• James S Bowness, MacfarlaneAlan J RAJRDepartment of Anaesthesia, Glasgow Royal Infirmary, Glasgow, UK; School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK., David Burckett-St Laurent, Catherine Harris, Steve Margetts, Megan Morecroft, David Phillips, Tom Rees, Nick Sleep, Asta Vasalauskaite, Simeon West, J Alison Noble, and Helen Higham.
• Oxford Simulation, Teaching and Research Centre, University of Oxford, Oxford, UK; Department of Anaesthesia, Aneurin Bevan University Health Board, Newport, UK. Electronic address: james.bowness@jesus.ox.ac.uk.
• Br J Anaesth. 2023 Feb 1; 130 (2): 226233226-233.

BackgroundUltrasound-guided regional anaesthesia relies on the visualisation of key landmark, target, and safety structures on ultrasound. However, this can be challenging, particularly for inexperienced practitioners. Artificial intelligence (AI) is increasingly being applied to medical image interpretation, including ultrasound. In this exploratory study, we evaluated ultrasound scanning performance by non-experts in ultrasound-guided regional anaesthesia, with and without the use of an assistive AI device.MethodsTwenty-one anaesthetists, all non-experts in ultrasound-guided regional anaesthesia, underwent a standardised teaching session in ultrasound scanning for six peripheral nerve blocks. All then performed a scan for each block; half of the scans were performed with AI assistance and half without. Experts assessed acquisition of the correct block view and correct identification of sono-anatomical structures on each view. Participants reported scan confidence, experts provided a global rating score of scan performance, and scans were timed.ResultsExperts assessed 126 ultrasound scans. Participants acquired the correct block view in 56/62 (90.3%) scans with the device compared with 47/62 (75.1%) without (P=0.031, two data points lost). Correct identification of sono-anatomical structures on the view was 188/212 (88.8%) with the device compared with 161/208 (77.4%) without (P=0.002). There was no significant overall difference in participant confidence, expert global performance score, or scan time.ConclusionsUse of an assistive AI device was associated with improved ultrasound image acquisition and interpretation. Such technology holds potential to augment performance of ultrasound scanning for regional anaesthesia by non-experts, potentially expanding patient access to these techniques.Clinical Trial RegistrationNCT05156099.Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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