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Proceedings Paper

Augmented reality guidance system for peripheral nerve blocks
Author(s): Chris Wedlake; John Moore; Maxim Rachinsky; Daniel Bainbridge; Andrew D. Wiles; Terry M. Peters
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Paper Abstract

Peripheral nerve block treatments are ubiquitous in hospitals and pain clinics worldwide. State of the art techniques use ultrasound (US) guidance and/or electrical stimulation to verify needle tip location. However, problems such as needle-US beam alignment, poor echogenicity of block needles and US beam thickness can make it difficult for the anesthetist to know the exact needle tip location. Inaccurate therapy delivery raises obvious safety and efficacy issues. We have developed and evaluated a needle guidance system that makes use of a magnetic tracking system (MTS) to provide an augmented reality (AR) guidance platform to accurately localize the needle tip as well as its projected trajectory. Five anesthetists and five novices performed simulated nerve block deliveries in a polyvinyl alcohol phantom to compare needle guidance under US alone to US placed in our AR environment. Our phantom study demonstrated a decrease in targeting attempts, decrease in contacting of critical structures, and an increase in accuracy of 0.68 mm compared to 1.34mm RMS in US guidance alone. Currently, the MTS uses 18 and 21 gauge hypodermic needles with a 5 degree of freedom sensor located at the needle tip. These needles can only be sterilized using an ethylene oxide process. In the interest of providing clinicians with a simple and efficient guidance system, we also evaluated attaching the sensor at the needle hub as a simple clip-on device. To do this, we simultaneously performed a needle bending study to assess the reliability of a hub-based sensor.

Paper Details

Date Published: 27 February 2010
PDF: 8 pages
Proc. SPIE 7625, Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling, 762537 (27 February 2010); doi: 10.1117/12.844410
Show Author Affiliations
Chris Wedlake, Robarts Research Institute (Canada)
John Moore, Robarts Research Institute (Canada)
Maxim Rachinsky, The Univ. of Western Ontario (Canada)
Daniel Bainbridge, The Univ. of Western Ontario (Canada)
Andrew D. Wiles, Robarts Research Institute (Canada)
Northern Digital Inc. (Canada)
The Univ. of Western Ontario (Canada)
Terry M. Peters, Robarts Research Institute (Canada)
The Univ. of Western Ontario (Canada)
Canadian Surgical Technologies and Advanced Robotics (Canada)

Published in SPIE Proceedings Vol. 7625:
Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling
Kenneth H. Wong; Michael I. Miga, Editor(s)

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