title: Use of ultrasound in needle placement in intercostal muscles: a method for increased accuracy in cadavers.
abstract: OBJECTIVE
  To validate the use of ultrasound technology for the positioning and leveling of intercostal needle placement.
  
  
  METHODS
  Double-blinded experimental study.
  
  
  METHODS
  An anatomy laboratory.
  
  
  METHODS
  Two board-certified physical medicine and rehabilitation physicians, 2 first-year medical students, 1 anatomist, and 8 cadavers.
  
  
  METHODS
  Four unfixed cadavers were used for unguided needle placement, and 3 unfixed and 1 partially fixed cadavers were used for ultrasound-guided needle placement. Ultrasound-guided needle placement was then confirmed with computed tomography and blind dissection.
  
  
  METHODS
  The accuracy of needle placement.
  
  
  RESULTS
  The unguided study showed needle placement in an intercostal muscle 89% of the time, but in only 15.4% of the time was the correct level sampled. In the 96 needle placements completed, the unguided needle placements had an accuracy of 8.3%, while ultrasound-guided needle placements had an accuracy of 93% (χ(2) with P<.005).
  
  
  CONCLUSIONS
  Ultrasound guidance dramatically increases needle placement accuracy for intercostal nerve blocks and intercostal muscle sampling for electromyography.
authors: Department of Anatomy, Eastern Virginia Medical School, Norfolk, VA 23507, USA. retroum@evms.edu
authors: Michele
authors: M
authors: Retrouvey
authors: Tony
authors: T
authors: Chiodo
authors: Anton
authors: A
authors: Quidley-Nevares
authors: Jonathan
authors: J
authors: Strand
authors: Craig
authors: C
authors: Goodmurphy
mesh_terms: D002102:Cadaver; D004311:Double-Blind Method; D006801:Humans; D007366:Intercostal Muscles / Q000601:surgery*; D010810:Physical and Rehabilitation Medicine; D018084:Ultrasonography, Interventional / Q000379:methods*