What brand of ultrasound and supplies for starting regional Blocks

[deleted682700]

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The Hospital where I work has recruited 2 orthopods starting mid feb 2017. The orthopods want regional blocks. The OR manager showed me a Hitachi ultrasound machine that was rusting in the OB department with ob us probe. I yelled at him and wanted the state of art, ultrasound machine that has printing capability and anesthesia friendly. Have to specify what and give him reasons as to why i dont want to improvize old ultrasound machine.
Question 1)
Which company and specific model is most user friendly and service after purchase

Question 2
What are ultrasound compatible regional needles with catheter capability? Which company

What are the contents of your regional cart

Thanks

 

[deleted162650]

Sonosite M-turbo but their other less expensive models are superior to the competition as well. Not sure what you mean by which needle. An assortment of 21/22g b-bevel needles and tuohys are all you need. Echogenic needles are for the weak 😉.

 

[Aether2000]

I had the chance to try the GE Venue 50 for a day....nice machine, much lower in quoted price compared to other US systems. It is a tablet system affixed to a stand, but the tablet is removable. Nice image recognition with standard block needles- don't need echogenic needles.

 

[BLADEMDA]

I had the chance to try the GE Venue 50 for a day....nice machine, much lower in quoted price compared to other US systems. It is a tablet system affixed to a stand, but the tablet is removable. Nice image recognition with standard block needles- don't need echogenic needles.

Braun has their own line of echogenic needles. I think like $5-$10 more per needle. Since the price difference is negligible between echogenic vs non echogenic Braun why not just opt for the better version?

The echogenic needle's advantages are more evident for "deep blocks" greater than 3-3.5 CM in depth. Blocks like ICBs, TAPs, etc benefit more from echogenic needles.

 

[sevoflurane]

Sonosite M-Turbo for me.
Recently switched to the Pajunk needles (although I still use the Braun needles and still like them). Very echogenic.

Here is one I took today after reading this thread. The echo shadow can be impressive.

 

[HMtoDO]

We also use Sonosite and switched to Pajunk echogenic needles and they give great images and everyone seems to like them.


Sent from my iPhone using SDN mobile

 

[BLADEMDA]

Sonosite M-Turbo for me.
Recently switched to the Pajunk needles (although I still use the Braun needles and still like them). Very echogenic.

Here is one I took today after reading this thread. The echo shadow can be impressive.

Yes, I prefer the Pajunk needles because of their superior echogenecity. But, the only time you really need them is for a deep block. The Pajunk TAP block needle is the most echogenic needle on the market.

 

[facted]

Pajunk needle is by far the best I think. Sonosite makes a great machine but there are others which are fine as well if cost is an issue.

 

[deleted162650]

Yes, I prefer the Pajunk needles because of their superior echogenecity. But, the only time you really need them is for a deep block. The Pajunk TAP block needle is the most echogenic needle on the market.

To me, a TAP is not a block where needle visualization is difficult. It's not hard to achieve a fairly perpendicular plane to the transducer by adjusting your entry point and putting some cant on the probe by depressing the back side into the fat a bit (not sure if I'm describing that well). The block where echogenicity can really help is an infraclav on a fatty because your angle has to be so steep. The other way around that one is to use a small curvilinear probe like a C11.

 

[sevoflurane]

To me, a TAP is not a block where needle visualization is difficult. It's not hard to achieve a fairly perpendicular plane to the transducer by adjusting your entry point and putting some cant on the probe by depressing the back side into the fat a bit (not sure if I'm describing that well). The block where echogenicity can really help is an infraclav on a fatty because your angle has to be so steep. The other way around that one is to use a small curvilinear probe like a C11.

Agree. Love the curvilinear probe. We have 3 different probes attatched to our sonosite fleet.
One is the curvilinear and it's def. useful for the Obese patient that is getting high pop blocks or other deep blocks like an Ant. Sciatic.

The echogenic needles are cheap. So I like to use all the tools available to me in order to make my life easier.

 

[BLADEMDA]

To me, a TAP is not a block where needle visualization is difficult. It's not hard to achieve a fairly perpendicular plane to the transducer by adjusting your entry point and putting some cant on the probe by depressing the back side into the fat a bit (not sure if I'm describing that well). The block where echogenicity can really help is an infraclav on a fatty because your angle has to be so steep. The other way around that one is to use a small curvilinear probe like a C11.

Sure, whatever you say. A tap block can be the most difficult block period when performed on a BMI of 45-50+ in the supine position while trying to perform a TFP or QL1.
No other ROUTINE block is more difficult for me and I have performed many thousands of every type in every patient population.


That's why I recommend a Pajunk TAP needle which I also utilize for deep ICB blocks in these types of patients.

 

[deleted162650]

Sure, whatever you say. A tap block can be the most difficult block period when performed on a BMI of 45-50+ in the supine position while trying to perform a TFP or QL1.
No other ROUTINE block is more difficult for me and I have performed many thousands of every type in every patient population.


That's why I recommend a Pajunk TAP needle which I also utilize for deep ICB blocks in these types of patients.

No need to get sassy there slim 😉. EVERYTHING is difficult in the BMI 45-50+ crowd. My solution to TAPs in the super morbidly obese is to not offer them. If I can't reach your TAP with a standard 3.5" needle then you're too fat for a TAP block.

Maybe I'll feel different after I do a few thousand of each type of block in every patient population 😎.

You seem to be getting a little crotchety lately Blade. I hope you're not on the way to becoming the next veteran SDN'er to go out in a blaze of glory. I really have learned a lot from you over the years.