A Novel Approach for Assessing Catheter Position After Ultrasound-Guided Placement of Continuous Interscalene Block

Abstract

The increasing use of ultrasound has allowed anesthesiologists to perform nerve blocks with a high success rate and without nerve stimulation or eliciting a paresthesia. The ability to visualize peripheral nerve catheters using ultrasound is limited. We present a novel method to confirm the position of an interscalene catheter tip using injection of agitated contrast. The described technique is simple and allows timely assessment of catheter tip position.

Bilateral Catheterization, Perpendicular or Parallel, to Femoral Nerve Block in Five Patients Undergoing Bilateral Simultaneous Total Knee Arthroplasty

“…The problems of the short axis technique are that the catheter tip may bypass the target nerve given the perpendicular orientation of the needle and nerve and it is sometimes difficult to thread past the tip of the placement needle and the catheter had been accidentally dislodged after placement [2,4].…”

Less leakage and dislodgement with a catheter-over-needle versus a catheter-through-needle approach for peripheral nerve block: an ex vivo study

“…However, the use of ultrasound has made it possible to predict target distance and visualize the positioning of catheters in real time, 18,19 suggesting the feasibility of preselecting a CON catheter assembly of appropriate length in order to place the catheter tip in proximity to a target nerve with accuracy. In designing future clinical studies, other factors, such as the materials used to make the catheter, should also be considered since most CON catheters used in the past were known to kink easily.…”

Paediatric Ultrasound-Guided Regional Anaesthesia: Peripheral Techniques

“…The advantage of the in-plane technique is that the needle shaft and tip can be visualised at all times; however the out-ofplane technique may be useful for catheter insertion. 4,8 The minimum amount of local anaesthetic to fully surround the nerve roots should be used, which is estimated to be 0.15-0.25 ml/ kg. 9 This can reduce the risk of phrenic nerve palsy as a result of local anaesthetic spreading to cover the anterior surface of scalenus anterior, on which the phrenic nerve travels.…”