title: An intersubject variable regional anesthesia simulator with a virtual patient architecture.
abstract: OBJECTIVE
  The main purpose is to provide an intuitive VR-based training environment for regional anesthesia (RA). The research question is how to process subject-specific datasets, organize them in a meaningful way and how to perform the simulation for peripheral regions.
  
  
  METHODS
  We propose a flexible virtual patient architecture and methods to process datasets. Image acquisition, image processing (especially segmentation), interactive nerve modeling and permutations (nerve instantiation) are described in detail. The simulation of electric impulse stimulation and according responses are essential for the training of peripheral RA and solved by an approach based on the electric distance.
  
  
  RESULTS
  We have created an XML-based virtual patient database with several subjects. Prototypes of the simulation are implemented and run on multimodal VR hardware (e.g., stereoscopic display and haptic device). A first user pilot study has confirmed our approach.
  
  
  CONCLUSIONS
  The virtual patient architecture enables support for arbitrary scenarios on different subjects. This concept can also be used for other simulators. In future work, we plan to extend the simulation and conduct further evaluations in order to provide a tool for routine training for RA.
authors.affiliation: Virtual Reality Group, RWTH Aachen University, Aachen, Germany. s.ullrich@ieee.org
authors.forename: Sebastian
authors.initials: S
authors.lastname: Ullrich
authors.forename: Oliver
authors.initials: O
authors.lastname: Grottke
authors.forename: Eduard
authors.initials: E
authors.lastname: Fried
authors.forename: Thorsten
authors.initials: T
authors.lastname: Frommen
authors.forename: Wei
authors.initials: W
authors.lastname: Liao
authors.forename: Rolf
authors.initials: R
authors.lastname: Rossaint
authors.forename: Torsten
authors.initials: T
authors.lastname: Kuhlen
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Deserno
mesh_terms: D000765:Anesthesia, Conduction; D000776:Anesthesiology / Q000193:education*; D003198:Computer Simulation; D004558:Electric Stimulation; D006801:Humans; D010525:Peripheral Nerves; D014584:User-Computer Interface