Assessment of Ultrasound-Guided Regional Anesthesia

Publication Date: April 1, 2016
Last Updated: March 14, 2022

Recommendations

Evidence-Based Recommendations to Enhance Detection of Needle-to-Nerve Proximity

Needle Tip Presentation
  • Needle-probe alignment and needle tip identification improve with operator competency (level IIa).
  • Educational tools such as phantoms and simulation facilitate skill acquisition, needle-probe alignment, and needle tip detection (level IIa).
  • Transducer manipulation improves needle tip visualization (level IIb).
  • Needle manipulation to alter the angle of insonation can improve needle tip visibility (level III).
  • Needle manipulation to alter bevel orientation improves needle tip visibility (level IIb).
  • Larger needle gauge increases US beam reflectiveness and may facilitate needle tip detection (level III).
  • Echogenic needles improve needle tip visibility (level IIa).
  • Needle priming and pumping assist in needle and needle tip detection (level IIb).
  • Needle guides assist in needle tip visualization (level IIb).
  • Beam steering enhances needle tip visibility (level IIb).
  • Image compounding technology enhances the sonographic presentation of block needles (level IIa).
  • Needle recognition software facilitates identification of needle tip position (level IIb).
  • Vibrating devices and Doppler effect permit estimation of needle tip position (level III).
  • Coupling US with magnetic resonance imaging improves the accuracy of needle tip detection (level IIb).
  • Needle-integrated optical fiber hydrophone can facilitate needle tip identification (level III).
  • Photoacoustic tracking may facilitate needle and catheter detection (level III).
  • Three-dimensional US imaging facilitates needle tip visualization (level IIb).
  • Four-dimensional US imaging can facilitate needle tip tracking (level III).
  • High definition US imaging improves needle tip visibility (level IIb).
  • Robotic-assisted guidance can improve needle tip recognition (level III).
Needle Tip Interpretation
  • Operator competency enhances needle tip recognition (level IIa).
  • Tissue movement is a surrogate measure of needle tip position (level III).
  • Hydrolocation is useful to estimate needle tip position (level IIb).
  • Bubble injection can facilitate needle tip recognition (level III).
  • Needle tracking assists in interpreting needle trajectory and needle tip recognition (level III).
Nerve Presentation
  • Tissue harmonic imaging can enhance nerve visualization (level III).
  • Spatial compound imaging can improve nerve presentation (level III).
Nerve Interpretation
  • Nerve swelling is indicative of intraneural injection (level IIb).
  • Development of concentric hypoechoic halo in the targeted nerve is indicative of intraneural injection (level IIb).
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Overview

Title

Assessment of Ultrasound-Guided Regional Anesthesia

Authoring Organization