Regardless of the Puncture Angle, a Tuohy Needle with Sand-Blasted Steel at the Tip of the Bevel Is a Valid Needle on the Ultrasonic Images

Background: A high ability to visualize the needle on the ultrasonic images is necessary to perform the ultrasound-guided nerve block safely. The Rafa Tuohy needleR (Vygon, Paris, France, Rafa) is a non-stimulating Tuohy needle with sand-blasted steel at the tip of the bevel. We examined the degree to which the Rafa enhanced the visibility of ultrasonic images compared with the non-coated Tuohy needle. Methods: We punctured the Blue Phantom. The dimensions of both the Rafa and the non-coated Tuohy needles were 18 G × 80 mm. The puncture angle is 30 degrees and 45 degrees from the Blue Phantom. We measured the intensity of the tip of the bevel at a depth of 0.5, 1.0, 1.5 and 2.0 cm for the puncture angle of 30 degrees, and 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0 cm for the puncture angle of 45 degrees. Six anesthesiologists with more than seven years of experience performed three punctures using each needle. Results: As an outcome, we concluded that at a puncture angle of both 30 degrees and 45 degrees, the intensity of the non-coated Tuohy needle decreased with the depth. On the other hand, at an angle of 30 degrees, the intensity of the Rafa needle did not decrease, and at an angle of 45 degrees the intensity only decreased very slightly as the depth increased. Conclusions: The Tuohy needle with sand-blasted steel at the tip of the bevel provided greater visualization than the non-coated Tuohy needle on the ultrasound images.