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Original research
Effect of needle type on plane block spread in a cadaveric porcine model
  1. Scott Hughey1,2,
  2. J Cole1,2,
  3. G J Booth1,2,
  4. R Gliniecki1 and
  5. E Stedjelarsen1,2
  1. 1 Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
  2. 2 Naval Biotechnology Group, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
  1. Correspondence to Dr Scott Hughey, Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA; scott.b.hughey.mil{at}mail.mil

Abstract

Introduction Plane blocks are an increasingly common type of regional anaesthesia technique in the perioperative period. Increased spread of local anaesthesia during plane blocks is thought to be related to an increased area of pain coverage. This study sought to assess differences in injectate spread comparing Tuohy needles with standard insulated stimulating block needles.

Methods 10 Yorkshire-Cross porcine cadavers were used in this study. Immediately following euthanasia, the cadavers underwent bilateral ultrasound-guided transversus abdominis plane (TAP) block injection with radiopaque contrast dye, with one side placed with a 20 g Tuohy needle, and the other side with a 20 g insulated stimulating block needle. Injectate spread was assessed using plain film X-ray and area of spread was measured to compare differences.

Results All 10 animals underwent successful ultrasound-guided TAP block placement. In all 10 animals, the area of contrast spread was greater with the Tuohy than stimulating needle. Wilcoxon signed-rank test was used to analyse the difference between the groups. The average difference between the two sides was 33.02% (p=0.002).

Conclusions This is the first study to demonstrate differences in injectate spread with different needle types. This suggests enhanced spread with Tuohy needle compared with standard block needle, and may encourage its use during plane blocks.

  • pain management
  • ultrasonography

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information. All data are presented in the manuscript.

http://dx.doi.org/10.1136/bmjmilitary-2021-001827

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplemental information. All data are presented in the manuscript.

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    Footnotes

    • Contributors All authors contributed significantly to the conception of the project, methods, data collection, data analysis, manuscript creation and final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Disclaimer The views expressed in this article reflect the results of research conducted by the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the US government. We are military service members. This work was prepared as part of my official duties. Title 17 U.S.C. 105 provides that 'Copyright protection under this title is not available for any work of the US government'. Title 17 U.S.C. 101 defines a US government work as a work prepared by a military service member or employee of the US government as part of that person's official duties.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.