluency, and/or improve training outcomes, would be of particular interest.…”

State‐of‐the‐art of lumbar puncture and its place in the journey of patients with Alzheimer's disease

“…Importantly, there was also a reduction in performance time (118 seconds vs. 80.6 seconds, respectively, P < .001), and 23 of 24 participants reported that they preferred the real-time, NGS-assisted LP. 86 Traditionally, physicians have learned to perform LP through unstructured observation and supervision during medical training.…”