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  1. Home
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Browsing by Author "Miranda Hiriart, Pablo"

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    Actualización en el manejo de intoxicación sistémica por anestésicos locales
    (2020) Miranda Hiriart, Pablo; Coloma, R.; Rueda, F.; Corvetto Aqueveque, Marcia Antonia
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    Comparison of Continuous Popliteal Nerve Blocks Using Lidocaine versus Bupivacaine Infusions for Ambulatory Foot Surgery: A Randomized, Double-blind, Noninferiority Trial
    (2023) Echevarría, Ghislaine; Altermatt Couratier, Fernando René; Miranda Hiriart, Pablo; Araneda Vilches, Andrea Lucía; Corvetto Aqueveque, Marcia Antonia; De La Fuente Sanhueza, René Francisco; Cuadra F., Juan Carlos de la
    Background and objectives: Continuous sciatic popliteal nerve block effectivelymanages pain after ankle and foot surgery. Most studies on continuous infusionof local anesthetics by perineural catheters have been made with bupivacaine,levobupivacaine, and ropivacaine, but lidocaine has not been used. The mainobjective of this study was to compare the quality of analgesia, motor function,and side effects between lidocaine and bupivacaine infusions in bilateralcontinuous popliteal nerve blocks for foot surgery.Methods: This was a prospective, double-blind, randomized, parallel-group,noninferiority study. We enrolled 70 patients undergoing bilateral foot or anklesurgery that could be performed under general anesthesia and continuous regionalanalgesia using sciatic popliteal nerve blocks. During their postoperative care, theywere randomized into 2 groups: group lidocaine (lidocaine 0.5%, 5 ml/h) or groupbupivacaine (bupivacaine 0.1%, 5 ml/h), administered through elastomeric pumps.The primary outcome was pain at 24 h after surgery, assessed by a verbal numericrating scale (ranging from 0 to 10). A pre-specified non-inferiority margin of 1.5 wasdefined. Secondary outcomes were the degree of motor and sensitive block, totalopioid use, and difficulties with pump or catheter management.Results: The mean postoperative pain at 24 h of surgery was 2.06 (95% bootstrapconfidence interval bCI 1.29, 2.83) and 1.82 (95% bCI 1.02, 2.62) in the lidocaineand bupivacaine group, respectively. The upper limit of the 95% bCI for the meandifference between lidocaine and bupivacaine was 0.82, declaring non-inferiority.No differences in the postoperative rescue analgesia use and satisfaction withcare were found. No differences in postoperative NRS, sensory block and motorblock were seen between groups.Conclusions: Lidocaine 0.5% and bupivacaine 0.1% provide similar postoperativeanalgesia through a sciatic popliteal catheter in ambulatory bilateral foot surgery patients.
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    Consideraciones anestésicas en el manejo del taponamiento cardíaco
    (2010) Miranda Hiriart, Pablo; Carvajal F., Claudia
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    Effect of Intrathecal fentanyl on secondary hyperalgesia, in patients undergoing anterior cruciate ligament repair
    (2020) Cuadra F., Juan Carlos de la; Echevarría, Ghislaine C.; Jara, X. P.; Fuente López, Natalia Francisca de la; Puga, V. A.; Miranda Hiriart, Pablo
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    EP072 Rebound pain with ambulatory perineural catheter for rotator cuff repair
    (2024) De La Cuadra Fontaine, Juan Carlos; Miranda Hiriart, Pablo; Morrison Corrales, Christopher Joseph; Altermatt Couratier, Fernando René
    Background and Aims The appearance of sudden intense pain, after a peripheral nerve block ceases, is kown as Rebound Pain (RP). The reported frequency is described as between 40-60%. To reduce its occurrence, the use of adjuvants and the use of perineural catheter have been described. Dexamethasone, both perineural and also intravenously, reduces the incidence of RP. The risk decreases to approximately 10-20%. The methodology of studies using continuous technique has not allowed us to further clarify the benefit of their use. Our objective was to measure the incidence of RP in patients undergoing shoulder rotator cuff surgery with the use of home perineural catheters in our postoperative ambulatory REDCAP registry.Methods The study has ethics committee approval. A review of REDCAP was carried out from January 1, 2020 to December 31, 2023, extracting data from patients with a diagnosis of rotator cuff tear. Pain >7 on a scale of 0-10 was considered rebound pain.Results 495 patients were identified. 58 were lost to post-discharge follow-up (11.7%). Among the remaining 437 patients, 81 (18.5%) reported pain >7 at least once. On first postoperative day, 26 (5.7%). On 2nd postoperative day, 33 patients (7,8%) At the end of the infusion, 5,8% of patients reported rebound pain according to the work definition.
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    Influencia de la posición en la visualización con ultrasonido del nervio ciático en la fosa poplítea por médicos en formación
    (2020) Miranda Hiriart, Pablo; Elgueta Le-Beuffe, María Francisca; Echevarría, Ghislaine C.; Bravo Bertoglio, María Pía; Cuadra F., Juan Carlos de la
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    LASRA 2022 Chile (26, 27 y 28 de mayo) Hotel W, Santiago, Chile (25 y 27 de mayo) Pontificia Universidad Católica de Chile. Optimizando Resultados
    (2022) Aliste, Julián; Altermatt Couratier, Fernando René; Atton, Rousmery; Bermúdez, Ernesto; Bernucci, María Francisca; Bravo, Daniela; Cabrera, María Carolina; Elgueta Le-Beuffe, María Francisca; Jankelevich, Alejandro; Layera, Sebastián; Miranda Hiriart, Pablo; Pesce, Ítalo
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    Levobupivacaine absorption pharmacokinetics with and without epinephrine during TAP block : analysis of doses based on the associated risk of local anaesthetic toxicity
    (2016) Miranda Hiriart, Pablo; Corvetto Aqueveque, Marcia Antonia; Altermatt Couratier, Fernando René; Araneda Levy, Ana María; Echevarria, G.; Cortínez Fernández, Luis Ignacio
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    Manejo anestésico y analgésico del paciente ortogeriátrico
    (Sociedad de Anestesiologia de Chile, 2014) Ramírez Bahamondes, Gaspar Ignacio; Miranda Hiriart, Pablo; Altermatt Couratier, Fernando René
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    Regional anesthesia during the COVID-19 pandemic: a time to reconsider practices? (Letter #2)
    (Springer, 2020) Aliste, Julián; Altermatt Couratier, Fernando René; Atton, Rous; Bravo, Daneila; Layera, Sebastián; Miranda Hiriart, Pablo; Pesce, Italo
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    Validation of the imperial college surgical assessment device for spinal anesthesia
    (2017) Corvetto Aqueveque, Marcia Antonia; Fuentes Amaya, Carlos.; Araneda, Andrea.; Achurra Tirado, Pablo; Miranda Hiriart, Pablo; Viviani García, Paola; Altermatt Couratier, Fernando René
    Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.Abstract Background Traditionally, technical proficiency for spinal anesthesia has been assessed using observational scales such as global rating scales or task specific checklists. However more objective metrics are required in order to improve novice’s training programs. The aim of this study is to validate the hand motion analysis of the Imperial College Surgical Assessment Device (ICSAD) in a simulated model of spinal anesthesia. Methods Three groups of physicians with different levels of experience were video recorded performing a spinal anesthesia in a simulated lumbar puncture torso. Participants’ technical performance was assessed with ICSAD, a Global Rating Scale (GRS) and a specific Checklist. Differences between the 3 groups were determined by Kruskal-Wallis test with post hoc Dunn’s correction for multiple comparisons. Spearman correlation coefficient between ICSAD variables and the scores of the observational scales were calculated to establish concurrent validity. Results Thirty subjects participated in the study: ten novice (first year residents), 10 intermediate (third year residents) and 10 experts (attending anesthesiologists). GRS scores were significantly higher in experts, than intermediates and novices. Regarding total path length, number of movements and procedural time measured with ICSAD, all groups had significant differences between them (p = 0.026, p = 0.045 and p = 0.005 respectively). Spearman correlation coefficient was −0,46 (p = 0.012) between total path length measured with ICSAD and GRS scores. Conclusions This is the first validation study of ICSAD as an assessment tool for spinal anesthesia in a simulated model. Using ICSAD can discriminate proficiency between expert and novices and correlates with previously validated GRS. Its use in the assessment of spinal anesthesia proficiency provides complementary data to existing tools. Our results could be used to design future training programs with reliable goals to accomplish.

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