Training Simulator for Epidural Needle Insertion

描述（由申请人提供）： 在这个第二阶段计划，物理科学公司。(PSI)建议开发一种硬膜外导管插入的训练模拟器，该模拟器结合了物理模型和虚拟现实模拟的特征。物理模型将包括人体躯干模型。躯干将覆盖一层人造皮肤，通过该皮肤可以触摸到解剖标志，以确定针头插入的位置，就像对患者所做的那样。当Touhy针穿刺人造皮肤时，它将遇到新颖的触觉反馈装置，其可行性已在第一阶段中得到证实。这个由计算机控制的装置计算针头的位置并施加适当的阻力。该系统将被设计为使得触觉反馈装置可以安装在人体模型中的不同位置处，用于通过正中和旁正中入路模拟硬膜外针在不同椎间关节处插入。该系统还将允许模拟其他针插入技术，例如脊椎穿刺。在第二阶段计划中，CIMIT模拟中心的合作者将开发性能测量算法，并设计一项研究，以验证模拟器上的性能与临床技能相关。本研究将由不同经验的住院医师和主治麻醉师进行。验证工作将在贝斯以色列女执事医疗中心产科麻醉师的支持下完成。完成后，模拟器将帮助培训医务人员在几个椎间关节处进行硬膜外麻醉，以缓解手术疼痛，慢性疼痛和分娩疼痛以及其他针头插入程序。它将允许模拟复杂的病例，允许受训者故意犯错误，并缓解治疗患者的初级医生的焦虑。

DESCRIPTION (provided by applicant): In this Phase II program, Physical Sciences Inc. (PSI) proposes to develop a training simulator for epidural catheter insertion that combines features of a physical model and virtual reality simulation. The physical model will consist of a human torso mannequin. The torso will be covered with an artificial skin through which anatomical landmarks can be palpated to determine the location of needle insertion, as is done to patients. When a Touhy needle punctures the artificial skin, it will encounter, the novel, haptic feedback device, the feasibility of which was demonstrated in Phase I. This computer-controlled device calculates the location of the needle and applies the appropriate resistive force. The system will be designed so that the haptic feedback device can be mounted at different locations in the mannequin for simulation of epidural needle insertion at different intervertebral joints by both the median and paramedian approaches. This system will also allow simulation of other needle insertion techniques, such as spinal tap. In the Phase II Program, collaborators at the CIMIT simulation center will develop performance measurement algorithms and design a study to validate that performance on the simulator is correlated with clinical skill. The study will be conducted with residents of varying experience and attending anesthesiologists. Validation work will be accomplished with support from obstetric anesthesiologists at the Beth Israel-Deaconess Medical Center. When completed, the simulator will aid training medical personnel to deliver epidural anesthesia at several intervertebral joints for relief of surgical pain, chronic pain, and childbirth pain, as well as other needle insertion procedures. It will allow complex cases to be simulated, allow trainees to purposely make mistakes, and ease the anxiety of junior physicians treating patients.