Smart sensor for guiding safe delivery of anesthetic and pain drugs through epidurals

项目摘要/摘要 物理科学公司(PSI)建议开发一种新的方法来指导更安全的疼痛传递 和/或硬膜外手术(EP)期间的麻醉药。硬膜外注射通常用于治疗疼痛。 由颈椎手术后继发的椎间盘突出、椎管狭窄、化学性椎间盘、慢性疼痛引起 综合征和颈椎病引起的慢性颈痛。它们也经常被用来缓解与疼痛相关的 为出生干杯。然而，如果操作不当，硬膜外注射可能会产生负面副作用，如 严重的头痛，感染，甚至神经损伤。还可能出现严重的副作用，包括 中风、瘫痪或失明。 这项建议旨在克服目前与硬膜外注射有关的问题，使用一种新的和更 可靠的低相干干涉(LCI)光学传感方法，可确定存在的组织类型 在针的顶端，同时监测施加在针上的力，使其安全地进入硬膜外 空间使用光纤布拉格传感器。 在第一阶段的工作中，PSSI开发了一种用于硬膜外引导的实验室原型，它结合了 在同一探头内实现布拉格传感的低相干干涉测量。这种方法已经过测试， 在动物组织标本上进行体外优化。虽然证明了可行性，但区分 PSI所具有的光源的相对高强度噪声在一定程度上阻碍了组织类型 并在实验中使用。因此，我们请求NIH支持部门购买性能更好的光源， 以及支付更好地匹配光谱的合适的布拉格光栅的非经常性工程成本 这种光源的特性。在改进设置后，该技术将在活体动物身上进行评估。 根据第一阶段的调查结果，该技术将在第二阶段得到进一步改进，并在 BWH的人类。

Project Summary/Abstract Physical Sciences Inc. (PSI) proposes to develop a novel approach for guiding safer delivery of pain and/or anesthetic drugs during epidural procedures (EPs). Epidural injections are typically used to treat pain from herniated discs, spinal stenosis, chemical discs, chronic pain secondary to post-cervical surgery syndrome, and chronic neck pain of discogenic origin. They are also regularly used to alleviate pain related to birth. However, when not properly performed, the epidural injections can have negative side effects, such as severe headache, infection, and even nerve damage. Serious side effects may also occur, including stroke, paralysis, or loss of vision. This proposal aims to overcome current issues related to epidural injections by using a novel and more reliable low coherence interferometry (LCI) optical sensing approach to determine what tissue type is present at the tip of the needle, while monitoring the force applied to the needle to safely pass it into the epidural space using a fiber Bragg sensor. During the Phase I effort PSSI has developed a laboratory prototype for epidural guidance that combines low coherence interferometry with Bragg sensing within the same probe. This approach was tested and optimized ex vivo on animal tissue specimens. Although feasibility was demonstrated, the differentiation of tissue types was somewhat impeded by the relatively high intensity noise of the light source owed by PSI and used in the experiments. Therefore, we request NIH support to purchase a better performing light source, as well as to cover the nonrecurring engineering cost of suitable Bragg gratings that better match the spectral characteristics of this light source. After improving the setup, the technology will be evaluated in live animals. Based on the Phase I findings, the technology will be further improved during Phase II and validated on humans at BWH.