scholarly journals A needle guidance device compared to free hand technique in an ultrasound-guided interventional task using a phantom

Anaesthesia ◽  
2008 ◽  
Vol 63 (9) ◽  
pp. 986-990 ◽  
Author(s):  
G.-J. Van Geffen ◽  
J. Mulder ◽  
M. Gielen ◽  
J. Van Egmond ◽  
G.-J. Scheffer ◽  
...  
Keyword(s):  
Needle Guidance ◽  
Ultrasound Guided ◽  
Free Hand Technique ◽  
Guidance Device

Comparison of two ultrasound-guided injection techniques targeting the sacroiliac joint region in equine cadavers

2016 ◽  
Vol 29 (05) ◽  
pp. 386-393 ◽  
Author(s):  
Chiara Bergamino ◽  
Ruth Sanders ◽  
Ursula Fogarty ◽  
Antonella Puggioni ◽  
Clodagh Kearney ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Ultra Sound ◽  
Needle Guidance ◽  
Sacroiliac Joints ◽  
Ultrasound Guided ◽  
Joint Region ◽  
Median Distance ◽  
Iodinated Contrast ◽  
Before And After ◽  
Injection Techniques

Summary Objectives: To compare the accuracy and distribution of injectate for cranial (CR) and caudomedial (CM) ultrasound-guided injections of equine sacroiliac joints. Methods: Both sacroiliac joints from 10 lumbo sacropelvic specimens were injected using cranial parasagittal (CR; curved 18 gauge, 25 cm spinal needles) and caudomedial (CM; straight 18 gauge, 15 cm spinal needles) ultrasound-guided approaches. Injectate consisted of 4 ml iodinated contrast and 2 ml methylene blue. Computed tomo-graphical (CT) scans were performed before and after injections. Time for needle guidance and repositioning attempts were recorded. The CT sequences were analysed for accuracy and distribution of contrast. Results: Intra-articular contrast was detected in sacroiliac joints following 15/40 injections. The CR and CM approaches deposited injectate ≤ 2 cm from sacroiliac joint margins following 17/20 and 20/20 injections, respectively. Median distance of closest contrast to the sacroiliac joint was 0.4 cm (interquartile range [IQR]: 1.5 cm) for CR approaches and 0.6 cm (IQR: 0.95 cm) for CM approaches. Cranial injections resulted in injectate contacting lumbosacral intertrans-verse joints 15/20 times. Caudomedial injections were perivascular 16/20 times. Limitations: Safety and efficacy could not be established. Clinical relevance: Cranial and CM ultra-sound-guided injections targeting sacroiliac joints were very accurate for periarticular injection, but accuracy was poor for intra- articular injection. Injectate was frequently found in contact with interosseous sacroiliac ligaments, as well as neurovascular and synovial structures in close vicinity of sacroiliac joints.

scholarly journals Gastric outlet obstruction with ascites: EUS-guided gastro-enterostomy is feasible

2021 ◽  
Vol 09 (12) ◽  
pp. E1918-E1923
Author(s):  
Jahangeer Basha ◽  
Sundeep Lakhtakia ◽  
Raghavendra Yarlagadda ◽  
Zaheer Nabi ◽  
Rajesh Gupta ◽  
...  
Keyword(s):  
Adverse Events ◽  
Gastric Outlet Obstruction ◽  
Clinical Success ◽  
Outlet Obstruction ◽  
Survival Times ◽  
Technical Success ◽  
Ultrasound Guided ◽  
Underlying Malignancy ◽  
Study Population ◽  
Free Hand Technique

Abstract Background and study aims Endoscopic ultrasound-guided gastro-enterostomy(EUS-GE) is a recently described novel minimally invasive endoscopic procedure for patients having malignant gastric outlet obstruction (GOO). The safety of EUS-GE in the presence of ascites with GOO is not known. The objective of the study was to evaluate the feasibility and safety of EUS-GE in patients with GOO and ascites. Patients and methods Consecutive patients with GOO who underwent EUS-GE between January 2019 and March 2021 constituted the study population. EUS-GE was performed using either EPASS or free-hand technique. The technical success, clinical success, adverse events, and survival times were evaluated. The outcomes were compared between patients with and without ascites. Results A total of 31 patients with GOO underwent EUS-GE of whom 29 (93.5 %) had malignant and two (6.4 %) had benign etiologies. Ascites was observed in 12 out of 31 (38.7%) patients and all had underlying malignancy. Majority (27, 87 %) of the EUS-GE procedures were performed using EPASS technique, and 4 (13 %) underwent free-hand technique. Eleven of 12 patients with ascites and GOO underwent EUS GE using EPASS technique. The technical success (91.6 % vs. 89.4 %; P = 0.841), clinical success (83.3 % vs. 89.4 %; P = 0.619), mean procedure time (32 vs. 31.6 min; P = 0.968) and adverse events (0 % vs. 10.5 %; P = 0.245) were not significantly different between patients with or without ascites. However, the median survival time was significantly low in patients with ascites when compared to without ascites (36 vs. 290 days; P < 001). Conclusions Ascites is a common occurrence in patients with malignant GOO. EUS GE is feasible in presence of ascites with EPASS technique.

Ultrasound-Guided Procedures in the Emergency Department—Needle Guidance and Localization

2013 ◽  
Vol 31 (1) ◽  
pp. 87-115 ◽  
Author(s):  
Alfredo Tirado ◽  
Arun Nagdev ◽  
Charlotte Henningsen ◽  
Pav Breckon ◽  
Kris Chiles
Keyword(s):  
Emergency Department ◽  
Needle Guidance ◽  
Ultrasound Guided

Basic Principles of Ultrasound Guided Nerve Block

2016 ◽  
Author(s):  
Stuart A. Grant ◽  
David B Auyong
Keyword(s):  
Regional Anesthesia ◽  
Nerve Block ◽  
Point Of Care ◽  
Ultrasound Images ◽  
Needle Guidance ◽  
Ultrasound Guided ◽  
Out Of Plane ◽  
Care Systems ◽  
Clinical Description ◽  
Guidance Technique

This chapter provides a clinical description of ultrasound physics tailored to provide the practitioner a solid background for optimal imaging and needle guidance technique during regional anesthesia. Important ultrasound characteristics are covered, including optimization of ultrasound images, transducer selection, and features found on most point-of-care systems. In-plane and out-of-plane needle guidance techniques and a three-step process for visualizing in-plane needle insertions are presented. Next, common artifacts and errors including attenuation, dropout, and intraneural injection are covered, along with clinical solutions to overcome these inaccuracies. Preparation details are reviewed to make the regional anesthesia procedures as reproducible and safe as possible. Also included are a practical review of peripheral nerve block catheter placement principles, an appendix listing what blocks may be used for what surgeries, and seven Keys to Ultrasound Success that can make ultrasound guided regional anesthesia understandable and clinically feasible for all practitioners.

scholarly journals Accuracy of Ultrasound-guided Nerve Blocks of the Cervical Zygapophysial Joints

2012 ◽  
Vol 117 (2) ◽  
pp. 347-352 ◽  
Author(s):  
Andreas Siegenthaler ◽  
Sabine Mlekusch ◽  
Sven Trelle ◽  
Juerg Schliessbach ◽  
Michele Curatolo ◽  
...  
Keyword(s):  
Ultrasound Imaging ◽  
Ultrasound Guidance ◽  
Good Accuracy ◽  
Medial Branch ◽  
Needle Placement ◽  
Needle Guidance ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Zygapophysial Joint ◽  
Fluoroscopic Imaging

Background Cervical zygapophysial joint nerve blocks typically are performed with fluoroscopic needle guidance. Descriptions of ultrasound-guided block of these nerves are available, but only one small study compared ultrasound with fluoroscopy, and only for the third occipital nerve. To evaluate the potential usefulness of ultrasound-guidance in clinical practice, studies that determine the accuracy of this technique using a validated control are essential. The aim of this study was to determine the accuracy of ultrasound-guided nerve blocks of the cervical zygapophysial joints using fluoroscopy as control. Methods Sixty volunteers were studied. Ultrasound-imaging was used to place the needle to the bony target of cervical zygapophysial joint nerve blocks. The levels of needle placement were determined randomly (three levels per volunteer). After ultrasound-guided needle placement and application of 0.2 ml contrast dye, fluoroscopic imaging was performed for later evaluation by a blinded pain physician and considered as gold standard. Raw agreement, chance-corrected agreement κ, and chance-independent agreement Φ between the ultrasound-guided placement and the assessment using fluoroscopy were calculated to quantify accuracy. Results One hundred eighty needles were placed in 60 volunteers. Raw agreement was 87% (95% CI 81-91%), κ was 0.74 (0.64-0.83), and Φ 0.99 (0.99-0.99). Accuracy varied significantly between the different cervical nerves: it was low for the C7 medial branch, whereas all other levels showed very good accuracy. Conclusions Ultrasound-imaging is an accurate technique for performing cervical zygapophysial joint nerve blocks in volunteers, except for the medial branch blocks of C7.

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