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A novel reusable three-dimensional printed canine epidural anesthesia simulator with consistent tactile feedback: a
Taehoon Sung1, Inhyung Lee1, Won-Gyun Son1
1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea.
Objective:
To develop a three-dimensional (3D) printed canine epidural anesthesia (EA) simulator that reproduces anatomical and tactile features, and to evaluate its educational effectiveness.
Study Design:
Prospective simulation-based training study.
Animals:
None.
Methods:
Computed tomography data from a single dog (27.9 kg) were used to design the 3D-printed lumbosacral vertebrae. Surrounding soft tissues were modeled with silicone, except for a replaceable gelatin block at the needle insertion site and a surgical drape over an aluminum foil conductive core to mimic the ligamentum flavum. Epidural space entry was confirmed using an insulated nerve stimulator needle. Ten veterinary anesthetists performed three attempts each and rated seven items on a 5-point Likert scale (1, strongly disagree to 5, strongly agree), covering tactile realism and perceived educational utility. In total 72 students and novice veterinarians each performed 10 attempts on the simulator, with time from landmark palpation to perceived pop sensation recorded. Confidence was assessed using seven items on a 10-point Likert scale (1, strongly disagree to 10, strongly agree) before and after training. Learning curves were analyzed using an exponential decay model and Kaplan-Meier survival analysis, and pre- and post-training confidence scores were compared with Wilcoxon signed-rank tests.
Results:
Anesthetists assigned median scores ≥ 4.0 for most items, with lower ratings for visual fidelity (median 3.5, range 1-5). The exponential decay model showed reductions in time to success with a plateau after the fifth successful attempt. Kaplan-Meier analysis indicated that all participants achieved at least one successful epidural within seven attempts. Confidence increased significantly for all survey items (adjusted p < 0.001).
Conclusions And Clinical Relevance:
The 3D-printed canine EA simulator provided consistent, repeatable tactile feedback and may serve as a practical platform for training in lumbosacral landmark identification and recognition of the 'pop' sensation associated with ligamentum flavum penetration.
