3D-printed simulator for neuraxial anesthesia training may improve safety of spinal procedures: 5 details

Imaging

Researchers developed a 3D-printable neuraxial anesthesia platform designed to assist anesthesiology residents with procedural training prior to patient interaction.

Researchers published their findings in PLOS Medicine.

Here are 5 things to know:

1. Using free/libre/open-source software and desktop 3D printing technologies, researchers were able to construct the $13, patient-specific neuraxial phantom. The phantom took 25 hours to print and two hours to assemble.

2. Researchers used a CT data set of the human torso to create a 3D model of the lumbar spine, which was then modified and placed inside a digitally designed housing unit and formulated on a desktop 3D printer using polylactic acid filament.

3. The model was filled with an echogenic comprised of gelatin and psyllium fiber.

4. To compare the 3D-printed phantom's effectiveness to a commercially available Simulab phantom, 22 staff anesthesiologists performed spinal and epidural procedures on each model.

5. Participants rated each model's tactile and imaging fidelity, and the results were as follows:

• Surface palpitation — slightly higher for Simulab phantom
• Soft-tissue resistance to needle — no significant difference
• Ligamentum flavum resistance — significantly higher for 3D printed phantom
• Dural puncture — significantly higher for 3D printed phantom
• Loss of resistance — significantly higher 3D printed phantom

Ultrasound images from the 3D-printed phantom were preferred by most participants.

Researchers noted three limitations of the 3D-printed phantom:

• the lack of realism in surface palpitation due to the softness of the gelatin solution used
• the perishable nature of the gelatin and psyllium created the time-consuming process of repeatedly making a new batch of gelatin
• needle track marks persisted in the models after each use

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