Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, Taoyuan 33302, Taiwan.
Portable Energy System Group, Green Technology Research Center, College of Engineering, Chang Gung University, Taoyuan 33302, Taiwan.
Sensors (Basel). 2018 Oct 23;18(11):3592. doi: 10.3390/s18113592.
Technology of reflectance spectroscopy incorporated with auto-fluorescence spectroscopy were employed to increase the safety of epidural placement in regional anesthesia which is generally used for surgery, epidural anesthesia, post-operative pain control and painless childbirth. Ex vivo study of auto-fluorescence spectroscopy was performed for the para-vertebral tissues contained fat, interspinous ligament, supraspinous ligament and ligamentumflavum by multimode microplate reader at wavelength 405 nm for the purpose of tissue differentiation. A specially designed optic-fiber-embedded needle was employed to incorporate with both reflectance and autofluorescence spectroscopies in order to probe the epidural space as double assurance demands. In vivo study was carried out in a Chinese native swine weighted about 30 kg under intubated general anesthesia with ventilation support. The reflective (405 nm) and autofluorescence signals (λ and λ*) were recorded at 5 different sites by an oscilloscope during the needle puncture procedure from skin to epidural space in the back of the swine. Study of either autofluorescence spectroscopy for tissue samples or ex vivo needle puncture in porcine trunk tissues indicates that ligmentumflavum has at least 10-fold higher fluorescence intensity than the other tissues. In the in vivo study, ligamentumflavum shows a double-peak character for both reflectance and autofluorescence signals. The epidural space is located right after the drop from the double-peak. Both peaks of reflectance and fluorescence are coincident which ensures that the epidural space is correctly detected. The fiber-optical technologies of double-assurance demands for tissue discrimination during epidural needle puncture can not only provide an objective visual information in a real-time fashion but also it can help the operator to achieve much higher success rate in this anesthesia procedure.
反射光谱技术与自动荧光光谱技术相结合，用于提高区域麻醉中硬膜外置管的安全性，区域麻醉通常用于手术、硬膜外麻醉、术后疼痛控制和无痛分娩。通过多模式微孔板读取器在 405nm 波长下对包含脂肪、棘间韧带、棘上韧带和黄韧带的椎旁组织进行自动荧光光谱的离体研究，目的是进行组织分化。专门设计的光纤嵌入式针与反射和自动荧光光谱相结合，以双保险的方式探测硬膜外间隙。在插管全身麻醉和通气支持下，对体重约 30 公斤的中国本地猪进行体内研究。在背部从皮肤到硬膜外间隙的针穿刺过程中，通过示波器记录反射（405nm）和自动荧光（λ和λ*）信号在 5 个不同部位。对组织样本的自动荧光光谱或猪躯干组织的离体针穿刺研究表明，黄韧带的荧光强度至少比其他组织高 10 倍。在体内研究中，黄韧带的反射和自动荧光信号均表现出双峰特征。硬膜外间隙位于双峰下降后的位置。反射和荧光的双峰都吻合，这确保了硬膜外间隙被正确检测到。在硬膜外针穿刺过程中，双保险需求的光纤技术不仅可以实时提供客观的视觉信息，还可以帮助操作者在该麻醉过程中实现更高的成功率。
