A non-invasive system for epidural space detection: comparison with Compuflo®

Epidural blockade is a method often used in clinical practice to obtain pain relief during labor. Basically, the epidural puncture blocks the nerve impulses from the lower spinal segments with a consequent decrease of sensation in the lower half of the body. In this arena, the correct localization of the epidural space is crucial to perform the procedure. The loss of resistance (LOR) technique is the most popular approach to localize the epidural space. The LOR is caused by the fact that the ligamentum flavum is much harder than the epidural space, therefore when the needle tip pierces this ligamentum, there is an abrupt decrease of pressure (known as LOR). Although, there are several commercially available tools to support the clinicians in this task, the large part of epidural punctures is performed without any support. Our group of research has developed a novel and noninvasive tool to detect the LOR during epidural puncture. The aim of this study is to compare the output collected by the proposed system (i.e., the Epidural Space Management Tool, ESMT) with the output provided by a commercial system (i.e., CompuFlo®, Milestone Scientific, Inc.). Experiments were performed by an expert anesthesiologist (M.C.) on a simple simulator that allows mimicking the real scenario. Results showed a good agreement between the trends of the output of the two mentioned systems. Finally, the proposed system (ESMT), showed promising results in terms of LOR detection during all the five procedures performed on the simulator.