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. 2014 Aug 27;9(8):e106055.
doi: 10.1371/journal.pone.0106055. eCollection 2014.

Portable optical epidural needle-a CMOS-based system solution and its circuit design

Cihun-Siyong Alex Gong  1 , Shih-Pin Lin  2 , M Susan Mandell  3 , Mei-Yung Tsou  2 , Yin Chang  4 , Chien-Kun Ting  2
Affiliations

Portable optical epidural needle-a CMOS-based system solution and its circuit design

Cihun-Siyong Alex Gong et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: One of the authors in the submitted paper, M. Susan Mandell, is a PLOS ONE Editorial Board member. This does not alter the authors’ adherence to PLOS ONE Editorial policies and criteria.

Figures

Figure 1
Figure 1. Conceptual drawing of the optic system.
Figure 2
Figure 2. Proposed application-specific device for the optical needle placement.
Figure 3
Figure 3. Standard operation procedure of proposed assistive system.
Figure 4
Figure 4. The reflective amplitude at different spinal levels in the porcine model (mean+/SD).
Figure 5
Figure 5. The receiver operating characteristic (ROC) cure of observations from epidural puncture in the porcine model.
The area under curve for 650 nm is 0.93.
See this image and copyright information in PMC

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