title: Evaluation of a New Needle Guidance System for Ultrasound: Results of a Prospective, Randomized, Blinded Study.
abstract: OBJECTIVE
  Accurate needle control during ultrasound (US)-guided nerve blocks may be an elusive goal for the anesthesiologist. Despite modifications to increase echogenicity, needle visibility still requires precise alignment within the transducer beam. In this study, we evaluated a magnetically guided ultrasound (MGU) system that produces a real-time, graphic display of the needle position and trajectory that is independent of the US beam.
  
  
  METHODS
  The MGU system was compared with echogenic needles and conventional ultrasound (CU) by anesthesiologists with and without prior experience performing US-guided nerve blocks. Participants were asked to perform tasks to quantify accuracy with respect to needle direction (directional accuracy) and needle tip position (positional accuracy). These evaluations were performed in a porcine tissue model.
  
  
  RESULTS
  Regarding directional accuracy, inexperienced subjects were able to contact a target capsule with a single needle pass during both in-plane (IP) and out-of-plane (OOP) approaches using the magnetic guidance system. By contrast, using CU, subjects required redirection 3.8 ± 2.4 (P = 0.02), and 4.5 ± 3.9 (P = 0.04) times, respectively, for IP and OOP approaches. Experienced subjects contacted the target capsule with a single pass for both IP and OOP approaches when using the magnetic guidance system. With CU, experienced subjects were able to contact the target with a single pass using an IP approach but required redirection 3.4 ± 2.8 (P = 0.046) times during OOP approaches. Positional accuracy was also superior for both inexperienced (P = 0.04) and experienced (P = 0.02) users during an OOP approach.
  
  
  CONCLUSIONS
  In a tissue model, the MGU system improved control of needle trajectory and needle tip position for both inexperienced and experienced subjects.
authors.affiliation: From the Department of Anesthesiology, University of Utah, Salt Lake City, UT.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Swenson
authors.forename: Kendell R
authors.initials: KR
authors.lastname: Klingler
authors.forename: Nathan L
authors.initials: NL
authors.lastname: Pace
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Davis
authors.forename: Evelyn C
authors.initials: EC
authors.lastname: Loose
mesh_terms: D000818:Animals; D002983:Clinical Competence; D004867:Equipment Design; D006801:Humans; D059032:Learning Curve; D008280:Magnetics / Q000295:instrumentation* / Q000379:methods; D008422:Materials Testing; D023421:Models, Animal; D009048:Motor Skills; D009339:Needles; D009407:Nerve Block / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D013552:Swine; D018084:Ultrasonography, Interventional / Q000295:instrumentation* / Q000379:methods; D014589:Utah