Evaluation of a New Needle Guidance System for Ultrasound: Results of a Prospective, Randomized, Blinded Study.

Background and Objectives: Accurate needle control during ultrasound (US)-guided nerve blocks may be an elusive goal for the anesthesiologist. Despite modifications to increase echogenicity, needle visibility still requires precise alignment within the transducer beam. In this study, we evaluated a magnetically guided ultrasound (MGU) system that produces a real-time, graphic display of the needle position and trajectory that is independent of the US beam. Methods: The MGU system was compared with echogenic needles and conventional ultrasound (CU) by anesthesiologists with and without prior experience performing US-guided nerve blocks. Participants were asked to perform tasks to quantify accuracy with respect to needle direction (directional accuracy) and needle tip position (positional accuracy). These evaluations were performed in a porcine tissue model. Results: Regarding directional accuracy, inexperienced subjects were able to contact a target capsule with a single needle pass during both in-plane (IP) and out-of-plane (OOP) approaches using the magnetic guidance system. By contrast, using CU, subjects required redirection 3.8 +/- 2.4 (P = 0.02), and 4.5 +/- 3.9 (P =0.04) times, respectively, for IP and OOP approaches. Experienced subjects contacted the target capsule with a single pass for both IP and OOP approaches when using the magnetic guidance system. With CU, experienced subjects were able to contact the target with a single pass using an IP approach but required redirection 3.4 +/- 2.8 (P = 0.046) times during OOP approaches. Positional accuracy was also superior for both inexperienced (P = 0.04) and experienced (P = 0.02) users during an OOP approach. Conclusions: In a tissue model, the MGU system improved control of needle trajectory and needle tip position for both inexperienced and experienced subjects. Copyright (C) 2016 by American Society of Regional Anesthesia and Pain Medicine.

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