title: Portable optical epidural needle-a CMOS-based system solution and its circuit design.
abstract: Epidural anesthesia is a common anesthesia method yet up to 10% of procedures fail to provide adequate analgesia. This is usually due to misinterpreting the tactile information derived from the advancing needle through the complex tissue planes. Incorrect placement also can cause dural puncture and neural injury. We developed an optic system capable of reliably identifying tissue planes surrounding the epidural space. However the new technology was too large and cumbersome for practical clinical use. We present a miniaturized version of our optic system using chip technology (first generation CMOS-based system) for logic functions. The new system was connected to an alarm that was triggered once the optic properties of the epidural were identified. The aims of this study were to test our miniaturized system in a porcine model and describe the technology to build this new clinical tool. Our system was tested in a porcine model and identified the epidural space in the lumbar, low and high thoracic regions of the spine. The new technology identified the epidural space in all but 1 of 46 attempts. Experimental results from our fabricated integrated circuit and animal study show the new tool has future clinical potential.
authors.affiliation: Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan; Portable Energy System Group, Green Technology Research Center, College of Engineering, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Cihun-Siyong Alex
authors.initials: CS
authors.lastname: Gong
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shih-Pin
authors.initials: SP
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, University of Colorado Health Sciences Center, Aurora, Colorado, United States of America.
authors.forename: M Susan
authors.initials: MS
authors.lastname: Mandell
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
authors.forename: Mei-Yung
authors.initials: MY
authors.lastname: Tsou
authors.affiliation: Institute of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yin
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chien-Kun
authors.initials: CK
authors.lastname: Ting
mesh_terms: D000767:Anesthesia, Epidural / Q000295:instrumentation*; D000818:Animals; D004824:Epidural Space / Q000033:anatomy & histology*; D005336:Fiber Optic Technology / Q000295:instrumentation*; D056656:Lab-On-A-Chip Devices; D009339:Needles; D012372:ROC Curve; D012666:Semiconductors; D013552:Swine; D013904:Thoracic Vertebrae / Q000033:anatomy & histology