The echogenicity of nerve blockade needles

Abstract

SummaryWe performed a prospective, randomised study to evaluate the echogenicity of 11 regional block needles when inserted into a gel phantom at 45°in the ultrasound plane. Two hundred anaesthetists viewed in random sequence recordings of each needle as it was advanced into the phantom. Participants scored the needle for echogenicity on a scale of 0-10 and categorised the needle as 'hyperechoic' or 'standard'. The mean (95% CI) echogenicity score was 1.7 (1.4-2.0) units higher for three needles marketed as 'hyperechoic' compared with standard needles marketed by the same companies, p < 0.001. The odds ratios (95% CI) that an anaesthetist would categorise a needle as hyperechoic were: 5.3 (3.6-8.0) if the needle was marketed as hyperechoic, p < 0.001; and 1.7 (1.1-2.6) if regional anaesthetic experience was ≥ 1 year compared with < 1 year, p = 0.025.

Comparison of Paravertebral Block by Anatomic Landmark Technique to Ultrasound-Guided Paravertebral Block for Breast Surgery Anesthesia

“…17,20 More echogenic, 21-to 22-gauge laser-etched needles, with reflectors that enable better visualization of the needle tip and proximal 2 cm, even on steep angle of insertion are now available, and we have now started practicing lateral in-plane needle insertion with transverse view of the PVB space using these needles. 22 This approach also makes it possible to see if the needle tip is too medial (avoiding inadvertent intraforaminal injection that can lead to a bilateral block) or too anterior (avoiding pleural tap/Horner syndrome).…”

Practical Electrochemical Method to Enhance Needle Visibility during Ultrasound Imaging

“…There were several phantoms available to study the imaging effects of echogenic needles, including pork, gel, chicken, and beef. ,,,,− Previous studies used liquid water as a puncture phantom to collect reflected waves of the needle under water bath conditions. , Other studies examined the imaging effects of needle puncture on live volunteers and human cadavers. ,− However, there is still no standard phantom for studying the imaging effects of needles under ultrasound. Water phantoms and artificially synthesized phantoms, such as gel, could enhance the imaging of needles under ultrasound but might result in significantly different imaging effects in actual biological organisms.…”

Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice

“…Echogenic needles , beam steering and compound imaging have been shown to increase needle visibility but, as they do not specifically aid in aligning probe and needle or in identifying the needle tip, these techniques are not addressed in this review.…”