Ultrasound visibility of regional anesthesia catheters: an in vitro study

Takatani, Junji; Takeshima, Naozumi; Okuda, Kentaro; Uchino, Tetsuya; Noguchi, Takayuki

Abstract

BACKGROUND
Ultrasound subjective visibility of in-plane needles is correlated with the intensity difference between the needle surface and the background. Regional anesthesia catheters are difficult to visualize by an ultrasound. In the present study, we investigated the ultrasound visibility of the catheters.
METHODS
Six catheters were placed at 0degrees and 30degrees relative to and at a depth of 1 cm below the pork phantom surface. Ultrasound images of in-plane catheters were evaluated, subjectively and objectively. Outer and inner objective visibilities were defined as the difference in the mean pixel intensity between the catheter surface and adjacent background, and between the surface and the center of the catheter, respectively. Evaluations were made based on the portion of the catheters. A P value < 0.05 was considered significant.
RESULTS
Subjective visibility was more strongly correlated with the inner objective visibility than with the outer objective visibility at both angles. Metallic 19-gauge catheters were more subjectively visible than the non-metallic 20-gauge catheters at 30degrees degrees (P < 0.01). Subjective, and outer and inner objective visibility were significantly lower at 30degrees than at 0degrees (P < 0.01, P < 0.01, P = 0.02). Perifix ONE at 0degrees and Perifix FX at 30degrees were the most visible catheters (P < 0.01 for both).
CONCLUSIONS
Subjective visibility of catheters can not be evaluated in the same manner as that of the needles. For the best possible visualization, we recommend selecting a catheter with a structure that enhances the dark at the center of catheter, rather than basing the catheter selection on the bore size.