scholarly journals Surface marking technique to locate needle insertion point for ultrasound-guided neuraxial block

2016 ◽  
Vol 116 (4) ◽  
pp. 568-569 ◽  
Author(s):  
B.P. Manickam ◽  
A McDonald
2020 ◽  
Vol 15 (4) ◽  
pp. 397-408
Author(s):  
Seokha Yoo ◽  
Youngwon Kim ◽  
Sun-Kyung Park ◽  
Sang-Hwan Ji ◽  
Jin-Tae Kim

Ultrasonography can be useful to perform a lumbar neuraxial block. It aids in understanding the anatomy of the lumbar spine before the procedure. Pre-procedural ultrasound imaging provides information about the accurate intervertebral level for puncture, optimal needle insertion point, and depth of needle advancement for a successful neuraxial block. The key ultrasonographic views for lumbar neuraxial block include the transverse midline interlaminar and parasagittal oblique views. Ultrasonography can facilitate lumbar neuraxial block in difficult cases, such as the elderly, obese patients, and patients with anatomical abnormality of the lumbar spine. This review elucidates the basics of spinal ultrasonography for lumbar neuraxial block and the current evidence regarding ultrasound-guided neuraxial block in adults.


2020 ◽  
pp. 217-220
Author(s):  
JOhn J. Finneran IV

Background: Percutaneous cryoneurolysis provides prolonged postoperative analgesia by placing a probe adjacent to a peripheral nerve and cooling the probe tip, inducing a reversible block that lasts weeks to months. Unfortunately, freezing the nerve can produce significant pain. Consequently, local anesthetic is generally applied to the nerve prior to cryoneurolysis, which, until now, required an additional needle insertion increasing both the risks and duration of the procedure. Case Presentation: Three patients underwent ultrasound-guided percutaneous cryoneurolysis of either the sciatic and saphenous nerves or the femoral nerve. In all patients, the local anesthetic injection and cryoneurolysis were accomplished with a single needle pass using the novel probe introducer. Conclusion: This introducer allows perineural local anesthetic injection followed immediately by cryoneurolysis, thereby sparing patients a second skin puncture, lowering the risks of the procedure, and decreasing the overall time required for cryoneurolysis. Key words: Cryoablation, cryoanalgesia, peripheral nerve block, postoperative analgesia, ultrasound


Author(s):  
Wing-Yin Chan ◽  
Dong Ni ◽  
Wai-Man Pang ◽  
Jing Qin ◽  
Yim-Pan Chui ◽  
...  

Pain Medicine ◽  
2019 ◽  
Vol 20 (9) ◽  
pp. 1750-1755 ◽  
Author(s):  
Hesham Elsharkawy ◽  
Wael Saasouh ◽  
Rovnat Babazade ◽  
Loran Mounir Soliman ◽  
Jean-Louis Horn ◽  
...  

Abstract Objective The anatomical landmarks method is currently the most widely used technique for epidural needle insertion and is faced with multiple difficulties in certain patient populations. Real-time ultrasound guidance has been recently used to aid in epidural needle insertion, with promising results. Our aim was to test the feasibility, success rate, and satisfaction associated with a novel real-time ultrasound-guided lumbar epidural needle insertion in the transverse interlaminar view. Design Prospective descriptive trial on a novel approach. Setting Operating room and preoperative holding area at a tertiary care hospital. Subjects Adult patients presenting for elective open prostatectomy and planned for surgical epidural anesthesia. Methods Consented adult patients aged 30–80 years scheduled for open prostatectomy under epidural anesthesia were enrolled. Exclusion criteria included allergy to local anesthetics, infection at the needle insertion site, coagulopathy, and patient refusal. A curvilinear low-frequency (2–5 MHz) ultrasound probe and echogenic 17-G Tuohy needles were used by one of three attending anesthesiologists. Feasibility of epidural insertion was defined as a 90% success rate within 10 minutes. Results Twenty-two patients were enrolled into the trial, 14 (63.6%) of whom found the process to be satisfactory or very satisfactory. The median time to perform the block was around 4.5 minutes, with an estimated success rate of 95%. No complications related to the epidural block were observed over the 48 hours after the procedure. Conclusions We demonstrate the feasibility of a novel real-time ultrasound-guided epidural with transverse interlaminar view.


2016 ◽  
Vol 01 (01) ◽  
pp. 1640007 ◽  
Author(s):  
Mohsen Khadem ◽  
Carlos Rossa ◽  
Ron S. Sloboda ◽  
Nawaid Usmani ◽  
Mahdi Tavakoli

In needle-based medical procedures, beveled tip flexible needles are steered inside soft tissue to reach the desired target locations. In this paper, we have developed an autonomous image-guided needle steering system that enhances targeting accuracy in needle insertion while minimizing tissue trauma. The system has three main components. First is a novel mechanics-based needle steering model that predicts needle deflection and accepts needle tip rotation as an input for needle steering. The second is a needle tip tracking system that determines needle deflection from the ultrasound images. The needle steering model employs the estimated needle deflection at the present time to predict needle tip trajectory in the future steps. The third component is a nonlinear model predictive controller (NMPC) that steers the needle inside the tissue by rotating the needle beveled tip. The MPC controller calculates control decisions based on iterative optimization of the predictions of the needle steering model. To validate the proposed ultrasound-guided needle steering system, needle insertion experiments in biological tissue phantoms are performed in two cases–with and without obstacle. The results demonstrate that our needle steering strategy guides the needle to the desired targets with the maximum error of 2.85[Formula: see text]mm.


Author(s):  
Shiv Kumar Singh ◽  
Tuhin Mistry

Introduction In most of the ultrasound guided regional anaesthesia workshops, anaesthesiologists usually concentrate on identification of nerves & plexus on human volunteers and practice needling techniques on phantom. Proper needle insertion technique and correct manipulation are two important skills for ultrasound-guided peripheral nerve blocks. These skills can be sharpened by practicing on ultrasound phantom. It also helps anaesthesiologists to develop, practice and maintain the skills needed for regional anaesthesia and vascular access procedures [1]. But the use of phantoms is often limited due to the cost of the blue phantom [2]. Many courses use meat-based products like turkey legs or porcine models but these may not be acceptable to everyone [3,4]. Vegetable based models using gelatine also may not be acceptable as it too is made from animal products. We describe novel use of Aloe Vera (AV)stem as phantom for US guided needling training. This natural AV gel-based phantom can be used for scanning, needling and refine other relevant skills. The AV phantom can be constructed from low cost, readily available natural source and is reusable. Various materials have been used to make ultrasound training phantoms. Commercially available phantoms are expensive and homemade nerve block models are cumbersome to prepare [5]. The Aloe Vera gel is obtained from Aloe Vera plant (Aloe barbadensis miller). It is a natural product which has been used for centuries in various field specially in dermatology. Aloe Vera leaves are triangular and fleshy with serrated edges. Each leaf contains an inner clear gel which is made of 99% water and other substances (glucomannans, amino acids, lipids, sterols and vitamins) [6]. Aloe Vera is odorless and semi-transparent unlike meat-based models. Preparing the Aloe Vera US Model The covering of the leaves is non-echogenic and hence the pulp from Aloe Vera leaves is separated and placed in layers and covered with a Transparent Dressing(Te


2017 ◽  
Author(s):  
Hillary Lia ◽  
Zsuzsanna Keri ◽  
Matthew S. Holden ◽  
Vinyas Harish ◽  
Christopher H. Mitchell ◽  
...  

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