Ultrasound imaging has been used for performing single-injection peripheral nerve blocks and continuous catheters. One limitation with current technology is the inability to confirm the location of the needle or catheter tip. We describe a new needle and catheter design that permits distal tip visualization using color flow Doppler. An 18-gauge 100-mm insulated Tuohy needle and a 20-gauge 50-mm polyamide catheter (open tip) with a Teflon-coated steel stylet (B. Braun, Bethlehem, PA) were customized by adhering in place two piezoelectric actuators. These created 1-8 kHz vibrations when coupled to a function generator (FG502, Tektronix, Richardson, TX) and a 100 W audio amplifier (R3000, KLH, Sun Valley, CA). Mimicking a lateral popliteal fossa block, the needle and catheter were inserted into the leg of an unembalmed cadaver. When activated, the tip of each was highlighted in color when scanned in the short axis using the color Doppler mode of a two-dimensional ultrasound and a 12 MHz L38 probe (MicroMaxx, Sonosite, Bothell, WA). Vibration technology may be a useful adjunct while performing ultrasound-guided regional anesthesia. Further study evaluating its usefulness and safety in live tissue is warranted.
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