• Trine Kåsine, Luis Romundstad, L A Rosseland, Morten Wang Fagerland, Paul Kessler, Ivar Nagelgaard Omenås, Anne Holmberg, and Axel R Sauter.
• Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway trikaa@ous-hf.no.
• Reg Anesth Pain Med. 2020 Aug 1; 45 (8): 634-639.

BackgroundOnvision is a new technology for needle tip detection and tracking in ultrasound-guided regional anesthesia. The system consists of a piezoelectric sensor close to the needle tip and an electronic console integrated in the ultrasound system. The needle tip is visualized by a green circle on the ultrasound screen. The aim of the study was to investigate the effect of the new needle tip tracking technology on in-plane infraclavicular plexus blocks.MethodsThe study was a randomized, controlled, observer blinded cross-over trial in 26 healthy volunteers. Two specialists in anesthesiology performed an ultrasound-guided infraclavicular lateral sagittal brachial plexus block with and without needle tip tracking. Primary outcome was procedure time, measured from insertion of the needle until local anesthesia injection was completed. Secondary outcome measures included the number of hand movements and path lengths (assessed by hand motion analysis), block success rate, onset time and duration, discomfort experienced by the volunteers, and the anesthesiologists' confidence as to whether their block would be successful or not.ResultsMean (SD) procedure time was 183.0 (56.1) s with and 206.8 (56.2) s without needle tip tracking (p=0.16). There were no significant differences in any of the secondary outcomes. Two volunteers' experienced Horner syndrome after blocks without needle tip tracking. No other adverse events occurred during the study.ConclusionOur study on needle tip tracking for infraclavicular blocks did not reveal any significant differences between active needle tip tracking and the control procedures, neither for primary outcome nor secondary outcome measurements.Trial Registration NumberNCT03631914.© American Society of Regional Anesthesia & Pain Medicine 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.

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