Epidural Technique

Capogna, Giorgio

doi:10.1007/978-3-030-45332-9_5

Cited by 1 publication

(3 citation statements)

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“…The worst-case error in all trial runs was found to be within 3 mm, and the overall reliability was 97.8%. According to anesthetist feedback, porcine tissue does have characteristics similar to human tissue and the graphs obtained following the porcine insertion of the needle are similar to graphs obtained from previous human insertions [25]. The graphs that are produced in the majority of cases demonstrate when the low resistance (LOR) happened as the needle reached the epidural space.…”

Section: Mechanical Approaches and Haptic Simulatorsmentioning

confidence: 62%

“…Through this work, he understood that the ventricles in the brain were in continuous contact with both the cerebral and spinal CSF spaces. This key discovery led Quincke to begin experimenting with LPs in an effort to treat the symptoms of hydrocephalus in children, which is a neurological disorder caused by the buildup of CSF in the brain's ventricles [25]. This anatomical and physiological uncovering was a scientific breakthrough since, prior to this discovery, Quincke drained CSF by drilling holes directly into the skull [24].…”

Section: History Of Lumbar Puncture and Spinal Needlesmentioning

confidence: 99%

“…The graphs that are produced in the majority of cases demonstrate when the low resistance (LOR) happened as the needle reached the epidural space. A peak on the graph may have occurred in some cases due to the needle hitting bone, but when re-angulation of the needle and subsequent advancement of the needle were carried out, the loss of resistance was still achieved [25].…”

Section: Mechanical Approaches and Haptic Simulatorsmentioning

confidence: 99%

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Recent Advances in Smart Epidural Spinal Needles

Althobaiti,

Ali,

Hariri

et al. 2023

Sensors

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Lumbar puncture is a minimally invasive procedure that utilizes a spinal needle to puncture the lumbar epidural space to take a sample from the cerebrospinal fluid or inject drugs for diagnostic and therapeutic purposes. Physicians rely on their expertise to localize epidural space. Due to its critical procedure, the failure rate can reach up to 28%. Hence, a high level of experience and caution is required to correctly insert the needle without puncturing the dura mater, which is a fibrous layer protecting the spinal cord. Failure of spinal anesthesia is, in some cases, related to faulty needle placement techniques since it is blindly inserted. Therefore, advanced techniques for localization of the epidural space are essential to avoid any possible side effects. As for epidural space localization, various ideas were carried out over recent years to provide accurate identification of the epidural space. Subsequently, several methodologies based on mechanical and optical schemes have been proposed. Several research groups worked from different aspects of the problem, namely, the clinical and engineering sides. Hence, the main goal of this paper is to review this research with the aim of remedying the gap between the clinical side of the problem and the engineering side by examining the main techniques in building sensors for such purposes. This manuscript provides an understanding of the clinical needs of spinal needles from an anatomical point of view. Most importantly, it discusses the mechanical and optical approaches in designing and building sensors to guide spinal needles. Finally, the standards that must be followed in building smart spinal needles for approval procedures are also presented, along with some insight into future directions.

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Section: Mechanical Approaches and Haptic Simulatorsmentioning

confidence: 62%

Section: History Of Lumbar Puncture and Spinal Needlesmentioning

confidence: 99%

Section: Mechanical Approaches and Haptic Simulatorsmentioning

confidence: 99%

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