Epidural Simulators

The key elements of simulation-based training, such as repeated practice, goal feedback, and debriefing, combined with the fact that patients are not exposed to the intervention of absolute beginners, make simulation the ideal model for preliminary teaching of regional anesthesia and therefore also of the epidural technique. Epidural “mannequin-type” simulators are three-dimensional anthropomorphic models that reproduce the anatomical structures that the anesthesiologist traverses with the needle during the execution of the epidural anesthesia technique, so that the learner can learn from the tactile experience on the simulator what the right pressure to apply is to perform the maneuver and how to locate the epidural space. The alternative to “mannequin-type” simulators is represented by haptic simulators, usually associated with 3D computerized images that combine a physical interface with a virtual reality visualization of the needle’s advancement. More recently, prototypes have been described that integrate a haptic sensor with virtual reality.