1
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Tanaka T, Imai R, Takeshima H. Split-based elevational localization of photoacoustic guidewire tip by 1D array probe using spatial impulse response. Phys Med Biol 2024; 69:065013. [PMID: 38344935 DOI: 10.1088/1361-6560/ad27fe] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/09/2024] [Indexed: 03/20/2024]
Abstract
Objective. Photoacoustic emitters on the tip of a therapeutic device have been intensively studied for echo-guided intervention purposes. In this study, a novel method for localizing the guidewire tip emitter in the elevation direction using a 1D array probe is proposed to resolve the issue of the tip potentially deviating from the ultrasound-imaged plane.Approach. Our method uses the 'interference split' that appears when the emitter is off-plane. Here, a point source from the emitter splits into two points in images. Based on the split, 'split-based elevation localization (SEL)' is introduced to estimate the absolute elevation position of the emitter. Additionally, 'Signed SEL' incorporates an asymmetric feature into the 1D probe to obtain the sign of the elevation localization. An attenuative coupler is attached to the half side of the probe to control the interference split. In SEL and Signed SEL, we propose a modeled split matching (MSM) algorithm to localize the tip position. MSM performs pattern matching of a measured split waveform with modeled split waveforms corresponding to all emitter positions in a region of interest. The modeled waveforms are precalculated using the spatial impulse response. The proposed method is numerically and experimentally validated.Main results. Numerical simulations for time-domain wave propagation clearly demonstrated the interference split phenomena. In the experimental validation with a vessel-mimicking phantom, the proposed methods successfully estimated the elevation positions,yb.SEL exhibited a root-mean-squared error (RMSE) of 2.0 mm for the range of 0 mm ≤yb≤ 30 mm, while Signed SEL estimated the absolute position with an RMSE of 2.4 mm and the sign with an accuracy of 80.8% for the range of -30 mm ≤yb≤ 30 mm.Significance.These results suggest that the proposed method could provide approximate tip positions and help sonographers track it by fanning the probe.
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Affiliation(s)
- Tomohiko Tanaka
- Innovative Technology Laboratory, FUJIFILM Healthcare Corporation, Tokyo, Japan
| | - Ryo Imai
- Research & Development Group, Hitachi, Ltd, Tokyo, Japan
| | - Hirozumi Takeshima
- Innovative Technology Laboratory, FUJIFILM Healthcare Corporation, Tokyo, Japan
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2
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Bidkar PU, Kannabiran N, Chatterjee P. Clinical applications of ultrasound in neurosurgery and neurocritical care: A narrative review. Med J Armed Forces India 2024; 80:16-28. [PMID: 38239602 PMCID: PMC10793236 DOI: 10.1016/j.mjafi.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/17/2023] [Indexed: 01/22/2024] Open
Abstract
Ultrasonography (USG) has become an invaluable tool in the assessment of neurocritical patients in the operating theaters and critical care units. Due to its easy availability, reliability, safety, and repeatability, neuro-intensivists and neuro-anesthesiologists utilize USG to make a diagnosis, assess prognosis, and decide upon treatment. In neurocritical care units, USG has myriad indications for use, both systemic and neurologic. The neurological indications include the assessment of stroke, vasospasm, traumatic brain injury, brain death, acute brain damage, optic nerve sheath diameter, and pupillary reflexes to name a few. The systemic indications range from assessment of cardio-pulmonary function and intravascular volume status to detection of deep venous thromboses, vocal cord assessment in intubated patients, placement of central venous catheters, and percutaneous tracheostomy. In this narrative review, we iterate the clinical applications of USG in neuroanesthesia and neurocritical care, which we penned after searching relevant databases in PubMed, Medline, Ovid, and Google Scholar by using terms such as ‘applications of transcranial Doppler’, ‘optic nerve sheath diameter’, ‘USG applications in the critical care unit’, and so on. Our search database includes several research papers, neurocritical care books, review articles, and scientific databases. This article reviews various applications of USG in neuroanesthesia, neurosurgery, and neurocritical care.
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Affiliation(s)
- Prasanna Udupi Bidkar
- Professor & Unit Head (Neuroanesthesiology), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | | | - Protiti Chatterjee
- Resident (Anesthesiology & Critical Care), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
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3
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Malamal G, Panicker MR. On the physics of ultrasound transmission for in-plane needle tracking in guided interventions. Biomed Phys Eng Express 2023; 9. [PMID: 36898145 DOI: 10.1088/2057-1976/acc338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/10/2023] [Indexed: 03/12/2023]
Abstract
Objective.In ultrasound (US) guided interventions, the accurate visualization and tracking of needles is a critical challenge, particularly during in-plane insertions. An inaccurate identification and localization of needles lead to severe inadvertent complications and increased procedure times. This is due to the inherent specular reflections from the needle with directivity depending on the angle of incidence of the US beam, and the needle inclination.Approach.Though several methods have been proposed for improved needle visualization, a detailed study emphasizing the physics of specular reflections resulting from the interaction of transmitted US beam with the needle remains to be explored. In this work, we discuss the properties of specular reflections from planar and spherical wave US transmissions respectively through multi-angle plane wave (PW) and synthetic transmit aperture (STA) techniques for in-plane needle insertion angles between 15°-50°.Main Results.The qualitative and quantitative results from simulations and experiments reveal that the spherical waves enable better visualization and characterization of needles than planar wavefronts. The needle visibility in PW transmissions is severely degraded by the receive aperture weighting during image reconstruction than STA due to greater deviation in reflection directivity. It is also observed that the spherical wave characteristics starts to alter to planar characteristics due to wave divergence at large needle insertion depths.Significance.The study highlights that synergistic transmit-receive imaging schemes addressing the physical properties of reflections from the transmit wavefronts are imperative for the precise imaging of needle interfaces and hence have strong potential in elevating the quality of outcomes from US guided interventional practices.
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Affiliation(s)
- Gayathri Malamal
- Center for Computational Imaging, Dept. of Electrical Engineering, Indian Institute of Technology Palakkad, India
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4
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Liao X, Li SH, El Akkawi MM, Fu XB, Liu HW, Huang YS. Surgical amputation for patients with diabetic foot ulcers: A Chinese expert panel consensus treatment guide. Front Surg 2022; 9:1003339. [PMID: 36425891 PMCID: PMC9679004 DOI: 10.3389/fsurg.2022.1003339] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/19/2022] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Diabetic foot disease is a serious complication of diabetes mellitus. Patients with diabetes mellitus have a 25% lifetime risk for developing a foot ulcer, and between 14% and 24% of patients require a major or minor lower limb amputation due to severe gangrene. However, decisions concerning whether to amputate or whether to perform a major or minor lower limb amputation, and how best to determine the amputation plane remain unclear. METHODS To consolidate the current literature with expert opinion to make recommendations that will guide surgical amputation for patients with diabetic foot ulcers. A total of 23 experts experienced in surgical treatment of patients with diabetic foot ulcers formed an expert consensus panel, and presented the relevant evidence, discussed clinical experiences, and derived consensus statements on surgical amputation for patients with diabetic foot ulcers. Each statement was discussed and revised until a unanimous consensus was achieved. RESULTS A total of 16 recommendations for surgical amputation for patients with diabetic foot ulcers were formulated. The experts believe that determination of the amputation plane should be comprehensively evaluated according to a patient's general health status, the degree of injury, and the severity of lower limb vasculopathy. The Wagner grading system and the severity of diabetic lower extremity artery disease are important criteria when determining the degree of amputation. The severity of both diabetic foot infection and systemic underlying diseases are important factors when considering appropriate treatment. Moreover, consideration should also be given to a patient's socioeconomic status. Given the complexities of treating the diabetic foot, relevant issues in which consensus could not be reached will be discussed and revised in future. CONCLUSION This expert consensus could be used to guide doctors in clinical practice, and help patients with diabetic foot ulcers gain access to appropriate amputation treatment.
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Affiliation(s)
- Xuan Liao
- Department of Plastic Surgery of the First Affiliated Hospital of Jinan University, Institute of New Technology of Plastic Surgery of Jinan University, Key Laboratory of Regenerative Medicine of Ministry of Education, Guangzhou, China
| | - Sheng-Hong Li
- Department of Plastic Surgery of the First Affiliated Hospital of Jinan University, Institute of New Technology of Plastic Surgery of Jinan University, Key Laboratory of Regenerative Medicine of Ministry of Education, Guangzhou, China
| | - Mariya Mohamad El Akkawi
- Department of Plastic Surgery of the First Affiliated Hospital of Jinan University, Institute of New Technology of Plastic Surgery of Jinan University, Key Laboratory of Regenerative Medicine of Ministry of Education, Guangzhou, China
| | - Xiao-bing Fu
- Wound Healing and Cell Biology Laboratory, Institute for Basic Research, Trauma Center of Postgraduate Medical College, General Hospital of PLA, Beijing, China
| | - Hong-wei Liu
- Department of Plastic Surgery of the First Affiliated Hospital of Jinan University, Institute of New Technology of Plastic Surgery of Jinan University, Key Laboratory of Regenerative Medicine of Ministry of Education, Guangzhou, China
| | - Yue-sheng Huang
- Department of Wound Repair; Institute of Wound Repair and Regeneration Medicine, Southern University of Science and Technology Hospital, Southern University of Science and Technology School of Medicine, Shenzhen, China
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5
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Shi M, Bodian S, West SJ, Sathasivam S, Gordon RJ, Collier P, Vercauteren T, Desjardins AE, Noimark S, Xia W. Enhanced Photoacoustic Visualisation of Clinical Needles by Combining Interstitial and Extracorporeal Illumination of Elastomeric Nanocomposite Coatings. SENSORS (BASEL, SWITZERLAND) 2022; 22:6417. [PMID: 36080876 PMCID: PMC9460224 DOI: 10.3390/s22176417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Ultrasound (US) image guidance is widely used for minimally invasive procedures, but the invasive medical devices (such as metallic needles), especially their tips, can be poorly visualised in US images, leading to significant complications. Photoacoustic (PA) imaging is promising for visualising invasive devices and peripheral tissue targets. Light-emitting diodes (LEDs) acting as PA excitation sources facilitate the clinical translation of PA imaging, but the image quality is degraded due to the low pulse energy leading to insufficient contrast with needles at deep locations. In this paper, photoacoustic visualisation of clinical needles was enhanced by elastomeric nanocomposite coatings with superficial and interstitial illumination. Candle soot nanoparticle-polydimethylsiloxane (CSNP-PDMS) composites with high optical absorption and large thermal expansion coefficients were applied onto the needle exterior and the end-face of an optical fibre placed in the needle lumen. The excitation light was delivered at the surface by LED arrays and through the embedded optical fibre by a pulsed diode laser to improve the visibility of the needle tip. The performance was validated using an ex-vivo tissue model. An LED-based PA/US imaging system was used for imaging the needle out-of-plane and in-plane insertions over approach angles of 20 deg to 55 deg. The CSNP-PDMS composite conferred substantial visual enhancements on both the needle shaft and the tip, with an average of 1.7- and 1.6-fold improvements in signal-to-noise ratios (SNRs), respectively. With the extended light field involving extracorporeal and interstitial illumination and the highly absorbing coatings, enhanced visualisation of the needle shaft and needle tip was achieved with PA imaging, which could be helpful in current US-guided minimally invasive surgeries.
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Affiliation(s)
- Mengjie Shi
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Semyon Bodian
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Simeon J. West
- Department of Anaesthesia, University College Hospital, London NW1 2BU, UK
| | - Sanjayan Sathasivam
- Department of Chemistry, University College London, London WC1H 0AJ, UK or
- School of Engineering, London South Bank University, London SE1 0AA, UK
| | | | - Paul Collier
- Johnson Matthey Technology Centre, Reading RG4 9NH, UK
| | - Tom Vercauteren
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Adrien E. Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Sacha Noimark
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK
| | - Wenfeng Xia
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
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6
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Formalin-free soft embalming of human cadavers using N-vinyl-2-pyrrolidone: perspectives for cadaver surgical training and medical device development. Anat Sci Int 2022; 97:273-282. [PMID: 35460067 DOI: 10.1007/s12565-022-00664-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/30/2022] [Indexed: 02/05/2023]
Abstract
The traditional apprenticeship approach to surgical skill education for young surgeons has drastically changed to more systematic surgical training using cadavers. Cadavers fixed with formalin are not suitable for surgical training because of their associated health hazards and overhardening. Recently, we established a formalin-free soft preservation method for human cadavers using N-vinyl-2-pyrrolidone. Since 2012, 61 cadavers have been embalmed with pyrrolidone in our institution. Tissues of pyrrolidone-embalmed cadavers are soft and pliable, and their bodies can be preserved for as long as 37 months without any signs of corruption. In this review, we introduce our recent attempts to apply pyrrolidone-embalmed cadavers in surgical and medical procedure training, including endotracheal intubation, motion physiology of the vocal folds, laparoscopic surgery, endoscopic skull base surgery, and development of novel medical devices. Future research perspectives on pyrrolidone embalming are discussed.
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7
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Watanabe K, Tokumine J, Lefor AK, Nakazawa H, Yamamoto K, Karasawa H, Nagase M, Yorozu T. Photoacoustic needle improves needle tip visibility during deep peripheral nerve block. Sci Rep 2021; 11:8432. [PMID: 33875687 PMCID: PMC8055898 DOI: 10.1038/s41598-021-87777-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/05/2021] [Indexed: 02/08/2023] Open
Abstract
We developed a novel technology using the photoacoustic effect that improve needle tip visibility. We evaluated whether this technology improves needle tip visibility when performing a deep peripheral nerve block in a cadaver model. A photoacoustic needle was developed using a conventional echogenic needle with an intraluminal optical fiber. A pulsed laser sends light from a source through the fiber, which is converted to ultrasound at the needle tip using the photoacoustic effect. A nerve block expert performed deep nerve blocks using the photoacoustic needle and the ultrasound views recorded, with or without photoacoustic ultrasound at the needle tip. Needle tip visibility was evaluated by questionnaire (Likert scale 1: very poor, 5: very good) completed by anesthesiologists evaluating recorded images. The score was presented as median [first quartile, third quartile]. Statistical analysis was performed using the Wilcoxon matched-pairs signed rank test. The scores of needle tip visibility with photoacoustic ultrasound from the needle tip (4.3 [4.0, 4.5]) was significantly higher than that without photoacoustic ultrasound (3.5 [3.2, 3.8]) (p < 0.01). Ultrasound emitted at the needle tip using the photoacoustic effect improves needle tip visibility during deep peripheral nerve blocks. Clinical trial number University Hospital Medical Information Network Center Clinical Trials Registration System (UMIN000036974).
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Affiliation(s)
- Kunitaro Watanabe
- Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Joho Tokumine
- Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan.
| | - Alan Kawarai Lefor
- Department of Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Harumasa Nakazawa
- Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Katsuya Yamamoto
- Medical System Research & Development Center, FUJIFILM Corporation, Kanagawa, Japan
| | - Hiroyuki Karasawa
- Medical System Research & Development Center, FUJIFILM Corporation, Kanagawa, Japan
| | - Miki Nagase
- Department of Anatomy, Kyorin University Faculty of Medicine, Mitaka, Tokyo, Japan
| | - Tomoko Yorozu
- Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
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8
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Cavaliere F, Allegri M, Apan A, Calderini E, Carassiti M, Cohen E, Coluzzi F, Di Marco P, Langeron O, Rossi M, Spieth P, Turnbull D. A year in review in Minerva Anestesiologica 2019. Anesthesia, analgesia, and perioperative medicine. Minerva Anestesiol 2021; 86:225-239. [PMID: 32118384 DOI: 10.23736/s0375-9393.20.14424-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Franco Cavaliere
- Department of Cardiovascular and Thoracic Sciences, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, Rome, Italy -
| | - Massimo Allegri
- Unità Operativa Terapia del Dolore della Colonna e dello Sportivo, Policlinic of Monza, Monza, Italy.,Italian Pain Group, Milan, Italy
| | - Alparslan Apan
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Giresun, Giresun, Turkey
| | - Edoardo Calderini
- Unit of Women-Child Anesthesia and Intensive Care, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy
| | - Massimiliano Carassiti
- Unit of Anesthesia, Intensive Care and Pain Management, Campus Bio-Medico University Hospital, Rome, Italy
| | - Edmond Cohen
- Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Flaminia Coluzzi
- Unit of Anesthesia, Department of Medical and Surgical Sciences and Biotechnologies, Intensive Care and Pain Medicine, Sapienza University, Rome, Italy
| | - Pierangelo Di Marco
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic, and Geriatric Sciences, Sapienza University, Rome, Italy
| | - Olivier Langeron
- Department of Anesthesia and Intensive Care, Henri Mondor University Hospital, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Marco Rossi
- Institute of Anesthesia and Intensive Care, Sacred Heart Catholic University, Rome, Italy
| | - Peter Spieth
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Dresden, Dresden, Germany
| | - David Turnbull
- Department of Anaesthetics and Neuro Critical Care, Royal Hallamshire Hospital, Sheffield, UK
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9
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Markham SK, Mani A, Bauer J, Silien C, Tofail SAM. Surface Texturing Design to Enhance Echogenicity of Biopsy Needles During Endoscopic Ultrasound Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2453-2463. [PMID: 32546410 DOI: 10.1016/j.ultrasmedbio.2020.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Abstract
The ultrasonic visibility of a biopsy needle tip is of critical importance for the success and safety of endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) procedures. The aim of this study was to design a surface topology, in silico, which enhances the ultrasound visibility of a needle by controlling and optimising the direction of the reflections. Topographic enhancements to needle surface redirect scattered waves back to the transducer to enhance needle visibility, or "echogenicity." Echogenicity enhancement is demonstrated across insonification angles of 30°-90° on full-length scale of biopsy needles used in practice. By applying a textured surface across the full length of the needle surface, the signal being returned to the transducer can be tripled from that of a constant periodic dimple echogenic surface and seven times that of an untextured flat surface. Our first principles model provides a quantitative insight to echogenicity and its enhancement. The model allows in silico design of needles for USG-FNA and biopsy with enhanced echogenicity and consequent improvement in visibility, including but not limited to needle tip area.
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Affiliation(s)
- Sarah K Markham
- Department of Physics and Bernal Institute, University of Limerick, Ireland
| | - Aladin Mani
- Department of Physics and Bernal Institute, University of Limerick, Ireland
| | - Joanna Bauer
- Wroclaw University of Science and Technology, Department of Bioengineering, Wroclaw, Poland
| | - Christophe Silien
- Department of Physics and Bernal Institute, University of Limerick, Ireland
| | - Syed A M Tofail
- Department of Physics and Bernal Institute, University of Limerick, Ireland.
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10
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Wang A, Lv G, Cheng X, Ma X, Wang W, Gui J, Hu J, Lu M, Chu G, Chen J, Zhang H, Jiang Y, Chen Y, Yang W, Jiang L, Geng H, Zheng R, Li Y, Feng W, Johnson B, Wang W, Zhu D, Hu Y. Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition). BURNS & TRAUMA 2020; 8:tkaa017. [PMID: 32685563 PMCID: PMC7336185 DOI: 10.1093/burnst/tkaa017] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/21/2020] [Indexed: 02/07/2023]
Abstract
In recent years, as living standards have continued to improve, the number of diabetes patients in China, along with the incidence of complications associated with the disease, has been increasing. Among these complications, diabetic foot disease is one of the main causes of disability and death in diabetic patients. Due to the differences in economy, culture, religion and level of medical care available across different regions, preventive and treatment methods and curative results for diabetic foot vary greatly. In multidisciplinary models built around diabetic foot, the timely assessment and diagnosis of wounds and appropriate methods of prevention and treatment with internal and external surgery are key to clinical practice for this pathology. In 2019, under the leadership of the Jiangsu Medical Association and Chinese Diabetes Society, the writing group for the Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition) was established with the participation of scholars from the specialist areas of endocrinology, burn injury, vascular surgery, orthopedics, foot and ankle surgery and cardiology. Drawing lessons from diabetic foot guidelines from other countries, this guide analyses clinical practices for diabetic foot, queries the theoretical basis and grades and gives recommendations based on the characteristics of the pathology in China. This paper begins with assessments and diagnoses of diabetic foot, then describes treatments for diabetic foot in detail, and ends with protections for high-risk feet and the prevention of ulcers. This manuscript covers the disciplines of internal medicine, surgical, nursing and rehabilitation and describes a total of 50 recommendations that we hope will provide procedures and protocols for clinicians dealing with diabetic foot. Registry number: IPGRP-2020cn124
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Affiliation(s)
- Aiping Wang
- Diabetic Foot Centre, The Air Force Hospital From Eastern Theater of PLA, Nanjing, 210002, China
| | - Guozhong Lv
- Department of Burn and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, 214062, China
| | - Xingbo Cheng
- Department of endocrinology, the First Affiliated Hospital of Suzhou University, Suzhou, 215006, China
| | - Xianghua Ma
- Department of endocrinology, Jiangsu Province Hospital, Nanjing, 210029, China.,Department of endocrinology, Xuzhou Central Hospital, Xuzhou, 221009,China
| | - Wei Wang
- Vascular Surgery, Gulou Hospital, Nanjing, 210008, China
| | - Jianchao Gui
- Department of orthopedics, Nanjing First Hospital, Nanjing, 210006, China
| | - Ji Hu
- Department of endocrinology, The Second Affiliated Hospital of Suzhou University, Suzhou, 215004, China
| | - Meng Lu
- Diabetic Foot Centre, The Air Force Hospital From Eastern Theater of PLA, Nanjing, 210002, China
| | - Guoping Chu
- Department of Burn and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, 214062, China
| | - Jin'an Chen
- Diabetic Foot Centre, The Air Force Hospital From Eastern Theater of PLA, Nanjing, 210002, China
| | - Hao Zhang
- Department of endocrinology, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Yiqiu Jiang
- Department of orthopedics, Nanjing First Hospital, Nanjing, 210006, China
| | - Yuedong Chen
- Diabetic Foot Centre, The Air Force Hospital From Eastern Theater of PLA, Nanjing, 210002, China
| | - Wengbo Yang
- Department of orthopedics, Nanjing First Hospital, Nanjing, 210006, China
| | - Lin Jiang
- Department of endocrinology, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Houfa Geng
- Department of endocrinology, Xuzhou Central Hospital, Xuzhou, 221009,China
| | - Rendong Zheng
- Department of endocrinology, Jiangsu Province Hospital on Traditional of Chinese and Western Medicine, 210028, China
| | - Yihui Li
- Diabetic Foot Centre, The Air Force Hospital From Eastern Theater of PLA, Nanjing, 210002, China
| | - Wei Feng
- Operating department, Jiangsu Medical Association, Nanjing, 210008, China
| | - Boey Johnson
- Diabetic Foot Centre, The National University Hospital, 119077, Singapore
| | - Wenjuan Wang
- Department of Chronic Non-Communicable Diseases, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Dalong Zhu
- Vascular Surgery, Gulou Hospital, Nanjing, 210008, China
| | - Yin Hu
- Operating department, Jiangsu Medical Association, Nanjing, 210008, China
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11
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Sonographic visibility of cannulas using convex ultrasound transducers. BIOMED ENG-BIOMED TE 2019; 64:691-698. [DOI: 10.1515/bmt-2018-0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 01/30/2019] [Indexed: 11/15/2022]
Abstract
Abstract
The key for safe ultrasound (US)-guided punctures is a good visibility of the cannula. When using convex transducers for deep punctures, the incident angle between US beam and cannula varies along the cannula leading to a complex visibility pattern. Here, we present a method to systematically investigate the visibility throughout the US image. For this, different objective criteria were defined and applied to measurement series with varying puncture angles and depths of the cannula. It is shown that the visibility not only depends on the puncture angle but also on the location of the cannula in the US image when using convex transducers. In some image regions, an unexpected good visibility was observed even for steep puncture angles. The systematic evaluation of the cannula visibility is of fundamental interest to sensitise physicians to the handling of convex transducers and to evaluate new techniques for further improvement.
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12
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O'Donnell BD, Loughnane F. Novel nerve imaging and regional anesthesia, bio-impedance and the future. Best Pract Res Clin Anaesthesiol 2019; 33:23-35. [DOI: 10.1016/j.bpa.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/20/2019] [Accepted: 02/22/2019] [Indexed: 11/24/2022]
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13
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Soliman LM, Farag E. The search for the holy grail for regional anesthesia continues. Minerva Anestesiol 2018; 85:7-9. [PMID: 30328338 DOI: 10.23736/s0375-9393.18.13263-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Loran M Soliman
- Department of General Anesthesia, Anesthesia Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ehab Farag
- Department of General Anesthesia, Anesthesia Institute, Cleveland Clinic, Cleveland, OH, USA - .,Outcomes Research, Anesthesia Institute, Cleveland Clinic, Cleveland, OH, USA
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14
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Abad-Gurumeta A, Casans-Francés R, Roca-Castillo E, Ripollés-Melchor J, Calvo-Vecino JM. Effect of ultrasound image enhancement software on the quality of vision of regional anesthesia needles. Minerva Anestesiol 2018; 85:53-59. [PMID: 30207134 DOI: 10.23736/s0375-9393.18.12900-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Our objective was to evaluate and compare the visualization of different types of needles with or without ultrasound image enhancement software, both in biological tissues and artificial models. METHODS This is an observational study on fresh porcine tissue and gelatin models. Six types of plexus needles were studied. The same anesthesiologist performed in-plane punctures with each needle at 30°, 40° and 50° in both 2D mode and using software-based enhanced mode without changing position, generating 72 images. The images were evaluated blind by 38 anesthesiologists with at least two years of experience in ultrasound and rated from 0 to 10. A univariate and multivariate analysis was performed to identify differences between the images according to needle, mode, angle and experimental model. We described the results as mean (standard deviation). RESULTS The Echoplex needle, 8.31 (1.94), was significantly better than the Sonoplex needle, 7.53 (2.16), P=0.0003, and both were significantly better than the other needles (P<0.0001). Significant differences were also found in favor of the gelatin model, 7.26 (2.48) vs. 6.24 (3.67), P<0.0001, and with ultrasound image enhancement software, 8.59 (1.55) vs. 4.91 (3.31), P<0.0001. These differences were confirmed by multivariate analysis. CONCLUSIONS Although there are differences between the different types of needles used with ultrasound visualization strategies, ultrasound image enhancement software provides good visualization, regardless of the model chosen.
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Affiliation(s)
- Alfredo Abad-Gurumeta
- Department of Anesthesiology and Critical Care, Infanta Leonor University Hospital, Madrid, Spain
| | - Rubén Casans-Francés
- Department of Anesthesiology and Pain Therapy, Hospital Mutua de Accidentes de Zaragoza, Zaragoza, Spain -
| | | | - Javier Ripollés-Melchor
- Department of Anesthesiology and Critical Care, Infanta Leonor University Hospital, Madrid, Spain
| | - José M Calvo-Vecino
- Department of Anesthesiology and Pain Therapy, University Assistance Complex of Salamanca, Salamanca, Spain
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15
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Park JW, Cheon MW, Lee MH. Phantom Study of a New Laser-Etched Needle for Improving Visibility During Ultrasonography-Guided Lumbar Medial Branch Access With Novices. Ann Rehabil Med 2016; 40:575-82. [PMID: 27606263 PMCID: PMC5012968 DOI: 10.5535/arm.2016.40.4.575] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 09/30/2015] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the visibility and procedural parameters between a standard spinal needle and a new laser-etched needle (LEN) in real-time ultrasonography guided lumbar medial branch access in a phantom of the lumbosacral spine. METHODS We conducted a prospective single-blinded observational study at a rehabilitation medicine center. A new model of LEN was manufactured with a standard 22-gauge spinal needle and a laser etching machine. Thirty-two inexperienced polyclinic medical students performed ultrasonography-guided lumbar medial branch access using both a standard spinal needle and a LEN with scanning protocol. The outcomes included needle visibility score, needle elapsed time, first-pass success rate, and number of needle sticks. RESULTS The LEN received significantly better visibility scores and shorter needle elapsed time compared to the standard spinal needle. First-pass success rate and the number of needle sticks were not significantly different between needles. CONCLUSION A new LEN is expected to offer better visibility and enable inexperienced users to perform an ultrasonography-guided lumbar medial branch block more quickly. However, further study of variables may be necessary for clinical application.
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Affiliation(s)
| | - Min Woo Cheon
- Department of Hospital Biomedical Engineering, Dongshin University, Gwangju, Korea
| | - Min Hong Lee
- Department of Rehabilitation Medicine, Chosun University Hospital, Gwangju, Korea
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16
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The Requisites of Needle-to-Nerve Proximity for Ultrasound-Guided Regional Anesthesia. Reg Anesth Pain Med 2016; 41:221-8. [DOI: 10.1097/aap.0000000000000201] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Ochoa-Pérez L, Cardozo-Ocampo A. Aplicaciones de la ultrasonografía en el sistema nervioso central para neuroanestesia y cuidado neurocrítico. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1016/j.rca.2015.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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18
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Ochoa-Pérez L, Cardozo-Ocampo A. Ultrasound applications in the central nervous system for neuroanaesthesia and neurocritical care. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1016/j.rcae.2015.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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19
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Elsharkawy H, Maheshwari A, Farag E, Mariano ER, Rosenquist RW. Development of technologies for placement of perineural catheters. J Anesth 2015; 30:138-47. [DOI: 10.1007/s00540-015-2076-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 08/26/2015] [Indexed: 10/23/2022]
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20
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Identification of location of nerve catheters using pumping maneuver and M-Mode—a novel technique. J Clin Anesth 2015; 27:325-30. [DOI: 10.1016/j.jclinane.2015.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 11/21/2014] [Accepted: 03/02/2015] [Indexed: 11/20/2022]
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21
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Cho S, Kim YJ, Baik HJ, Kim JH, Woo JH. Comparison of ultrasound-guided axillary brachial plexus block techniques: perineural injection versus single or double perivascular infiltration. Yonsei Med J 2015; 56:838-44. [PMID: 25837194 PMCID: PMC4397458 DOI: 10.3349/ymj.2015.56.3.838] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
PURPOSE We compared three methods of ultrasound-guided axillary brachial plexus block, which were single, and double perivascular (PV) infiltration techniques, and a perineural (PN) injection technique. MATERIALS AND METHODS 78 patients of American Society of Anesthesiologists physical status I-II undergoing surgery of the forearm, wrist, or hand were randomly allocated to three groups. 2% lidocaine with epinephrine 5 μg/mL was used. The PN group (n=26) received injections at the median, ulnar, and radial nerve with 8 mL for each nerve. The PV1 group (n=26) received a single injection of 24 mL at 12-o'clock position of the axillary artery. The PV2 group (n=26) received two injections of 12 mL each at 12-o'clock and 6-o'clock position. For all groups, musculocutaneous nerve was blocked separately. RESULTS The PN group (391.2±171.6 sec) had the longest anesthetic procedure duration than PV1 (192.8±59.0 sec) and PV2 (211.4±58.6 sec). There were no differences in onset time. The average induction time was longer in PN group (673.4±149.6 sec) than PV1 (557.6±194.9 sec) and PV2 (561.5±129.8 sec). There were no differences in the success rate (89.7% vs. 86.2% vs. 89.7%). CONCLUSION The PV injection technique consisting of a single injection in 12-o'clock position above the axillary artery in addition to a musculocutaneous nerve block is equally effective and less time consuming than the PN technique. Therefore, the PV technique is an alternative method that may be used in busy clinics or for difficult cases.
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Affiliation(s)
- Sooyoung Cho
- Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Youn Jin Kim
- Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
| | - Hee Jung Baik
- Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Jong Hak Kim
- Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Jae Hee Woo
- Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
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22
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Ultrasound applications in the central nervous system for neuroanaesthesia and neurocritical care☆. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1097/01819236-201543040-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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23
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Gadsden J, Latmore M, Levine DM. Evaluation of the eZono 4000 with eZGuide for ultrasound-guided procedures. Expert Rev Med Devices 2014; 12:251-61. [PMID: 25543816 DOI: 10.1586/17434440.2015.995095] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ultrasound-guided procedures are increasingly common in a variety of acute care settings, such as the operating room, critical care unit and emergency room. However, accurate judgment of needle tip position using traditional ultrasound technology is frequently difficult, and serious injury can result from inadvertently advancing beyond or through the target. Needle navigation is a recent innovation that allows the clinician to visualize the needle position and trajectory in real time as it approaches the target. A novel ultrasound machine has recently been introduced that is portable and designed for procedural guidance. The eZono 4000™ features an innovative needle navigation technology that is simple to use and permits the use of a wide range of commercially available needles, avoiding the inconvenience and cost of proprietary equipment. This article discusses this new ultrasound machine in the context of other currently available ultrasound machines featuring needle navigation.
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Affiliation(s)
- Jeff Gadsden
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
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24
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Fuzier R, Casalprim J, Bataille B, Harper I, Magues JP. The echogenicity of nerve blockade needles. Anaesthesia 2014; 70:462-6. [DOI: 10.1111/anae.12977] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2014] [Indexed: 11/28/2022]
Affiliation(s)
- R. Fuzier
- Department of Anaesthesiology; Institut Claudius Regaud; IUCT-O; Toulouse France
- Pharmacoepidemiology Research Unit; INSERM 1027; University of Toulouse; Toulouse France
| | - J. Casalprim
- Department of Anaesthesiology; CHU Purpan; Toulouse France
| | - B. Bataille
- Department of Anaesthesiology and Critical Care; CH Hotel Dieu; Narbonne France
| | - I. Harper
- Department of Anaesthesiology; Wansbeck General Hospital; Ashington UK
| | - J. P. Magues
- Department of Anaesthesiology; CHU Purpan; Toulouse France
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25
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Munirama S, Joy J, Columb M, Habershaw R, Eisma R, Corner G, Cochran S, McLeod G. A randomised, single-blind technical study comparing the ultrasonic visibility of smooth-surfaced and textured needles in a soft embalmed cadaver model. Anaesthesia 2014; 70:537-42. [DOI: 10.1111/anae.12925] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2014] [Indexed: 11/28/2022]
Affiliation(s)
- S. Munirama
- Institute of Academic Anaesthesia; University of Dundee; Dundee UK
| | - J. Joy
- Institute for Medical Science and Technology; University of Dundee; Dundee UK
| | - M. Columb
- Departments of Anaesthesia & Intensive Care Medicine; Wythenshawe Hospital; Manchester UK
| | - R. Habershaw
- Institute for Medical Science and Technology; University of Dundee; Dundee UK
| | - R. Eisma
- Centre for Anatomy and Human Identification; University of Dundee; Dundee UK
| | | | - S. Cochran
- Institute for Medical Science and Technology; University of Dundee; Dundee UK
| | - G. McLeod
- Institute of Academic Anaesthesia; University of Dundee; Dundee UK
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Danninger T, Opperer M, Memtsoudis SG. Perioperative pain control after total knee arthroplasty: An evidence based review of the role of peripheral nerve blocks. World J Orthop 2014; 5:225-232. [PMID: 25035824 PMCID: PMC4095014 DOI: 10.5312/wjo.v5.i3.225] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 04/07/2014] [Accepted: 05/14/2014] [Indexed: 02/06/2023] Open
Abstract
Over the last decades, the number of total knee arthroplasty procedures performed in the United States has been increasing dramatically. This very successful intervention, however, is associated with significant postoperative pain, and adequate postoperative analgesia is mandatory in order to allow for successful rehabilitation and recovery. The use of regional anesthesia and peripheral nerve blocks has facilitated and improved this goal. Many different approaches and techniques for peripheral nerve blockades, either landmark or, more recently, ultrasound guided have been described over the last decades. This includes but is not restricted to techniques discussed in this review. The introduction of ultrasound has improved many approaches to peripheral nerves either in success rate and/or time to block. Moreover, ultrasound has enhanced the safety of peripheral nerve blocks due to immediate needle visualization and as consequence needle guidance during the block. In contrast to patient controlled analgesia using opioids, patients with a regional anesthetic technique suffer from fewer adverse events and show higher patient satisfaction; this is important as hospital rankings and advertisement have become more common worldwide and many patients use these factors in order to choose a certain institution for a specific procedure. This review provides a short overview of currently used regional anesthetic and analgesic techniques focusing on related implications, considerations and outcomes.
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27
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Reusz G, Sarkany P, Gal J, Csomos A. Needle-related ultrasound artifacts and their importance in anaesthetic practice. Br J Anaesth 2014; 112:794-802. [DOI: 10.1093/bja/aet585] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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28
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Mariano ER, Yun RDH, Kim TE, Carvalho B. Application of echogenic technology for catheters used in ultrasound-guided continuous peripheral nerve blocks. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:905-911. [PMID: 24764346 DOI: 10.7863/ultra.33.5.905] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Limited data exist regarding the echogenicity of perineural catheters, but visualization is crucial to ensure accurate placement and efficacy of the subsequent local anesthetic infusion. The objective of this study was to determine the comparative echogenicity of various regional anesthesia catheters. In an in vitro porcine-bovine model, we compared the echogenic qualities of 3 commercially available regional anesthesia catheters and 1 catheter under development to optimize echogenicity. Outcomes included visual echogenicity ranking, image quality, and scanning time, as assessed by 2 blinded investigators. The experimental catheter was found to be more echogenic than 2 of the 3 comparators.
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Affiliation(s)
- Edward R Mariano
- MAS, Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, 3801 Miranda Ave, 112A, Palo Alto, CA 94304 USA.
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29
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Compound imaging technology and echogenic needle design: effects on needle visibility and tissue imaging. Reg Anesth Pain Med 2014; 38:452-5. [PMID: 23759709 DOI: 10.1097/aap.0b013e31829730d5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Needle visualization in ultrasound-guided regional anesthesia can be improved by using needles of echogenic design with higher rate of reflection of ultrasound waves. Imaging solutions such as compound imaging might further improve imaging of both needle and tissue; these effects have not yet been studied. We hypothesized that compound imaging would significantly improve needle visibility, regardless of the insertion angle or needle type used. The effects of compound imaging on needle artifacts and tissue imaging were also investigated. METHODS A total of 200 video clips of in-plane needle insertions were obtained in embalmed cadavers with a conventional needle and an echogenic needle at 5 different insertion angles, with both conventional B-mode ultrasound imaging and compound imaging technology. Visibility of the needle shaft and needle tip as well as the needle artifact rate were assessed by a blinded investigator on a 4-point ordinal scale. The effects on tissue image quality and speckle artifacts were also assessed. Stepwise linear regression was performed to differentiate effects on needle visibility scores. RESULTS Imaging of the needle shaft and tip was significantly enhanced when compound imaging technology was used (P < 0.0001). Use of echogenically designed needles or shallow needle insertion angles improved visibility of both shaft and tip (both P < 0.0001). With compound imaging, there are fewer needle artifacts, and tissue imaging quality and speckle artifact rate are significantly improved. CONCLUSIONS Compound imaging technology enhances needle imaging with both echogenic and conventional needles. Tissue imaging and speckle artifacts are also optimized. Echogenic needle design results in better needle visibility scores in both B-mode and compound imaging.
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30
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Kilicaslan A, Topal A, Tavlan A, Erol A, Otelcioglu S. Differences in tip visibility and nerve block parameters between two echogenic needles during a simulation study with inexperienced anesthesia trainees. J Anesth 2013; 28:460-2. [DOI: 10.1007/s00540-013-1720-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
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31
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Nguyen V, Menhadji A, Chu R, Cho J, Osann K, Bucur P, Patel P, Okhunov Z, Lusch A, McDougall E, Landman J. In Vitro Randomized Comparison of a Standard and Novel Echogenic Needle for Ultrasonography-Guided Renal Targeting. J Endourol 2013; 27:1277-81. [DOI: 10.1089/end.2013.0292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Vien Nguyen
- Department of Urology, University of California, Irvine, Orange, California
| | - Ashleigh Menhadji
- Department of Urology, University of California, Irvine, Orange, California
| | - Ringo Chu
- Department of Urology, University of California, Irvine, Orange, California
| | - Jane Cho
- Department of Urology, University of California, Irvine, Orange, California
| | - Kathryn Osann
- Department of Urology, University of California, Irvine, Orange, California
| | - Philip Bucur
- Department of Urology, University of California, Irvine, Orange, California
| | - Puja Patel
- Department of Urology, University of California, Irvine, Orange, California
| | - Zhamshid Okhunov
- Department of Urology, University of California, Irvine, Orange, California
| | - Achim Lusch
- Department of Urology, University of California, Irvine, Orange, California
| | - Elspeth McDougall
- Department of Urology, University of California, Irvine, Orange, California
| | - Jaime Landman
- Department of Urology, University of California, Irvine, Orange, California
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Brahmbhatt A, Barrington MJ. Quality Assurance in Regional Anesthesia: Current Status and Future Directions. CURRENT ANESTHESIOLOGY REPORTS 2013. [DOI: 10.1007/s40140-013-0032-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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33
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DUGER C, ISBIR AC, KAYGUSUZ K, KOL IOZDEMIR, GURSOY S, OZTURK H, MIMAROĞLU C. The importance of needle echogenity in ultrasound guided axillary brachial plexus block: a randomized controlled clinical study. Int J Med Sci 2013; 10:1108-12. [PMID: 23869186 PMCID: PMC3714386 DOI: 10.7150/ijms.6598] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 06/18/2013] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE In this study we aimed to compare the echogenic needles and the nerve stimulation addition to non-echogenic needles in ultrasound guided axillary brachial plexus block for upper extremity surgery. METHODS 90 patients were enrolled to the study. The patients were allocated into three groups randomly: Group E (n=30): ultrasound guided axillary block using echogenic needle, Group N (n=30): ultrasound guided axillary block using non-echogenic needle, Group NS (n=30): ultrasound guided axillary block using non-echogenic needle with nerve stimulator assistance. Duration of block procedure, mean arterial pressure, heart rate, pulse-oximetry, onset time of sensory and motor block, duration of sensory and motor block, time to first analgesic use, total need for analgesics, postoperative pain scores, patient and surgeon satisfaction scores were recorded. RESULTS Duration of block procedure values were lower in group E and NS, sensory and motor block durations, were significantly lower in group N. Sensorial and motor block onset time values were found lower in group NS but higher in group N. Patient and surgeon satisfaction scores were found lower in group N. CONCLUSION We conclude that ultrasound guided axillary block may be performed successfully using both echogenic needles and nerve stimulation assisted non-echogenic needles.
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Affiliation(s)
- Cevdet DUGER
- 1. Department of Anesthesiology, Cumhuriyet University, School of Medicine, Sivas, TURKEY
| | - Ahmet Cemil ISBIR
- 1. Department of Anesthesiology, Cumhuriyet University, School of Medicine, Sivas, TURKEY
| | - Kenan KAYGUSUZ
- 1. Department of Anesthesiology, Cumhuriyet University, School of Medicine, Sivas, TURKEY
| | - Iclal OZDEMIR KOL
- 1. Department of Anesthesiology, Cumhuriyet University, School of Medicine, Sivas, TURKEY
| | - Sinan GURSOY
- 1. Department of Anesthesiology, Cumhuriyet University, School of Medicine, Sivas, TURKEY
| | - Hayati OZTURK
- 2. Department of Orthopedics, Cumhuriyet University, School of Medicine, Sivas, TURKEY
| | - Caner MIMAROĞLU
- 1. Department of Anesthesiology, Cumhuriyet University, School of Medicine, Sivas, TURKEY
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