title: Technical communication: First robotic ultrasound-guided nerve blocks in humans using the Magellan system.
abstract: BACKGROUND
  Ultrasound-guided nerve blocks are becoming a standard of modern anesthesia. We developed a robotic system, Magellan, to perform nerve blocks using a remote control center.
  
  
  METHODS
  Thirteen patients were enrolled in this pilot study. The Magellan system consists of 3 main components: a joystick, a robotic arm, and a software control system. The joystick allows simulation of wrist or arm movements of the proceduralist. After localization of the sciatic nerve, 35 mL of bupivacaine 0.25% was injected. The success rate of sciatic nerve blocks and block performance times (performance time=interval of time from the start of the ultrasound search for the nerve to the end of the injection of the drug; robotic time=interval of time from the identification of the nerve to the end of the injection of the drug) were determined. Data are presented as median (25th, 75th; minimal, maximal) and categorical data.
  
  
  RESULTS
  Eight men and 5 women aged 34 years were included in this study. Nerve blocks were successful in all patients. A successful attempt was defined as the introduction of the needle into the nerve sheath; motor or sensory block was not used to determine the success rate. The nerve performance time was 189 seconds (150, 233; 90, 305), whereas the robotic time was 164 seconds (121, 210; 73, 271).
  
  
  CONCLUSIONS
  We present the first human testing of a robotic ultrasound-guided nerve block system. The success rate was 100%. The total performance time was approximately 3 minutes to 4 minutes.
authors.affiliation: Department of Anaesthesiology, McGill University, Montreal General Hospital, 1650 Cedar Avenue Montreal, Canada. thomas.hemmerling@mcgill.ca
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Hemmerling
authors.forename: Riccardo
authors.initials: R
authors.lastname: Taddei
authors.forename: Mohamad
authors.initials: M
authors.lastname: Wehbe
authors.forename: Shantale
authors.initials: S
authors.lastname: Cyr
authors.forename: Cedrick
authors.initials: C
authors.lastname: Zaouter
authors.forename: Joshua
authors.initials: J
authors.lastname: Morse
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D009407:Nerve Block / Q000191:economics / Q000379:methods*; D010147:Pain Measurement; D010865:Pilot Projects; D016684:Prone Position; D012371:Robotics / Q000191:economics / Q000379:methods*; D012584:Sciatic Nerve; D018084:Ultrasonography, Interventional / Q000191:economics / Q000295:instrumentation* / Q000379:methods*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local