Needle Echogenicity in Sonographically Guided Regional Anesthesia

Abstract

This study shows that anesthesiologists prefer certain visual characteristics of needles used in sonographically guided regional anesthesia procedures. Specifically, needle tip clarity most closely predicted clinician needle preferences. These results support the idea that all echogenic needle designs do not uniformly enhance needle visualization. Further studies are needed to determine whether needles with superior tip clarity predict not only clinician preferences but also improved sonographically guided regional anesthetic outcomes.

Phantom Study of a New Laser-Etched Needle for Improving Visibility During Ultrasonography-Guided Lumbar Medial Branch Access With Novices

“…Taking a step forward, specific needle surface modifications allowing ultrasound reflection irrespective of angle of orientation have been recently developed in an attempt to enhance needle visualization in US for regional blocks [71421]. Sviggum et al [22] reported that the SonoPlex Stim needle (Pajunk Medical Systems, Tucker, GA, USA) was rated highest for brightness and clarity in a gel phantom compared to several echo-enhanced needles. The SonoPlex Stim uses contains a texturized needle surface with multiple flat, angled laser-based markings called 'Cornerstone' reflectors.…”

“…These indented regions increase the surface area of the needle across which the waves are reflected. These indentations between the smooth surfaces cause intense waves reflecting at different angles to bounce back to the probe by changing the reflected angles of the waves coming from the transducer [71922]. Gofeld et al [23] also noted that SonoPlex Stim appeared to have better needle tip visibility in their human cadaveric study followed by EchoStim (Havel Inc., Cincinnati, OH, USA) among representative commercially available echogenic needles in the United States.…”

“…All these specific characteristics are designed to reflect a greater percentage of the ultrasound beam striking the needle back to the ultrasound probe at steeper insertion angles in diverse US-guided regional anesthesia. Previous studies investigating such disposable echogenic needles have found that they provided outstanding visibility compared with standard needles [14192223]. Although all these needles have the potential to enhance needle echogenicity, economic factors may impede the routine use of echo-enhanced needles.…”

Practical office ultrasound for the hip surgeon: current concepts

“…Maintaining the needle in an orientation perpendicular to the ultrasound beam will ensure that the needle is echogenic and easily identifiable. Some manufacturers produce needles with specific design features that enhance their echogenicity; this may assist especially in deep-targeted injections or areas with limited access 34. Additionally, as ultrasound is a dynamic image, oscillating the needle gently while slowly scanning with the transducer can help to locate the needle tip in difficult situations 35 36…”

Increased Needle Visibility in Ultrasound-Guided Percutaneous Liver Biopsy by an Echogenic Sheath: A Proof of Concept Study in a Human Cadaver

“…For the safety and success of a PLB, it is crucial that needle visibility and identification are optimal. These are also of importance in other procedures, such as those involving vascular access [ 7 , 8 ] or in ultrasound-guided regional anesthesia [ 5 ]. To overcome poor needle visibility, two solutions are available: the imaging techniques may be adjusted or the visibility of the needle itself may be improved by increasing its echogenicity, i.e., the ability to reflect the ultrasound signal.…”