Smart glasses integrated with a wireless ultrasound system for radial artery catheterization in elderly patients: a randomized controlled trial.

BACKGROUND: Radial artery catheterization can be challenging in elderly patients. The clinical value of integrated system combining a wireless ultrasound probe and smart glasses remains unclear. This study evaluated whether this approach improves first puncture success compared with conventional ultrasound guidance. MATERIALS AND METHODS: This prospective randomized controlled trial enrolled 194 patients aged ≥65 years with American Society of Anesthesiologists physical status I-III who were scheduled for elective surgery requiring radial artery catheterization. Patients were randomly assigned to the smart glasses group or conventional ultrasound group in a 1:1 ratio. The primary outcome was the first puncture success rate. Secondary outcomes included procedure-related behavioral indicators of hand-eye coordination, procedure time, and operator satisfaction. RESULTS: A total of 194 patients were analyzed. The first puncture success rate was significantly higher in the smart glasses group than in the ultrasound group [88/97, 90.72% vs. 66/97, 68.04%; p < 0.001; relative risk (RR) = 1.333; 95% confidence interval (CI), 1.147-1.550]. Compared with the ultrasound group, the smart glasses group showed fewer head rotations [0 (0, 0) vs. 2 (1, 3); p < 0.001], ultrasound probe repositionings [0 (0, 1) vs. 1 (0, 2); p < 0.001], and needle redirections [2 (0, 2) vs. 2 (1, 3); p < 0.001]. Operator satisfaction, measured using a visual analog scale (VAS), was higher in the smart glasses group than in the ultrasound group [86 (79-90) vs. 70 (60-79); median difference, 13.00; 95% CI, 10.00-17.00; p < 0.001]. CONCLUSION: Compared with conventional ultrasound guidance, integrated wireless ultrasound and smart glasses system improved the first puncture success rate of radial artery catheterization in elderly patients and enhanced procedure-related behavioral indicators associated with hand-eye coordination, including head rotations, ultrasound probe repositioning, and needle angle adjustments. This approach also shortened procedure time and improved operator satisfaction.