Search

This study aimed to investigate the effect of different injectate volumes on ultrasonographic parameters and the correlation to clinical outcomes under perineural dextrose injection (PDI). In this post hoc analysis of the randomized, double-blinded, three-arm trial, ultrasound-guided PDI with either 1 mL, 2 mL, and 4 mL 5% dextrose water was administered, respectively, in 14, 14, and 17 patients. Ultrasound outcomes included mobility, shear-wave elastography (SWE), and cross-sectional area (CSA) of the median nerve; clinical outcomes were Visual Analog Scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) score. Outcomes were measured before injection, and after injection at the 1st, 4th, 12th, and 24th week. For ultrasound outcomes, CSA decreased significantly from baseline data at all follow-up time-points in the 2 mL group (p = 0.005) and the 4 mL group (p = 0.015). The mean change of mobility from baseline showed a greater improvement on the 4 mL group than the other groups at the 1st week post-injection. For clinical outcomes, negative correlation between the VAS and mobility at the 1st (p = 0.046) and 4th week (p = 0.031) post-injection in the 4 mL group were observed. In conclusion, PDI with higher volume yielded better nerve mobility and decreased CSA of median nerve, but no changes of nerve elasticity. [ABSTRACT FROM AUTHOR]

Ultrasound-guided injection is a widely used technique, however, it takes substantial amounts of time for novices to master the skill. The most critical issue to improve the accuracy of the injection is to align the needle with the scan plane of the ultrasound beam and orient the needle angle after piercing skin to aim at the targeted tissue. In the present study, we developed a two-dimensional laser align device to assist physicians to accurately position the needle in the scan plane and advance it at an angle correctly pointing to the target. The device is inexpensive, light-weighted, and easy to fabricate and accommodate for any types of ultrasound probe. Statistical analysis revealed that the assistance with our device significantly reduced the successful targeting time and times of retargeting in comparison with the traditional freehand approach or only with in-plane assistance for inexperience subjects. Our results indicate that the device exhibits great potential in effectively reducing the learning time to master the skill and speeding up the procedure for ultrasound-guided injection. [ABSTRACT FROM AUTHOR]