Near Remote Method to Guide Performance of Regional Anesthesia

Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorDr. Glenio Mizubuti (MD, PhD)

About this trial

Ultrasound-guided regional anesthesia/analgesia techniques (or simply, 'regional blocks') have gained popularity as they can reduce, and sometimes even eliminate, the need for opiate analgesics (and, consequently, their side effects), thereby improving patient safety, reducing length of hospital stay and medical costs, and improving patient satisfaction. However, a major barrier to mainstream uptake of such techniques relates to training. These techniques require the acquisition of new skills under expert guidance, which is often not possible given the daily demands placed upon anesthesiologists. As a result, many opportunities for providing regional blocks may be missed.

The purpose of this study is to implement a new real-time 'near remote' guidance method in which trainees who are to perform regional blocks can do so via tele-mentoring under expert guidance. This will be done using a novel technology whereby the ultrasound image is concurrently displayed on an iPad screen (for the block operator/trainee) as well as on the (near remotely supervising) expert mentor's smartphone. Trainees and mentors will use this method to perform various standard of care regional blocks, either in the perioperative or emergency department settings. Participants' opinions of the novel teaching and learning method will be assessed.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Mentors: Staff anesthesiologists who are experts in regional blocks.

Trainees: Senior (PGY3-5) residents (anesthesiology and emergency medicine), and staff (emergency medicine) physicians who have already performed and are comfortable with being supervised near remotely for the regional block at hand.

Patients: Greater or equal to 18 years of age presenting for surgery or with traumatic injuries amenable to regional blocks.

All of the above: Able to read and understand English, and competent to provide written informed consent.

Disqualifiers

Mentors: Staff anesthesiologists who are not experts in the performance/teaching of regional blocks.

Trainees: Junior (PGY1-2) residents (for any/all types of regional blocks), and senior (PGY3-5) residents and staff physicians who are not comfortable with being supervised near remotely for the regional block at hand.

Patients: Less than 18 years of age.

All of the above: Unable to read and understand English, and not competent to provide written informed consent.

Trial population

Participants will include: (1) mentors, i.e., staff regional anesthesiologists who are experts in ultrasound-guided regional blocks; (2) trainees, i.e., PGY-3 to PGY-5 anesthesia and emergency medicine residents, and emergency medicine staff physicians; and (3) patients, i.e., individuals 18 years and older scheduled for surgery amenable to regional blocks or presenting to the emergency department with traumatic injuries amenable to regional blocks.

Trial design

Design model

Other

Time perspective

Prospective

Treatments tested in this trial

  • Real time 'near remote' guidance of regional blocks

    Procedure/Surgery

    Trainees who are to perform regional blocks will do so under expert guidance via tele-mentoring. This will be done using a novel technology consisting of a wirelessly linked iPad which will display the ultrasound image to the block operator/trainee. This image will be concurrently visualized by an expert mentor through their smartphone, who will then provide feedback/guidance in real-time to the operator/trainee.

Treatment groups

No treatment groups listed

Trial outcomes

Primary outcomes

1

Participant opinion

The investigators will assess the opinions of mentors and trainees regarding the use of 'near-remote' guidance for the performance of ultrasound-guided regional blocks.

Time frame
Immediately following block performance

Secondary outcomes

1

Block success

Patients' sensation to ice

Time frame
Within 30 min following block performance
2

Block image

Saved ultrasound image at the end of the block procedure. Specifically, this image will be saved after completion of local anesthetic injection and before removal of the block needle for subsequent review by a blinded expert.

Time frame
Through study completion, an average of 1 year
3

Complications

Any complications associated with performed regional blocks

Time frame
Immediately postoperatively
4

Patient satisfaction

Patient satisfaction with block performance

Time frame
Immediately postoperatively

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Dr. Glenio Mizubuti (MD, PhD)

Lead sponsor

Queen's University

Sponsor institution