Conor O’Shea, Peter Lee, Michael O’Shea, Timothy Power, Pádraig Cantillon-Murphy
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Medical devices - Epidural administration - Visualpressure drop indicator.
Background: Inadvertent dural puncture is the most
significant complication associated with epidural
anaesthesia. These spinal taps can result in severe and
prolonged headaches for the patient and, in rare cases,
serious neurological complications. The current gold
standard in epidural administration involves blindly
passing a needle through the spinous processes of the
vertebra until loss-of-resistance (LOR) is achieved on
reaching the epidural space, resulting in a subtle and
sudden pressure drop at the needle tip. The LOR
technique relies exclusively on subjective haptic feedback
on the syringe plunger and requires significant training
until a reasonable proficiency is achieved. ProDural is a
novel visual syringe for signalling needle entry into the
epidural space. ProDural provides both visual and haptic
feedback of probe entry into the epidural space by rapid
and immediate collapse of an inflatable diaphragm whilst
retaining haptic feedback.
Methods: ProDural was designed based on criteria
established through end user surveys, ethnographic
feedback and existing technology assessment. The
resulting solution was evaluated through physical bench-
top experiments and analytical modelling prior to a pre-
clinical cadaver trial.
Conclusion: These initial trials indicate that ProDural may
represent a promising approach to improving the accuracy
of epidural needle placement and may reduce the steep
learning curve associated with epidural administration.