P224 Needle pass time as a metric to monitor progression of EBUS trainees

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

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Ultrasound Guided Axillary Brachial Plexus Block Versus Supraclavicular Block In Emergency Crushed Hand Patients : A Comparative Study

The Open Anesthesia Journal ◽

10.2174/2589645801812010034 ◽

2018 ◽

Vol 12 (1) ◽

pp. 34-41

Author(s):

Rania Maher Hussien ◽

Dalia Ahmed Ibrahim

Keyword(s):

Brachial Plexus ◽

Brachial Plexus Block ◽

Onset Time ◽

Hand Surgery ◽

Good Alternative ◽

Ultrasound Guided ◽

Performance Time ◽

Needle Pass ◽

Supraclavicular Block ◽

Plexus Block

Background: The current study focusses on ultrasound guided Brachial Plexus Block (BPB) which plays an important role in patients with hand trauma either in pain control or for surgical intervention. The brachial plexus can be blocked by several techniques but the most commonly used are the Supraclavicular (SCB) and Axillary (AXB) blocks. Objective: To compare the two techniques with regards to the performance time, needling time, anesthesia-related time, block-related complications, number of needle pass and block related pain. Methods: After approval of the ethical committee and obtaining a written informed consent from patients, this prospective, randomized, interventional double-blinded study was done to patients undergoing emergency crushed hand surgery. 80 patients were allocated randomly into two equal groups. Under ultrasound guidance, the SCB and AXB were done for the two groups, respectively. The needling time, performance time, anesthesia-related time, onset time, number of 1st needle pass in each group and block related complications were noted. Statistical Analysis: Data were analysed using the Statistical Package for Social Science (IBM SPSS) version 23 SPSS. Results: Longer needling, performance, anesthesia-related time in the AXB group than SCB and less complications have occurred with AXB than SCB group. Conclusion: Axillary block of brachial plexus is a good alternative to Supraclavicular block in emergency crushed hand surgery and the choice is made according to the requirement of each case.

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Comparison of Number of Passes and Cytopathological Specimen Adequacy for Thyroid Fine-Needle Aspiration Biopsy in the Absence of an On-Site Pathologist

European Thyroid Journal ◽

10.1159/000504094 ◽

2019 ◽

Vol 9 (1) ◽

pp. 49-54 ◽

Cited By ~ 1

Author(s):

Taha Yusuf Kuzan ◽

Ceren Canbey Goret

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Biopsy ◽

High Sensitivity ◽

Needle Aspiration ◽

Aspiration Biopsy ◽

Fine Needle ◽

Needle Pass ◽

Microscopic Evaluation ◽

Significant Difference ◽

Needle Aspiration Biopsy

Aim: Ultrasound-guided fine-needle aspiration biopsy (FNAB) is a reliable, minimally invasive diagnostic method with high sensitivity and specificity in the evaluation of thyroid nodules. Our aim in this retrospective study was to determine if there was a difference in the adequacy ratio based on the number of needle passes in the thyroid FNABs in the absence of rapid on-site evaluation (ROSE) by the pathologist and to determine the optimal needle pass number for FNAB. Methods: Between November 2018 and February 2019, thyroid FNABs of 121 (99 female, 22 male) patients were evaluated retrospectively. Samples for each biopsy were numbered according to the order of retrieval, and 4 pairs of slides were prepared by the radiologist without on-site microscopic evaluation. Cytological results were determined according to the Bethesda classification. Results: The rate of adequacy in the first, second, third, and fourth passes were 76.0, 82.6, 77.7, and 71.2%, respectively. No statistically significant difference was found between these four groups in terms of adequacy (p = 0.21). The adequacy rates of the 1st, 1st+2nd, 1st+2nd+3rd, and cumulative evaluation of all four biopsies were 76.0, 87.6, 90.1, and 91.7%, respectively (p = 0.001). A statistically significant difference was found in the comparison of the 1st biopsy and the cumulative 1st+2nd biopsy in terms of adequacy rates (p = 0.019). However, there was no statistically significant difference between the cumulative 1st+2nd biopsy and the cumulative 1st+2nd+3rd biopsy in terms of adequacy rates (p = 0.54). Conclusions: In cases where ROSE cannot be performed, we recommend a minimum of 2 and a maximum of 3 needle entries for FNAB adequacy with the right technique and preparation.

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Microdissection Testicular Sperm Extraction (mTESE) vs. multiple needle-pass percutaneous Testicular Sperm Aspiration (TESA) in men with non-obstructive azoospermia: A randomized clinical trial

European Urology ◽

10.1016/s0302-2838(21)00892-7 ◽

2021 ◽

Vol 79 ◽

pp. S702-S703

Author(s):

C.F.S. Jensen ◽

D.A. Ohl ◽

M. Fode ◽

N. Jørgensen ◽

A. Giwercman ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Testicular Sperm Extraction ◽

Obstructive Azoospermia ◽

Testicular Sperm ◽

Needle Pass ◽

Sperm Aspiration ◽

Testicular Sperm Aspiration

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Multiple needle-pass percutaneous testicular sperm aspiration as first-line treatment in azoospermic men

Andrology ◽

10.1111/andr.12143 ◽

2016 ◽

Vol 4 (2) ◽

pp. 257-262 ◽

Cited By ~ 13

Author(s):

C. F. S. Jensen ◽

D. A. Ohl ◽

M. R. Hiner ◽

M. Fode ◽

T. Shah ◽

...

Keyword(s):

Line Treatment ◽

Testicular Sperm ◽

First Line ◽

Needle Pass ◽

Sperm Aspiration ◽

Testicular Sperm Aspiration ◽

First Line Treatment

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A Coaxial Dual-element Focused Ultrasound Probe for Guidance of Epidural Catheterization: An Experimental Study

Ultrasonic Imaging ◽

10.1177/0161734617697740 ◽

2017 ◽

Vol 39 (5) ◽

pp. 283-294 ◽

Cited By ~ 1

Author(s):

Guo-Chung Dong ◽

Li-Chen Chiu ◽

Chien-Kun Ting ◽

Jia-Ruei Hsu ◽

Chih-Chung Huang ◽

...

Keyword(s):

Focused Ultrasound ◽

Needle Insertion ◽

Epidural Block ◽

Epidural Needle ◽

Lumbar Region ◽

Ultrasound Probe ◽

Bone Contact ◽

Ultrasonic Probe ◽

Needle Pass ◽

Epidural Catheterization

Ultrasound guidance for epidural block has improved clinical blind-trial problems but the design of present ultrasonic probes poses operating difficulty of ultrasound-guided catheterization, increasing the failure rate. The purpose of this study was to develop a novel ultrasonic probe to avoid needle contact with vertebral bone during epidural catheterization. The probe has a central circular passage for needle insertion. Two focused annular transducers are deployed around the passage for on-axis guidance. A 17-gauge insulated Tuohy needle containing the self-developed fiber-optic–modified stylet was inserted into the back of the anesthetized pig, in the lumbar region under the guidance of our ultrasonic probe. The inner transducer of the probe detected the shallow echo signals of the peak-peak amplitude of 2.8 V over L3 at the depth of 2.4 cm, and the amplitude was decreased to 0.8 V directly over the L3 to L4 interspace. The outer transducer could detect the echoes from the deeper bone at the depth of 4.5 cm, which did not appear for the inner transducer. The operator tilted the probe slightly in left-right and cranial-caudal directions until the echoes at the depth of 4.5 cm disappeared, and the epidural needle was inserted through the central passage of the probe. The needle was advanced and stopped when the epidural space was identified by optical technique. The needle passed without bone contact. Designs of the hollow probe for needle pass and dual transducers with different focal lengths for detection of shallow and deep vertebrae may benefit operation, bone/nonbone identification, and cost.

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