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Use of Ultrasound in Needle Placement in Intercostal Muscles: A Method for Increased Accuracy in Cadavers

Authors
  • Retrouvey, Michele
  • Chiodo, Tony
  • Quidley-Nevares, Anton
  • Strand, Jonathan
  • Goodmurphy, Craig
Type
Published Article
Journal
Archives of Physical Medicine and Rehabilitation
Publisher
Elsevier
Publication Date
Jan 01, 2013
Volume
94
Issue
7
Pages
1256–1259
Identifiers
DOI: 10.1016/j.apmr.2013.01.026
Source
Elsevier
Keywords
License
Unknown

Abstract

ObjectiveTo validate the use of ultrasound technology for the positioning and leveling of intercostal needle placement. DesignDouble-blinded experimental study. SettingAn anatomy laboratory. ParticipantsTwo board-certified physical medicine and rehabilitation physicians, 2 first-year medical students, 1 anatomist, and 8 cadavers. InterventionsFour unfixed cadavers were used for unguided needle placement, and 3 unfixed and 1 partially fixed cadavers were used for ultrasound-guided needle placement. Ultrasound-guided needle placement was then confirmed with computed tomography and blind dissection. Main Outcome MeasureThe accuracy of needle placement. ResultsThe unguided study showed needle placement in an intercostal muscle 89% of the time, but in only 15.4% of the time was the correct level sampled. In the 96 needle placements completed, the unguided needle placements had an accuracy of 8.3%, while ultrasound-guided needle placements had an accuracy of 93% (χ2 with P<.005). ConclusionsUltrasound guidance dramatically increases needle placement accuracy for intercostal nerve blocks and intercostal muscle sampling for electromyography.

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