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ESRA19-0530 Onvision™ needle tip tracking using ultrasound imaging for out-of-plane lumbar plexus blocks – a first in human volunteer study
  1. T Kåsine1,2,
  2. L Romundstad1,
  3. LA Rosseland2,3,
  4. K Ullensvang1,
  5. MW Fagerland4,
  6. P Kessler5 and
  7. AR Sauter1
  1. 1Oslo University Hospital, Division of Emergencies and Critical Care, Department of Anaesthesiology, Oslo, Norway
  2. 2University of Oslo, Institute of Clinical Medicine, Faculty of Medicine, Oslo, Norway
  3. 3Oslo University Hospital, Division of Emergencies and Critical Care, Department of Research and Development, Oslo, Norway
  4. 4Oslo University Hospital, Centre for Biostatistics and Epidemiology OCBE, Research Support Services, Oslo, Norway
  5. 5Orthopedic University Hospital Friedrichsheim, Department of Anaesthesiology, Intensive Care and Pain Medicine, Frankfurt, Germany


Background and aims The Onvision™ is a new technology for needle tip tracking (NTT). The technology makes use of a piezoelectric sensor on the needle tip that is represented by a green circle on the ultrasound screen (figure 1). In a phantom study NTT significantly reduced the procedure time for out-of-plane simulated blocks (Kåsine et al. 2019). The aim of this study was to investigate the effect of NTT on procedure time and hand motion analysis in a first-in-human volunteer study.

Abstract ESRA19-0530 Figure 1

Methods This was a randomised, controlled, crossover study in healthy volunteers. Two anaesthesiologists performed lumbar plexus blocks with an out-of-plane approach using Karmakar’s trident technique. 27 volunteers received blocks with and without Onvision™ NTT using 20 ml lidocaine 20 mg/ml with adrenaline. Procedure time was the primary outcome. Number of hand movements and path length were measured by motion analysis. Other secondary outcomes were block success, onset time, block duration, discomfort experienced by the volunteers, and the anaesthesiologists’ confidence in block success.

Results We found a statistically non-significant reduction in procedure time when NTT was used (table 1). Decreased numbers of intended hand movements and path lengths were found for the needling hand. No significant differences were found for other secondary outcomes. Mild adverse events included high unilateral epidural spread (one volunteer; without NTT) and systemic toxicity of local anaesthetics (one volunteer; with NTT).

Abstract ESRA19-0530 Table 1

Procedure time and hand motion

Conclusions NTT significantly reduced the number of hand movements (34%) and path lengths (44%). This indicates improved needle control. The reduction in procedure time with NTT was statistically non-significant.

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