What is it about?
Spinal and epidural nerve block procedure training are the objective of this work because they are blind procedure, where the correct points inside the body are not visible. They are defined by learning the resistance of the bypassed tissues along needle insertion. The transition of tissue must consider: Skin, subcutaneous fat, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, arachnoid mater and subarachnoid space for anesthesia during childbirth. Loss of Resistance (LOR) characteristic is used to detect the epidural space location (for epidural) and a “pop” sensation can be feeling when perforating the dura mater for (spinal anesthesia). This works aims to help on learning how to correctly identify (by the hand sensation) the internal points where these types of anesthesia should be administered using a virtual environment and haptic.
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Photo by Diana Polekhina on Unsplash
Why is it important?
We implement a resistance to needle progression related to tissues behavior considering stiffness, friction and cutting forces, and answer before and after the puncture in each tissue. Each tissue thickness of the virtual body is modeled from the height, weight and age in the simulator, in real time for training purpose using an equation that we created from more than 3000 data of pregnant women of 6 population groups. Several tests were done, some tests aimed to map the force model when applied in a virtual simulation environment with the goal of verifying the possibility of distinguishing different tissues (Pop and LOR sensations), others are related to the users opinion about the system.
Perspectives
Average fail rate are 41% for Spinal and from 6% to 25% for Epidural anesthesia (these are the most used in obstetrics procedures like labor or cesarean). We hope to reduce epidural and spinal block failure with the possibility of more medical training because professional skill and expertise are lost without frequent practice. The use of virtual simulators is good for medical skills improvement because it allows experimentation without risk of failures and helps building trainee self-confidence. The use of haptic allows the emulation of physical sensations (forces, moments and restrictions), answering to the user movements and interactions. Tissue thickness modification offers real-based different challenges for the trainees by virtual patient configuration.
Aura Conci
Universidade Federal Fluminense
Read the Original
This page is a summary of: Users Consideration on Haptics Interface in Spinal Anesthesia, June 2024, ACM (Association for Computing Machinery),
DOI: 10.1145/3672406.3672411.
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