Ultrasound Anesthesia Needle Guidance

Ultrasound Anesthesia Needle Guidance

Ultrasound guidance is increasingly used for needle-based interventions in anaesthesia practice, including vascular access and peripheral nerve blocks.ultrasound anesthesia needle It improves local anesthetic delivery by allowing needle position to be monitored, and it reduces the risk of accidental damage to unintended vessels or nerves. In addition, ultrasound can help identify a difficult to locate vein for vascular access, particularly in patients with obesity or certain chronic medical conditions.

However, achieving sufficient needle visibility with ultrasound is challenging and requires training.ultrasound anesthesia needle As point-of-care ultrasound (POCUS) becomes increasingly affordable, portable and popular in anesthesia, leading anesthesiologists and certified registered nurse anesthetists have advocated its use in training programs and introduced POCUS guidelines and certification.1

The most common technique to improve needle tip visualization is by increasing the angle of the needle insertion with respect to the face of the transducer.ultrasound anesthesia needle This increases the number of echoes transmitted back to the probe, which can be visualised on the US screen. However, it also means that the needle tip is further away from the target and the needle shaft is longer. Alternatively, the needle insertion site can be indented slightly to decrease the acute angle with respect to the transducer face, but this may require a larger needle and further distance from the target.

A variety of other technologies have been developed to assist in needle alignment and identification, from simple mechanical devices through to sophisticated automated software that can detect the needle tip.ultrasound anesthesia needle This scoping review summarises these techniques and compares their advantages and disadvantages, as well as providing advice on the use of each for improving needle tip visualisation with ultrasound.

In this study, two senior anesthesiologists with extensive experience of ultrasound-guided block procedures performed in-plane infraclavicular lateral sagittal brachial plexus blocks on a volunteer with the arm to be anaesthetised held supine and with the elbow flexed. Both anesthesiologists had practiced using the photoacoustic effect needle guide on Thiel cadavers and muscle tissue phantom models prior to the experiment.

The participants were blinded to the experimental setup using an opacity board, and a needle-emitting ultrasound view and a normal US view of the injected arm were recorded. Each participant rated the needle tip visibility on a Likert scale (1: very poor, 2: fair, 3: good, 4: excellent).

The results showed that novice anesthesiologists become proficient in ultrasound-guided needle visualization at a variable rate and that it takes approximately 28 supervised, simulated trials with feedback to achieve competency. In addition, the photoacoustic needle guide significantly improved needle tip visibility when compared to conventional ultrasound-guided techniques in this cohort of novices. Moreover, the method was safe and easy to use and did not affect block success rates.

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