title: Toward a comprehensive hybrid physical-virtual reality simulator of peripheral anesthesia with ultrasound and neurostimulator guidance.
abstract: We are developing a simulator of peripheral nerve block utilizing a mixed-reality approach: the combination of a physical model, an MRI-derived virtual model, mechatronics and spatial tracking. Our design uses tangible (physical) interfaces to simulate surface anatomy, haptic feedback during needle insertion, mechatronic display of muscle twitch corresponding to the specific nerve stimulated, and visual and haptic feedback for the injection syringe. The twitch response is calculated incorporating the sensed output of a real neurostimulator. The virtual model is isomorphic with the physical model and is derived from segmented MRI data. This model provides the subsurface anatomy and, combined with electromagnetic tracking of a sham ultrasound probe and a standard nerve block needle, supports simulated ultrasound display and measurement of needle location and proximity to nerves and vessels. The needle tracking and virtual model also support objective performance metrics of needle targeting technique.
authors.affiliation: Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA 15213, USA. jts35@pitt.edu
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Samosky
authors.forename: Pete
authors.initials: P
authors.lastname: Allen
authors.forename: Steve
authors.initials: S
authors.lastname: Boronyak
authors.forename: Barton
authors.initials: B
authors.lastname: Branstetter
authors.forename: Steven
authors.initials: S
authors.lastname: Hein
authors.forename: Mark
authors.initials: M
authors.lastname: Juhas
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Nelson
authors.forename: Steven
authors.initials: S
authors.lastname: Orebaugh
authors.forename: Rohan
authors.initials: R
authors.lastname: Pinto
authors.forename: Adam
authors.initials: A
authors.lastname: Smelko
authors.forename: Mitch
authors.initials: M
authors.lastname: Thompson
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weaver
mesh_terms: D003198:Computer Simulation; D004558:Electric Stimulation / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008348:Manikins; D008954:Models, Biological; D009407:Nerve Block / Q000295:instrumentation* / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D018511:Systems Integration; D018084:Ultrasonography, Interventional / Q000295:instrumentation / Q000379:methods*; D014584:User-Computer Interface