Thoracic epidural insertion using extended reality hologram assistance: a randomised trial of regional anaesthesia skill performance on the soft embalmed Thiel cadaver
Authors' conclusion
Extended reality hologram-assisted thoracic epidural insertion did not alter Global Rating Scale scores for the holographic vs landmark techniques, but reduced needle movements.
Study context
- Population
- Anaesthetists of all grades performing cadaveric thoracic epidurals (T1/2 to T10/11) on a soft embalmed Thiel cadavercompleted the study
- Participants
- 58 participants
- Comparison
- Extended reality vs Landmark
- Primary endpoint
- Log-log slope of Global Rating Scale assessments
Methodological detailscadaveric simulation (soft embalmed Thiel cadaver), 10 randomly allocated anatomical sites between T1/2 and T 10/11, randomised equally to each technique; loss of resistance to fluid as endpoint
- Cadaveric simulation (soft embalmed Thiel cadaver)
- 10 randomly allocated anatomical sites between T1/2 and T 10/11, randomised equally to each technique; loss of resistance to fluid as endpoint
Primary result
As reported in the abstract
Global Rating Scale slopes
- Global Rating Scale slopes did not differ between groups or by grade of anaesthetist
Secondary outcomes
| Outcome | Extended reality | Landmark | RR (CI) | |
|---|---|---|---|---|
| Ideal performance (single skin insertion and ≤2 subsequent needle movements) | 52% | 28% | 1.50 (0.91–2.53) | |
| 0.20.5125Relative risk (log scale) |
Mean
| Outcome | Extended reality | Landmark | P value |
|---|---|---|---|
| Mean log number of needle movementsSpread printed in parentheses, kind not named | 0.94 (SD 0.95) | 1.49 (SD 0.97) | P < 0.001 |
Original publication
Thoracic epidural insertion using extended reality hologram assistance: a randomised trial of regional anaesthesia skill performance on the soft embalmed Thiel cadaver. Br J Anaesth. Published 1 January 2026. doi:10.
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