• Hesham Elsharkawy, Vafi Salmasi, Alaa Abd-Elsayed, and Alparslan Turan.
• Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA. Electronic address: elsharh@ccf.org.
• J Clin Anesth. 2015 Jun 1;27(4):325-30.

BackgroundOptimum positioning of the nerve catheter is crucial for a successful nerve block. We present a novel technique for confirmation of catheter position.MethodsWe are describing a novel technique for localization of the shaft and tip of the peripheral nerve catheter. After introduction of the catheter 3 to 5 cm beyond the needle tip and removal of the needle, the guide wire was reintroduced and was moved inward and outward rapidly. This movement produced the color Doppler effect along the track of the catheter and the catheter tip that helped us verify the proper positioning of the catheter.ResultsWe used our technique in a cadaveric study for bilateral supraclavicular brachial plexus block, followed by a series of 5 patients undergoing femoral, sciatic (anterior approach), popliteal (2 patients), and brachial plexus blocks. Catheters were also identified on M-Mode sonography during pumping maneuver and during the injection of medications.ConclusionPumping maneuver and M-Mode can be additional tools in the array of modalities applied to verify proper positioning of a nerve catheter.Copyright © 2015 Elsevier Inc. All rights reserved.

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