Desjardins Adrien E, Hendriks Benno H W, van der Voort Marjolein, Nachabé Rami, Bierhoff Walter, Braun Guus, Babic Drazenko, Rathmell James P, Holmin Staffan, Söderman Michael, Holmström Björn
Biomed Opt Express. 2011 Jun 1;2(6):1452-61. doi: 10.1364/BOE.2.001452. Epub 2011 May 6.
Epidural injection is commonly used to provide intraoperative anesthesia, postoperative and obstetric analgesia, and to treat acute radicular pain. Identification of the epidural space is typically carried out using the loss of resistance (LOR) technique, but the usefulness of this technique is limited by false LOR and the inability to reliably detect intravascular or subarachnoid needle placement. In this study, we present a novel epidural needle that allows for the acquisition of optical reflectance spectra from tissue close to the beveled surface. This needle has optical fibers embedded in the cannula that deliver and receive light. With two spectrometers, light received from tissue is resolved across the wavelength range of 500 to 1600 nm. To determine the feasibility of optical tissue differentiation, spectra were acquired from porcine tissues during a post mortem laminectomy. The spectra were processed with an algorithm that derives estimates of the hemoglobin and lipid concentrations. The results of this study suggest that the optical epidural needle has the potential to improve the accuracy of epidural space identification.
硬膜外注射常用于提供术中麻醉、术后镇痛和产科镇痛,以及治疗急性神经根性疼痛。硬膜外腔的识别通常采用阻力消失(LOR)技术,但该技术的有效性受到假阻力消失以及无法可靠检测血管内或蛛网膜下腔针置入的限制。在本研究中,我们展示了一种新型硬膜外针,它能够从靠近斜面的组织获取光学反射光谱。该针在套管中嵌入了光纤,用于传输和接收光。通过两台光谱仪,从组织接收的光在500至1600nm的波长范围内进行解析。为了确定光学组织鉴别法的可行性,在猪死后椎板切除术中从猪组织获取光谱。光谱用一种算法进行处理,该算法可得出血红蛋白和脂质浓度的估计值。本研究结果表明,光学硬膜外针有提高硬膜外腔识别准确性的潜力。