Optical Guidance Systems for Epidural Space Identification
Optical Guidance Systems for Epidural Space Identification
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DOI：
10.1109/jstqe.2016.2600027
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发表时间：
2017-03-01
影响因子：
4.9
通讯作者：
Cusano, Andrea
中科院分区：
文献类型：
--
作者：
Carotenuto, Benito;Micco, Alberto;Cusano, Andrea
硬膜外是最广泛的局部区域技术，用于缓解手术，术后和慢性疼痛，约50%的分娩使用硬膜外。目前，医生对硬膜外腔的识别仍然依靠主观感知，采用“盲”手动技术，其失败率高达7%。在过去的几年里，许多旨在协助和指导硬膜外针头放置的系统被提出。特别是，光学系统基本上依赖于光纤探头在硬膜外针腔内的集成，在针穿入过程中实时识别不同的组织类型。在本研究中，除了对迄今为止提出的系统进行详尽的概述外，我们还报告了一种新型的传感器化医疗针，该针是基于在硬膜外针腔内明智地集成光纤布拉格光栅传感器。我们的设备，通过提供针尖在其前进过程中所经历的压力的连续和实时测量，能够有效地检测针头从一个组织到另一个组织的通道。在硬膜外训练假体上进行的一项初步研究表明，我们的方法可以使针头更容易、更安全地置入硬膜外空间。
Epidurals are the most diffused loco-regional techniques for the relief of operative, postoperative, and chronic pain and are used for about 50% of deliveries. Currently, doctors still identify epidural space relying on subjective perception, by using "blind" manual techniques to which are associated failure rate up to 7%. In the last years, many systems aimed at assisting and guiding the placement of epidural needle have been proposed. In particular, optical systems basically rely on the integration inside the epidural needle lumen of optical fiber probes providing realtime discrimination of differing tissue types during needle penetration. In this study, aside of providing an exhaustive overview on the systems proposed so far, we also report on a novel sensorized medical needle, based on the judicious integration of a fiber Bragg grating sensor inside the epidural needle lumen. Our device, by providing continuous and real-time measurements of the pressure experienced by the needle tip during its advancement, is able to effectively detect the needle passage from one tissue to the other. A pilot study carried out on an epidural training phantom demonstrates the validity of our approach for making the needle placement into the epidural space easier and safer.