Article Text
Abstract
Background and Aims Ultrasound-guided regional anaesthesia education continues to rely on patient or live-model based training. Teaching phantoms with accurate sonoanatomy are scarce; those which are available lack realism1 and are prohibitively expensive2. We evaluated the feasibility of a novel manufacturing process to create low-cost high-fidelity USGRA training phantoms, exemplified by an ESP block simulator.
Methods A 3D model of a container enclosing a thoracic spine fragment was designed using CT segmentation and Fusion 360 CAD (Figure 1/A). This was 3D printed by fused deposition modelling of biodegradable polylactic acid. The enclosure was filled with mineral oil resin gel wax and 0.05% TiO2 (Figure 1/B), facilitating a tissue-like image. Silicone and polypropylene were interspersed within the gel to simulate muscle layers. The complete phantom was incorporated into a manikin torso covered with silicone ‘skin’, establishing a lifelike presence (Figure 1/C). The materials cost was €18, and 15 hours required for 3D-printing. Anaesthetists of all grades (n=23, 10 consultants, 13 trainees) were invited to evaluate the phantom.
Results Most respondents (74%) strongly agreed that the phantom was realistic and 50% of free-text feedback included ‘realistic’ (Fig. 2). No respondents noted any anatomical features as incorrect or absent.
Conclusions There are no other ESP block phantoms which incorporate both physical- and sono-anatomy of all major structures identified by international consensus3. Our novel process features innovative materials that yield highly realistic yet low-cost phantoms. It can be employed to generate phantoms for any ‘Plan-A’ block, avoiding instruction on patients or cadavers.
Project partially supported by an NIAA Grant.