A New Pressure Guided Management Tool for Epidural Space Detection: Feasibility Assessment on a Simulator

Carassiti, Massimiliano; Mattei, Alessia; Quarta, R.; Massaroni, Carlo; Saccomandi, Paola; Tesei, Marco; Setola, Roberto; Schena, Emiliano

doi:10.1111/aor.13007

Cited by 22 publications

(14 citation statements)

References 15 publications

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“…Carassiti et al of the Università Campus Bio‐Medico di Roma, Rome, Italy assessed a new pressure guided management tool for epidural space detection. The detection of epidural space is usually performed by the technique of loss of resistance (LOR) without technological support, although there are few commercial options.…”

Section: Biomaterials and Biomechanicsmentioning

confidence: 99%

Artificial Organs 2017: A Year in Review

Malchesky¹

2018

Artificial Organs

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In this Editor's Review, articles published in 2017 are organized by category and summarized. We provide a brief reflection of the research and progress in artificial organs intended to advance and better human life while providing insight for continued application of these technologies and methods. Artificial Organs continues in the original mission of its founders "to foster communications in the field of artificial organs on an international level." Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ Replacement, Recovery, and Regeneration from all over the world. Peer-reviewed Special Issues this year included contributions from the 12th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion edited by Dr. Akif Undar, Artificial Oxygen Carriers edited by Drs. Akira Kawaguchi and Jan Simoni, the 24th Congress of the International Society for Mechanical Circulatory Support edited by Dr. Toru Masuzawa, Challenges in the Field of Biomedical Devices: A Multidisciplinary Perspective edited by Dr. Vincenzo Piemonte and colleagues and Functional Electrical Stimulation edited by Dr. Winfried Mayr and colleagues. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide meaningful suggestions to the author's work whether eventually accepted or rejected. Without these excellent and dedicated reviewers the quality expected from such a journal could not be possible. We also express our special thanks to our Publisher, John Wiley & Sons for their expert attention and support in the production and marketing of Artificial Organs. We look forward to reporting further advances in the coming years.

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Section: Biomaterials and Biomechanicsmentioning

confidence: 99%

Artificial Organs 2017: A Year in Review

Malchesky¹

2018

Artificial Organs

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“…However, the infusion pump used was unable to measure or control the pressure itself. New pressure based tools have been recently described [7][8][9], but unfortunately their use is confined to animal and experimental fields and the tools are not available on the market yet.…”

Section: Introductionmentioning

confidence: 99%

Epidural Needle Extension through the Ligamentum Flavum Using the Standard versus the CompuFlo®-Assisted Loss of Resistance to Saline Technique: A Simulation Study

Capogna

Coccoluto

Velardo

2020

Anesthesiology Research and Practice

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Background. The CompuFlo® epidural system has been recently introduced and validated as an objective and sensible tool to detect the epidural space. We aimed to verify whether the high sensitivity of the instrument may help the anesthesiologist to identify the epidural space very early, limiting the extension of the Tuohy needle into the epidural space. Methods. In this prospective, simulation study, we evaluated the Tuohy needle extension through a simulated ligamentum flavum during the epidural procedure performed by 52 expert anesthesiologists by using the CompuFlo® epidural instrument or their standard loss of resistance to saline technique (LORT). Results. The mean (SD) needle extension length was 3.90 (3.71) mm in the standard technique group and 0.68 (0.46) mm in the CompuFlo® group (P<000001). The extremely reduced variability of the data in the CompuFlo® group (F test 0.01) made the results obtained with this instrument highly predictable. Conclusions. Puncturing high-resistance material that simulated the ligamentum flavum, the use of CompuFlo® has determined the arrest of the needle more precociously when compared with the traditional LORT.

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“…More recently, a banana was suggested as a teaching model for loss of resistance (LOR) after comparison with three simulators 3. Another study describing a recently developed simulator uses pressure guidance for detection of LOR but lacks the advantage of MRI modeling 4. The TU-Delft Simulator for Epidural Needle Skills (SENS) with 2 degrees of freedom was used in our study.…”

Section: Introductionmentioning

confidence: 99%

Face and construct validity of TU-Delft epidural simulator and the value of real-time visualization

Živković

Samkar

Hermanns

et al. 2019

Regional Anesthesia &Amp; Pain Medicine

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Background and objectivesLearning epidural anesthesia traditionally involves bedside teaching. Visualization aids or a simulator can help in acquiring motor skills, increasing patient safety and steepening the learning curve. We evaluated the face and construct validity of the TU-Delft Epidural Simulator and the effect of needle visualization.MethodsSixty-eight anesthesiologists, anesthesia residents, and final-year medical students tested the epidural simulator. Participants performed six epidural simulations with and six without needle visualization. We tested face validity on a Likert scale questionnaire. We collected data with the simulator software (spinal taps, dura contacts, bone contacts, attempts, and time) and tested for correlation with the performer’s experience (construct validity). A visualization aid was tested in a randomized crossover design.ResultsFace validity as rated by the participants was above average, with a mean of 3.7 (2.0–4.8) on a 5-point scale. Construct validity was indicated by significantly more spinal taps (0.4 [0–4) vs 0.07 [0–2], p=0.04) and more dura contacts (0.58 [0–6] vs 0.37 [0–3], p=0.002) by the inexperienced group compared with the expert group. The visualization aid improved performance by reducing the number of bone contacts and the number of attempts, and by decreasing the procedure time. Prior visualization training reduced the total procedure time from 279 s (69–574) to 180 s (53–605) (p=0.01) for the “blind” procedure.ConclusionsThe TU-Delft Epidural Simulator is a useful tool for teaching motor skills during epidural needle placement. Prior use of a visualization tool improves performance even without visual support during consequent simulations.

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A New Pressure Guided Management Tool for Epidural Space Detection: Feasibility Assessment on a Simulator

Cited by 22 publications

References 15 publications

Artificial Organs 2017: A Year in Review

Artificial Organs 2017: A Year in Review

Epidural Needle Extension through the Ligamentum Flavum Using the Standard versus the CompuFlo®-Assisted Loss of Resistance to Saline Technique: A Simulation Study

Face and construct validity of TU-Delft epidural simulator and the value of real-time visualization

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