Novice performance of ultrasound-guided needle advancement: standard 38-mm transducer vs 25-mm hockey stick transducer.

Abstract

The optimal method to develop expertise in ultrasound-guided regional anaesthesia is unknown. Studies of laryngoscopic expertise in novices demonstrate that the choice of laryngoscope affects performance. In this study, we aimed to compare the effect of two different linear array transducers (38-mm standard vs 25-mm hockey stick) on novice performance of ultrasound-guided needle advancement. Following randomisation, participants watched a video model of expert performance of ultrasound-guided needle advancement. Recruits performed the modelled task on a turkey breast model. The median (IQR [range]) composite error score was statistically significantly larger for participants in the hockey stick transducer group compared with the standard transducer group; 10.0 (7.3-14.3 [2.5-29.0]) vs 7.5 (4.5-10.0 [2.0-28.0]) respectively, (p = 0.01). This study has demonstrated that performance of ultrasound-guided needle advancement by novice operators after simple video instruction is better (as assessed using a composite error score) with a standard 38-mm transducer than with a 25-mm hockey stick transducer.