Comparison of in-plane and out-of-plane needle insertion with vs. without needle guidance
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First comparison of two methods of needle insertion: long axis (“in-plane”) versus short axis (“out-of-plane”) approach, each with and without a prototype needle guidance system (NGS).
Materials and methods
24 medical students without prior experience punctured an ultrasound phantom (transparent except for the decklayer) in four conditions, with the goal of achieving as many accurate punctures as possible within a fixed time.
Out-of-plane with NGS led to substantially more hits at first attempt than punctures without NGS (p < 0.001), as well as to a greater total number of hits (p = 0.004), and participants were faster to hit the target the first time (p = 0.009).
Thus, navigation increases accuracy as well as efficiency of ultrasound guided punctures on the phantom. It could prove advantageous in clinical applications for fine needle biopsies, musculoskeletal injections, vascular access, and in regional anesthesia.
KeywordsNeedle guidance Fine needle biopsy In-plane Out-of-plane Comparison of short and long axis Ultrasound
Compliance with ethical standards
The Company eZono AG Jena (Spitzweidenweg 30, D-07743 Jena, Germany) provided the ultrasound scanner with the prototype needle guidance system for the time the trial was running. No further funding was secured for this study.
Conflict of interest
eZono provided a prototype of the ultrasound machine for the time of the study and was otherwise not involved in study design, execution, and analysis. VCM has received a travel grant from the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery to present parts of this study on the 84th annual meeting 2013 in Nürnberg, Germany. GFV has received a research grant from the Interdisziplinäres Zentrum für Klinische Forschung (IZKF) of the Jena University Hospital, Jena, Germany.
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- 3.Karakitsos D, Labropoulos N, De Groot E, Patrianakos AP, Kouraklis G, Poularas J, Samonis G, Tsoutsos DA, Konstadoulakis MM, Karabinis A (2006) Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Crit Care 10(6):R162. doi: 10.1186/cc5101 CrossRefPubMedPubMedCentralGoogle Scholar
- 8.Wallach D, Toporek G, Weber S, Bale R, Widmann G (2013) Comparison of freehand-navigated and aiming device-navigated targeting of liver lesions. The international journal of medical robotics+computer assisted surgery MRCAS. doi: 10.1002/rcs.1505
- 10.Levine DM LM, Gadsden J (2014) Training with on-screen needle-probe alignment cues improves skill acquisition in novice trainees performing ultrasound-guided nerve blocks. Abstract Presented at the 39th Annual Regional Anesthesiology and Acute Pain Meeting, Chicago, IL, 3–6 April 2014Google Scholar