Randomized control trial of a holographic needle guidance technique for thoracic epidural placement

• DOI: 10.1136/rapm-2023-104703
• Publication Date: 2024-01-11T18:30:16Z
• Authors: Julian Wiegelmann; Stephen Choi; Paul G McHardy; Clyde Matava; Oskar Singer; Lilia Kaustov; Fahad Alam
• Keywords: Thoracic spine

Introduction The Microsoft HoloLens is a head-mounted mixed reality device, which allows for overlaying hologram-like computer-generated elements onto the real world. This technology can be combined with preprocedural ultrasound during thoracic epidural placement to create visual of ideal needle angulation and trajectory in users’ field view. could result technically easier potentially safer alternative traditional blind landmark techniques. Methods Patients were randomly assigned one two groups: (1) HoloLens-assisted technique (intervention—group H) or (2) (control—group C). primary outcome was needling time (defined as skin puncture insertion catheter) procedure. secondary outcomes number punctures, movements, bone contacts, failure. Procedural pain recovery room levels also evaluated. Results Eighty-three patients included this study. procedure reduced group compared control (4.5 min vs 7.3 min, p=0.02, 95% CI), movements required (7.2 14.4, p=0.01), respectively. There no difference intraprocedure postprocedure pain, total punctures. Three experienced failure versus patient group. Conclusions study shows that may facilitated by using guidance hologram more efficient. Trial registration NCT04028284 .