Ricerc@Sapienza

Abstract: Epidurals are the most diffused loco-regional techniques for the relief of operative, postoperative, and chronic pain and are used for about 50% of deliveries. Currently, doctors still identify epidural space relying on subjective perception, by using ¿blind¿ manual techniques that are associated with failure rates up to 7%. In the last years, many systems aimed at assisting and guiding the placement of epidural needles have been proposed. In this study, a novel sensorized medical needle, based on the judicious integration of a fiber Bragg grating sensor inside the epidural needle lumen, will be tested. The device, by providing continuous and real-time measurements of the pressure experienced by the needle tip during its advancement, is able to effectively detect the needle passage from one tissue to the other. Due to the promising results obtained with phantom (CIRS Model 034 Lumbar Training Phantom ) it has been decided to validate this theory in-vivo. The scope of the study is to find out the wavelength associated with the correct insertion of a needle in the epidural space. Six young pigs are needed and due to the availability of 7 vertebral spaces (L1-S1) and the possibility of 6 different insertion points (median, paramedian dx, paramedian sx, all repeated twice), 6 pigs will allow 252 insertions. The procedures will be repeated with different intensities and wavelengths in order for random errors to be eliminated and obtain a more accurate result. A computerized system elaborates the signals of the fibres and will produce a spectrogram of the different wavelengths refracted that will be recorded and then compared. The outcomes of the procedures will be separated in two categories:
* Correct epidural and catheter position
* Incorrect epidural and catheter position
Once these two set of results have been split up, their respective spectrograms can be compared and analysed to determine if the wavelengths of successful procedures are similar.