Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China.
Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, Taoyuan, 33302, Taiwan, Republic of China.
Sci Rep. 2019 Feb 7;9(1):1552. doi: 10.1038/s41598-018-38436-z.
Several approaches of locating the epidural space have been proposed. However, loss of Resistance method (LOR) remains the most common method for epidural anesthesia. Different optical signals were received from the ligamentum flavum and the epidural space allows operator to pinpoint position of the needle and determine whether the needle tip has entered the epidural space. Optical signals throughout the penetration process was recorded and position of needle tip was confirmed with a C-arm fluoroscopy. 60 lumbar punctures were performed in 20 vivo porcine models, and success rate of locating the epidural space with the optical auxiliary is calculated statistically. The data are expressed in mean ± SD. During all the lumber puncture processes, the strength of optical signals received decreased significantly while the needle tip penetrates the ligamentum flavum and entered the epidural space. The strength of optical signal received when needle tip was in the ligamentum flavum was 1.38 ± 0.57. The signal strength at epidural space was 0.46 ± 0.35. Strength of signal decreased by 67% when entered epidural space, and there is no significant differences in decrease of strength from data obtained from thevertebrae (lumbar segments)L2-L3, L3-L4, and L4-L5. Finally, we calculated with assistance of the proposed optical auxiliary, the success rate for guiding the needle tip to the epidural space using was as high as 87%. It is evidently believed that the optical auxiliary equipped is visualized to assist operators inserting needle accurately and efficiently into epidural space during epidural anesthesia operation.
已经提出了几种定位硬膜外腔的方法。然而，阻力消失法（LOR）仍然是硬膜外麻醉最常用的方法。从黄韧带和硬膜外腔接收到不同的光学信号，使操作者能够确定针尖的位置，并确定针尖是否已进入硬膜外腔。在整个穿透过程中记录光学信号，并使用 C 臂荧光透视术确认针尖的位置。在 20 个活体猪模型中进行了 60 次腰椎穿刺，并统计计算了使用光学辅助定位硬膜外腔的成功率。数据以平均值±标准差表示。在所有腰椎穿刺过程中，当针尖穿透黄韧带并进入硬膜外腔时，接收到的光学信号强度显着降低。当针尖位于黄韧带上时，接收到的光学信号强度为 1.38±0.57。在硬膜外腔中接收到的信号强度为 0.46±0.35。当进入硬膜外腔时，信号强度降低了 67%，并且从 L2-L3、L3-L4 和 L4-L5 脊柱（腰椎节段）获得的数据中信号强度的降低没有显着差异。最后，我们使用建议的光学辅助计算，使用该光学辅助引导针尖进入硬膜外腔的成功率高达 87%。显然，相信配备的光学辅助设备可以可视化，以协助操作者在硬膜外麻醉手术中准确有效地将针插入硬膜外腔。
