BobBarker

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I purchased a vscan air. First patient was for tibial nerve blocks. I could see my anatomy fine. I used a 20g Tuohy but could not see it at all. Got the blocks in using hydrodissection. Looking for recs for cheap but better needles.
 

Ligament

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Pajunk sonographic needles are the best, but very very expensive
Clint Pharmaceuticals carries a brand of sonographic needles made in Japan I believe which are cheaper and good. Good enough that I rarely need the Pajunk needles.
 

Orin

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I purchased a vscan air. First patient was for tibial nerve blocks. I could see my anatomy fine. I used a 20g Tuohy but could not see it at all. Got the blocks in using hydrodissection. Looking for recs for cheap but better needles.
Do you have a phantom to check this out in? A 20g Tuohy is very hyperechoic so I would want to rule out something weird with the signal processing on the handheld unit. There's a surprising amount of processing that goes into making a nice US image. Looking on the GE Website, I oddly enough don't see any clinical pictures with needles in view although their pics look nice.
 
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BobBarker

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Good point. I had it in nerve mode also. So maybe vasc or msk presets would be better. I haven’t done any us in years but I still think I should have seen the needle. I gave myself a knee injection with it also and could not see the 25g needle. But my knee got numb.
 

Orin

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Good point. I had it in nerve mode also. So maybe vasc or msk presets would be better. I haven’t done any us in years but I still think I should have seen the needle. I gave myself a knee injection with it also and could not see the 25g needle. But my knee got numb.
That's weird. It should do fine but I would really play with it before you invest in a fancy needle. It might just have a very narrow slice where it captures as compared to a traditional probe.
 

epidural man

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I have used all kinds of echogenic needles. Nothing beats the 20g Tuohy - a real one with a stylet. Lots of people make a "touhy" needle for blocks that don't have the stylet. That makes a big difference. I suspect the hollow channel in the middle makes the needle more echogenic - thus the reason a thinner wall, large hole, another thin wall - is better than just a shape of the tip.
 

SeniorWrangler

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Nothing beats those Pajunk 100s… like doing the injection with a lightsaber bzzoww!
 
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oreosandsake

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Hate to be the one to say it but maybe practice a little if it’s been a while since you’ve used much US. The beam is less than 1 mm thick typically. 25g needle is o.5 mm if I remember correctly. 20g is pretty hefty
 
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Ligament

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You should only need sonographic needles for deep structures requiring acute angles of entry. Otherwise they are a poor ROI. If your needle is at all perpendicular to the beam it should be quite visible.
 
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Sooshi

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I've been a big fan of BBraun's stimuplex needles - crisp as all get-out. After playing with them in residency it was very disappointing and difficult to go back to the old-fashioned pointy things.
 
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