Should Anaesthesiologists Be Taught to Perform Ultrasound-Assisted Neuraxial Access in Spinal Anaesthesia?-Protocol of a Randomised Controlled Study.

Abstract

Neuraxial blockade, typically guided by manual palpation, can be challenging in certain patient populations. Ultrasound-assisted neuraxial access has the potential to improve success rates, particularly for novice anaesthesiologists, though structured training programs in this technique are limited. This multicentre, randomised controlled trial will evaluate the use of ultrasound-assisted neuraxial block, following a simulation-based training programme based on the mastery-learning approach. Participants, consisting of novice and senior anaesthesiologists, will receive training in either ultrasound-assisted or traditional manual palpation techniques. Performance will be assessed in a clinical setting during elective lower limb surgery. Statistical analyses will compare the clinical outcomes of ultrasound-assisted versus manual palpation techniques. The primary outcome is the success rate of the first spinal block attempt. Secondary outcomes include the number of attempts, needle redirections, time spent, and the need for additional interventions. Patient satisfaction and complications will be evaluated as tertiary outcomes. This study may present the potential impact of a structured training program on anaesthesiologists' skills in ultrasound-assisted neuraxial access and potentially lead to better patient outcomes. By comparing ultrasound-assisted techniques with traditional manual palpation, the findings may lead to improvements in training methods and ultrasound-assisted approaches for neuraxial access.