In-vivo obstetric pressure measurements for patient-specific epidural simulator

Authors: Vaughan, N., Dubey, V.N., Wee, M.Y.K. and Isaacs, R.

Journal: Proceedings of the ASME Design Engineering Technical Conference

Volume: 1A

DOI: 10.1115/DETC201435427

Abstract:

The aim of this study was to measure changing pressures during Tuohy epidural needle insertions for obstetric parturients of various BMI. This has identified correlations between BMI and epidural pressure. Also we investigated links between BMI and the thicknesses and depths of ligaments and epidural space as measured from MRI and ultrasound scans. To date there have been no studies relating epidural pressure and ligament thickness changes with varying Body Mass Indices (BMI). Further goals following measurement of pressure differences between various BMI patients, were to allow a patient-specific epidural simulator to be developed, which has not been achieved before. The trial has also assessed the suitability of our in-house developed wireless pressure measurement device for use in-vivo. Previously we conducted needle insertion trial with porcine for validation of the measurement system. Results showed that for each group average pressures during insertion decrease as BMI increases. Pressure measurements obtained from the patients were matched to tissue thickness measurements from MRI and ultrasound scans. The mean Loss of Resistance (LOR) pressure in each group reduces as BMI increases. Variation in the shape of the pressure graphs was noticed between two epiduralists performing the procedure, suggesting each anaesthetist may have a signature graph shape. This is a new finding which offers potential use in epidural training and assessment. It can be seen that insertions performed by the first epiduralist have a higher pressure range than insertions performed by second epiduralist.

Source: Scopus

IN-VIVO OBSTETRIC PRESSURE MEASUREMENTS FOR PATIENT-SPECIFIC EPIDURAL SIMULATOR

Authors: Vaughan, N., Dubey, V.N., Wee, M.Y.K. and Isaacs, R.

Journal: PROCEEDINGS OF THE ASME INTERNATIONAL DESIGN ENGINEERING TECHNICAL CONFERENCES AND COMPUTERS AND INFORMATION IN ENGINEERING CONFERENCE, 2014, VOL 1A

ISBN: 978-0-7918-4628-5

Source: Web of Science (Lite)

In-Vivo Obstetric Pressure Measurements For Patient-Specific Epidural Simulator

Authors: Vaughan, N., Dubey, V.N., Wee, M.Y.K. and Isaacs, R.

Conference: ASME 2014 International Design, Engineering Technical Conferences and the Computers and Information in Engineering Conference, IDETC/CIE

Dates: 17-20 August 2014

Journal: asmedigitalcollection.asme.org

Publisher: ASME

Abstract:

The aim of this study was to measure changing pressures during Tuohy epidural needle insertions for obstetric parturients of various BMI. This has identified correlations between BMI and epidural pressure. Also we investigated links between BMI and the thicknesses and depths of ligaments and epidural space as measured from MRI and ultrasound scans. To date there have been no studies relating epidural pressure and ligament thickness changes with varying Body Mass Indices (BMI).

Further goals following measurement of pressure differences between various BMI patients, were to allow a patient-specific epidural simulator to be developed, which has not been achieved before. The trial has also assessed the suitability of our in-house developed wireless pressure measurement device for use in-vivo. Previously we conducted needle insertion trial with porcine for validation of the measurement system. Results showed that for each group average pressures during insertion decrease as BMI increases. Pressure measurements obtained from the patients were matched to tissue thickness measurements from MRI and ultrasound scans. The mean Loss of Resistance (LOR) pressure in each group reduces as BMI increases. Variation in the shape of the pressure graphs was noticed between two epiduralists performing the procedure, suggesting each anaesthetist may have a signature graph shape. This is a new finding which offers potential use in epidural training and assessment. It can be seen that insertions performed by the first epiduralist have a higher pressure range than insertions performed by second epiduralist.

Source: Manual

Preferred by: Venky Dubey