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Nominal logistic regression analysis of variables determining needle visibility in ultrasound images – a full factorial cadaver study
Needle visualization is essential to avoid vascular puncture and nerve injury in ultrasound-guided regional anesthesia. Several factors that statistically influence needle visibility have been described but the dimensions of their individual impact remain unclear. This study aimed to quantify the...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Philipps-Universität Marburg
2024
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| Subjects: | |
| Online Access: | PDF Full Text |
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| Summary: | Needle visualization is essential to avoid vascular puncture and nerve injury in ultrasound-guided
regional anesthesia. Several factors that statistically influence needle visibility have been described but the
dimensions of their individual impact remain unclear. This study aimed to quantify the impact of various independent
factors on ultrasound needle visibility.
total of 1500 ultrasound videos of in-plane needle insertions were obtained in embalmed cadavers with
ten different commercially available echogenic and non-echogenic needles at different insertion angles and bevel
orientations in a full factorial study design. The visibility of needle tip and shaft were rated as “good” or “poor” visibility.
Nominal logistic regression analyses were calculated for the visibility of the needle tip and shaft.
SonoPlex Stim Sprotte, SonoTAP Facet (needle tip and shaft) and Spinostar PencilPoint (needle tip)), insertion
angle and bevel orientation were associated with good ultrasound visibility, reaching statistical significance (p < 0.05).
The range of the effect on the log-odds scale for needle tip visibility was largest for the insertion angle with 6.33,
followed by the tissue condition (3.76), bevel orientation (1.45) and the needle types (1.25). Regarding the needle
shaft visibility, the largest effect range was observed with the insertion angle (7.36), followed by the tissue conditions
with 3.96, needle type (1.86) and bevel orientation (0.95).
In-plane needle visibility in ultrasound images depends mainly on the insertion angle, as expected.
This is closely followed by the tissue condition, which is a factor related to the patient, thus cannot be altered to
improve needle visibility. In the dimensions of the log-odds scale, the choice of a specific needle is far less important
towards achieving a good visualization, whereas optimizing the bevel orientation can have a larger impact than the
needle choice. Concluding from the relative dimensions of factors that determine needle visibility in this model, the
importance of needles with echogenic features may be overrated. |
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| Item Description: | Gefördert durch den Open-Access-Publikationsfonds der UB Marburg. |
| DOI: | 10.1186/s12871-023-02339-y |