Optical Detection of the Brachial Plexus for Peripheral Nerve Blocks

Brynolf, Marcus; Sommer, Michael; Desjardins, Adrien E.; Voort, Marjolein van der; Roggeveen, Stefan; Bierhoff, Walter; Hendriks, Benno H. W.; Rathmell, James P.; Kessels, Alfons G.H.; Söderman, Michael; Holmström, Björn

doi:10.1097/aap.0b013e318220f15a

Cited by 27 publications

(26 citation statements)

References 32 publications

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“…5,6 Studies have been reported on the use of STS in swine and in patients. [7][8][9][10] This study extends previous research by investigating STS in a larger, more homogenous patient group. The main objective was to test the hypothesis that STS can discriminate between correct (ie, safe) and incorrect placement of the needle tip during LTEI.…”

supporting

confidence: 79%

The Role of Spectral Tissue Sensing During Lumbar Transforaminal Epidural Injection

Balthasar

Lucassen²,

Sommer³

et al. 2016

Regional Anesthesia and Pain Medicine

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Spectral tissue sensing (STS) exploits the scattering and absorption of light by tissue. The main objective of the present study was to determine whether STS can discriminate between correct and incorrect placement of the needle tip during lumbar transforaminal epidural injection. This was a single-blind prospective observational study in 30 patients with lumbar radicular pain scheduled for lumbar transforaminal epidural injection. Spectral tissue sensing data from the needle tip were acquired along the needle trajectory at 4 predefined measurement points and compared with ultrasound, fluoroscopy, and digital subtraction angiography images. Spectral tissue sensing data contained the full spectra. The lipid and hemoglobin content at the different measurement points was also calculated, and partial least-squares discriminant analysis was used to estimate the sensitivity and specificity of STS. Spectral tissue sensing identified correct needle placement with a sensitivity of 57% and a specificity of 82%, and intraforaminal versus extraforaminal locations were identified with a sensitivity of 80% and a specificity of 71%.

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supporting

confidence: 79%

The Role of Spectral Tissue Sensing During Lumbar Transforaminal Epidural Injection

Balthasar

Lucassen²,

Sommer³

et al. 2016

Regional Anesthesia and Pain Medicine

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“…Pilot studies performed in swine, which involved insertions to the epidural space and the brachial plexus, provided initial indications that vascular penetration events can be detected with optical reflectance spectroscopy. 16,17 The purpose of this study was to investigate whether optical reflectance spectroscopy has the potential to detect vascular penetration in humans. During blocks of the sympathetic chain and the communicating ramus in humans, a custom-designed needle stylet with integrated optical fibers was used to acquire reflectance spectra from tissues at the needle tip.…”

Section: Discussionmentioning

confidence: 99%

“…The potential of this concept was recently demonstrated by 2 studies, in which the brachial plexus in swine was positively identified by optical spectroscopy performed with optical fibers integrated into the needle stylet. 14,17 Detection of vascular penetration events with optical spectroscopy could also be valuable in the context of ultrasoundguided peripheral nerve block procedures. Ultrasound guidance is generally considered beneficial for reducing the risk of vascular penetration, although it is not clear whether this reduction is linked to a reduction in the risk of local anesthetic systemic toxicity.…”

Section: Discussionmentioning

confidence: 99%

Optical Detection of Vascular Penetration During Nerve Blocks

Balthasar¹,

Desjardins

Voort

et al. 2012

Regional Anesthesia and Pain Medicine

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“…The transition of the needle tip from the skeletal muscle to the nerve target region was associated with higher lipid parameter values and lower hemoglobin parameter values; the transition of the needle tip from muscle fascia to the nerve target region was associated with higher lipid parameter values. 9 The objective of this pilot study was to investigate the potential of optical reflectance spectroscopy to differentiate between tissue transitions encountered during insertions toward peripheral nerves in humans during interventional pain management procedures.…”

mentioning

confidence: 99%