不同組織間定位輔助裝置之研製—以硬脊膜外腔定位為例

Abstract

硬脊膜外腔麻醉手術是一種常見的麻醉手術，而該麻醉手術最常出現的意外是不小心穿破硬脊膜。為了避免這類意外，正確定位硬脊膜外腔是手術成敗的關鍵。傳統的阻力消失法是最常見的硬脊膜外腔定位技術，但實際執行時卻需要麻醉醫師良好的觸覺感知能力及經驗。近年來有許多新技術被提出來，這些技術提供了額外的視覺或聽覺的輔助訊號以精確鑑定硬脊膜外腔之位置，然而與傳統的方式相比較之後，卻因為太過於複雜而沒有被廣泛接受。 本研究設計了一個新穎的硬脊膜外腔之定位裝置，藉由在一般硬脊膜外腔定位針筒的末端裝上一個壓阻式力量感測器，可以同時產生聲音和視覺的輔助訊號。本裝置具有體積小、成本低的優點，且使用上與傳統阻力消失法方式一致，較容易為麻醉科醫師所接受。此外，由於力量感測器位於針筒外部，與其他將感測器裝於針筒內部的方法比較起來更可降低與患者體液直接接觸而造成感染的風險。

Epidural anesthesia is a widely accepted procedure. Since accidental dural puncture is the common accident, identifying epidural space during the procedure is the most important thing. Traditional technique, namely loss of resistance, is commonly used to detect the epidural space. However, this technique requires well tactile perception of an experienced anesthetist. Several devices were proposed to improve the technique by supplying additional visual or acoustic signals while the epidural space is arrived. Yet these devices are seldom used due to their complexity. By using a piezo-resistive force sensor placed at the bottom of the epidural syringe, a novel auxiliary device that can generate visual as well as acoustic signals was proposed. The device is small, low cost and mimic to the traditional loss of resistance technique. Furthermore, the force sensor will not direct contact with the subjects and hence greatly reduce the risk of infection.