• Jens Kessler, Bernhard Moriggl, and Thomas Grau.
• Department of Anesthesiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany, jens.kessler@med.uni-heidelberg.de.
• Surg Radiol Anat. 2014 May 1;36(4):383-92.

PurposeTo date, there have been few studies of the simulation of ultrasound-guided regional anesthesia for teaching purposes. The present study aimed to evaluate the visibility of nerves and their adjacent structures, and the feasibility of the use of ultrasound-guided blocks in specially prepared cadavers to develop a new teaching model.MethodsNerves of the brachial, lumbar, and sacral plexus were examined, and their visibility evaluated in 12 specially embalmed cadavers. Thereafter a needle was advanced under direct ultrasound guidance to target nerves, and selected blocks were imitated using saline. The model was evaluated with standardized questionnaires in two international workshops with 124 participants.ResultsThe selected nerves were successfully identified in all cadavers. The typical ultrasound appearance of nerves and their adjacent structures was very similar to the echotexture of the living, and the spread of injected saline around nerves was comparable to that of local anesthetics used in live patients. 79 % of the participants completed the questionnaire and confirmed the value of this optimized teaching model.ConclusionsThis cadaver model is a promising teaching tool for practicing both the visualization of nerves and the needle manipulation. Moreover, it is possible to simulate the interventional application and the spread of local anesthetics using saline. With the aim of maximizing the effectiveness of teaching, it is hoped that we, and others, may be able to establish the use of this kind of tool as a valuable adjunct to other models of teaching regional anesthesia.

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