title: Echogenic regional anaesthesia needles: a comparison study in Thiel cadavers.
abstract: Ultrasound guidance is now the standard procedure for regional nerve block in anesthesiology. However, ultrasonic visualisation of needle manipulation and guidance within tissues remains a problem. Two new echogenic needles (Pajunk and Braun) have been introduced to anesthesiology clinical practice but evaluation has been restricted to preserved animal tissue. In this study, the visibility of both echogenic needles was compared with a standard nonechogenic needle in a Thiel cadaver model. A total of 144 intramuscular injections were made in the upper arm in-plane and out-of-plane to the ultrasound beam at four angles (30°, 45°, 60° and 75°). The visibility of the needle was assessed by two independent, blinded observers using a 5-point Likert ordinal scale. Weighted κ for interobserver agreement was 0.77 (95% confidence interval [CI]: 0.68-0.86). The Pajunk echogenic needle was more visible than the Braun standard needle in-plane (p = 0.04), and the Braun standard and Braun echogenic needles out-of-plane (p = 0.02). Independent predictors of visibility using logistic regression were needle (p < 0.001) and plane of insertion (p = 0.08), receiver operator characteristic (ROC) area under the curve 0.90. In conclusion, the Pajunk echogenic needle offers the best visibility for ultrasound-guided regional anesthesia.
authors.affiliation: Institute for Medical Science and Technology, University of Dundee, Dundee, Scotland, UK.
authors.forename: Shuo
authors.initials: S
authors.lastname: Guo
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwab
authors.forename: Graeme
authors.initials: G
authors.lastname: McLeod
authors.forename: George
authors.initials: G
authors.lastname: Corner
authors.forename: Sandy
authors.initials: S
authors.lastname: Cochran
authors.forename: Roos
authors.initials: R
authors.lastname: Eisma
authors.forename: Roger
authors.initials: R
authors.lastname: Soames
mesh_terms: D000704:Analysis of Variance; D000765:Anesthesia, Conduction / Q000295:instrumentation*; D002102:Cadaver; D016009:Chi-Square Distribution; D006801:Humans; D016015:Logistic Models; D009339:Needles; D010865:Pilot Projects; D012372:ROC Curve; D018084:Ultrasonography, Interventional; D034941:Upper Extremity / Q000000981:diagnostic imaging*