Reliable needle visualization during ultrasound guided regional and vascular procedures. A simple solution to steep angle echogenicity loss with any ultrasound system, based on target depth.
Ultrasound guided regional anesthesia has become recognized as the evolving alternative to standard landmark based techniques for nerve blockade and vascular access. It’s limitations begin to be recognized as needle angles are increased beyond 30 degrees as in those commonly used for deep injections. This element regarding it’s use remains difficult to overcome especially for novice users. Loss of needle visibility on the monitor screen, remains a source of irritation for many providers, leaving them confused as to the value of ultrasound’s true utility. This article will explore a simple, reliable strategy for improved needle visibility on any ultrasound machine, using the mathematical property of the law of Sines. The only numerical value needed from the user is the depth to determine this technique.
2. Chan V, Perlas A. Atlas of Ultrasound-Guided Procedures in Interventional Pain Management, 13 DOI 10.1007/978-1-4419-1681-5_2, © Springer Science+Business Media, LLC 2011. Chaper 2 , pages 15-17.
3. Reusz G, Sarkany J, Gal J et al., Needle-related ultrasound artifacts and their importance in anaesthetic practice British Journal of Anaesthesia Page 1 of 9 doi:10.1093/bja/aet585
4. Schafhalter-Zoppoth I, McCulloch CE, Gray AT. Ultrasound visibility of needles used for regional nerve block: an in vitro study. Reg Anesth Pain Med. 2004 Sep-Oct;29(5):480-8.
5. Miura M, Kazuhide T, Toshiyasu S. Visibility of Ultrasound-guided Echogenic Needle and Its Potential in Clinical Delivery of Regional Anesthesia. Exp Clin Med., 39(2) 80-86, 2014
6. Junji T, Naozumi T, Kentaro O, Tetsuya Uchino, et al., Ultrasound visibility of regional anesthesia catheters: an in vitro study. Korean J Anesthesiol. Jul 2012; 63(1): 59–64. Published online Jul 24, 2012. doi: 10.4097/kjae.2012.63.1.59 PMCID: PMC3408517
7. Abbal B, Choquet O, Gourari A, [Epub ahead of print] Enhanced visual acuity with echogenic needles in ultrasound-guided axillary brachial plexus block : A randomized, comparative, observer-blinded study. Minerva Anestesiol. 2014 Jul 24.
8. Hocking G, Hebard S, Mitchell C. A review of the benefits and pitfalls of phantoms in ultrasound-guided regional anesthesia. Journal Reg Anesth Pain Med. 2011 Mar-Apr;36(2):162-70.
9. Hebard S, Hocking G. Echogenic technology can improve needle visibility during ultrasound-guided regional anesthesia. Journal Reg Anesth Pain Med. 2011 Mar-Apr;36(2):185-9.
10. Weismann T, Borntrager A, Zoremba M, et al., Compound Imaging Technology and echogenic needle design: Effects on needle visibility and tissue imaging. Regional Anesthesia and Pain Medicine, 38(5) Sept-Oct 2013.
11. Kline JP. Ultrasound guidance in anesthesia. AANA J. 2011 Jun;79(3):209-17.
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