Anaesthesiology

Look Ma, no free hands! A novel needle guidance device for ultrasound-guided interventions

During ultrasound-guided regional anaesthesia techniques, the continuous visualisation of the needle is important, especially in tissues that are close to blood vessels, nerves or pleura. To improve these methods, a novel needle guidance device has been developed by Dutch physicians in Nijmegen.

Effective needle guidance is necessary in order to avoid damage to collateral structures during regional anaesthesia procedures. Ultrasound-guided needle insertion therefore depends largely on needle visibility, which can be achieved through the in-plane (IP) technique, involving the visualization of the entire needle and the tip.  Nevertheless, maintaining the needle tip within an ultrasound beam of only 0.3mm is challenging, meaning that robust needle guidance systems are key.  Existing needle guidance devices can work well, but are limited in their effectiveness when thin needles are used in inhomogeneous tissues, and when suboptimal delivery of an anaesthetic requires a repositioning of the needle.

To address these challenges, an anaesthesiology group at the Radboud University Medical Centre in the Netherlands tested a newly-developed needle guidance device. The results of this analysis were recently described in an advance online publication in Anaesthesia, with Geert-Jan van Geffen as the lead author.  Through the assessment of this device in a porcine phantom, the Nijmegen team determined that the needle-guidance device performed appreciably better than a free-hand method for ultrasound-guided needle insertion. 

Because of the improved needle visibility and reduced procedure times achieved through the use of this device, it can be expected that further clinical studies will soon substantiate these results in human patients.

Article by Geert-Jan van Geffen et al. on needle guidance device, Anaesthesia, June 2008 [advance online publication]

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