Abstract
Purpose
The use of smart glasses during ultrasound-guided needle procedures may reduce operators’ head movements but has not been shown to improve procedural performance. Laser guidance has been shown to decrease the time required for ultrasound-guided procedures in phantom models but has not been tested clinically. We hypothesized that adding laser guidance to the use of smart glasses for ultrasound-guided radial artery catheterization using the long axis approach would improve performance by relatively inexperienced users unfamilar with these techniques.
Methods
In an unblinded controlled trial, we enrolled 52 patients requiring radial artery catheterization under anesthesia, randomized into two groups: smart glasses only (SO) (control; N = 26) or smart glasses with laser guidance group (SL) (N = 26). We assessed catheterization time (primary outcome), the number of needle redirections, first-pass success rate, and operator satisfaction (100 = most satisfactory; 0 = unsatisfactory).
Results
Comparing the SL with the SO group, catheterization time was shorter (median [interquartile range], 13 [9–20] sec vs 24 [18–46] sec, P < 0.001) and the number of needle redirections was lower (0 [0–1] vs 3 [1–3], P < 0.001) while the first-pass success rate (50% vs 12%, P = 0.007) and operator satisfaction score (85 [76–95] vs 52 [44–74], P < 0.001) were higher.
Conclusion
Laser guidance improved the performance of ultrasound-guided radial artery catheterization using smart glasses in users inexperienced in the long axis in-plane approach. Nevertheless, it is unclear whether these findings are clinically significant.
Study registration date
CRIS.nih.go.kr (KCT0007168); registered 8 April 2022.
Résumé
Objectif
L’utilisation de lunettes intelligentes pendant les procédures de ponctions échoguidées peut réduire les mouvements de la tête des opérateurs et opératrices, mais il n’a pas été démontré qu’elle améliorait les performances procédurales. Il a été démontré que le guidage laser réduisait le temps requis pour les interventions échoguidées sur des modèles fantômes, mais cette modalité n’a pas été testée cliniquement. Nous avons émis l’hypothèse que l’ajout d’un guidage laser à l’utilisation de lunettes intelligentes pour le cathétérisme échoguidé de l’artère radiale en utilisant une approche longitudinale (long axe) améliorerait les performances d’utilisateurs et utilisatrices relativement inexpérimenté·es et peu familier·ères avec ces techniques.
Méthode
Dans une étude contrôlée sans insu, nous avons recruté et randomisé en deux groupes 52 patient·es nécessitant un cathétérisme de l’artère radiale sous anesthésie : lunettes intelligentes uniquement (LIU) (témoin N = 26) ou lunettes intelligentes avec guidage laser (LIL) (N = 26). Nous avons évalué le temps de cathétérisme (critère d’évaluation principal), le nombre de réorientation d’aiguilles, le taux de réussite au premier passage et la satisfaction de l’opérateur·trice (100 = le plus satisfaisant; 0 = insatisfaisant).
Résultats
En comparant le groupe LIL au groupe LIU, le temps de cathétérisme était plus court (médiane [écart interquartile], 13 [9-20] sec vs 24 [18–46] sec, P < 0,001) et le nombre de réorientations d’aiguilles était plus faible (0 [0–1] vs 3 [1–3], P < 0,001), tandis que le taux de réussite au premier passage (50 % vs 12 %, P = 0,007) et le score de satisfaction des opératrices et opérateurs (85 [76–95] vs 52 [44–74], P < 0,001) étaient plus élevés.
Conclusion
Le guidage laser à l’aide de lunettes intelligentes a amélioré les performances du cathétérisme échoguidé de l’artère radiale chez des utilisateurs et utilisatrices inexpérimenté·es en approche longitudinale. Nous ne pouvons toutefois pas déterminer si ces résultats sont cliniquement significatifs.
Date d’enregistrement de l’étude
CRIS.nih.go.kr (KCT0007168); enregistré le 8 avril 2022.
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Author contributions
Yoon J. Kim contributed to conceptualization, data curation, formal analysis, funding acquisition, investigation, and writing the original draft. Chul-Woo Jung contributed to project administration and visualization. Seungeun Choi and Youngwon Kim contributed to investigation, reviewing, and editing. Jeong-Hwa Seo contributed to conceptualization, supervision, data curation, reviewing, and editing.
Disclosures
The authors declare that they have no conflict of interest.
Funding statement
This research was supported by grant (No. 0420212220) from the Seoul National University Hospital Research Fund.
Data availability
The data that support the findings of this study are available from the corresponding author.
Editorial responsibility
This submission was handled by Dr. Stephan K. W. Schwarz, Editor-in-Chief, Canadian Journal of Anesthesia/Journal canadien d’anesthésie.
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Kim, Y.J., Jung, CW., Choi, S. et al. Laser guidance for ultrasound-guided radial artery catheterization using smart glasses: a randomized trial. Can J Anesth/J Can Anesth 70, 1635–1642 (2023). https://doi.org/10.1007/s12630-023-02532-0
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DOI: https://doi.org/10.1007/s12630-023-02532-0