Investigation of an intelligent system for fiber optic-based epidural anesthesia.

Cihun-Siyong Alex Gong,Chien‐Kun Ting

doi:10.1155/2014/437679

Abstract

Even though there have been many approaches to assist the anesthesiologists in performing regional anesthesia, none of the prior arts may be said as an unrestricted technique. The lack of a design that is with sufficient sensitivity to the targets of interest and automatic indication of needle placement makes it difficult to all-round implementation of field usage of objectiveness. In addition, light-weight easy-to-use realization is the key point of portability. This paper reports on an intelligent system of epidural space identification using optical technique, with particular emphasis on efficiency-enhanced aspects. Statistical algorithms, implemented in a dedicated field-programmable hardware platform along with an on-platform application-specific integrated chip, used to advance real-time self decision making in needle advancement are discussed together with the feedback results. Clinicians' viewpoint of improving the correct rate of our technique is explained in detail. Our study demonstrates not only that the improved system is able to behave as if it is a skillful anesthesiologist but also it has potential to bring promising assist into clinical use under varied conditions and small amount of sample, provided that several concerns are addressed.

Highlights

Ever-increasing demand for advance on clinical technologies is driving a revolution in information and communications engineering to enable effective and sustainable solutions to pressing problems in medicine
Despite the results shown in our early studies [16] indicating that “Linear discriminant analysis (LDA) was the best fit to discriminate between the epidural space and ligamentum flavum in our model,” the logistic discrimination was implemented in our portable hardware platform to pursue higher accuracy of the optical needle placement system
The resulting “mean” calculated from the data from each of 216 pairs of reflective signals from the ligamentum flavum and epidural space can be used to describe “population.” The leave-one-out cross-validation method has been used to minimize the ill-effect caused by classification error and the radiography with contrast medium was used to confirm proper epidural needle placement (Figure 6)

Summary

Introduction

Ever-increasing demand for advance on clinical technologies is driving a revolution in information and communications engineering to enable effective and sustainable solutions to pressing problems in medicine. The lack of a truly efficient object-based approach for quantification will result in unpredicted quality and turns out to be fear of failure for anesthesiologists who understand the resulting medical complications. Several techniques have been demonstrated so far in the literature to improve the clinical practice since the possibly reported invention of the first lumbar puncture in 1885 [6]. The significantly high impedance of the epidural space (ES) can be considered as an index to differentiate it from others. The drawback of this method might be its electricity which is the physiological nature of the human being for neural transmission (disturbance!). The inherent “negative pressure” characteristics of the epidural space can be used to identify it from the dura mater and ligamentum flavum (LF)

Objectives

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Results

Conclusion