Abstract
Epidural analgesia represents a clinical common practice aiming at pain mitigation. This loco-regional technique is widely used in several applications such as labor, surgery and lower back pain. It involves the injections of anesthetics or analgesics into the epidural space (ES). The ES detection is still demanding and is usually performed by the techniques named loss of resistance (LOR). In this study, we propose a novel soft system (SS) based on one fiber Bragg grating sensor (FBG) embedded in a soft polymeric matrix for LOR detection during the epidural puncture. The SS was designed to allow instrumenting the syringe’s plunger without relevant modifications of the anesthetist’s sensations during the procedure. After the metrological characterization of the SS, we assessed the capability of this solution in detecting LOR by carrying it out in silico and in clinical settings. For both trials, results revealed the capability of the proposed solutions in detecting the LOR and then in recording the force exerted on the plunger.
Highlights
Among many drug therapies, epidural analgesia is a well-established loco-regional technique widely used in pain relief in applications with relevant clinical and socioeconomic impacts [1,2]
The most popular technique to guide the needle within the epidural space (ES) is Loss of resistance (LOR) which is based on the tactile feedback coming from the syringe plunger: when the anesthesiologist pushes the syringe from the skin to the ES, the needle passes through several different tissues’ layers
Clinicians perform the procedure by means of the LOR method, which can be accomplished by stuffing the syringe with air or saline solution as preferred by the physician [34]
Summary
Epidural analgesia is a well-established loco-regional technique widely used in pain relief in applications with relevant clinical and socioeconomic impacts [1,2]. It allows achieving a central nerve block by injecting an anesthetic within the epidural space (hereafter ES) and close to the nerve that transports the pain. Epidural analgesia is broadly accepted during labor since it is effective in increasing maternal satisfaction and reducing pain without having effects on neonatal status [5] It may be considered a relevant factor in the psychological adjustment of women in the postpartum [6,7]. A large part of the epidural analgesia procedures is performed blindly; their success is operator-dependent [12]
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