Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
ReviewSpinal cord stimulation for complex regional pain syndrome.
The therapy of spinal cord stimulation (SCS) is based on producing an electrical field on the dorsal surface of the spinal cord that blocks only neuropathic pain (ie, pain from damage to the nervous system). Most SCS devices deliver a biphasic pulse consisting of a pair of equal amplitude pulses with opposite polarity. SCS therapy is based on the gate control theory of pain and has been used for the treatment of diverse conditions of neuropathic pain, including complex regional pain syndromes (CRPS). ⋯ When used in the right patient, SCS provides significant pain relief in a majority of patients with CRPS. This review focuses on the effects of SCS on CRPS. In addition, an overview of the state of the art technologies used for implantable SCS medical devices is also provided.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
A wavelet based method for steady-state detection in anesthesia.
With the recent concern on patient's outcome following general anesthesia, automatic control of drugs has been a field of interest. The Bispectral Index (BIS) is an EEG based hypnosis monitor, in current use at the operating theatre as a guiding tool for the anesthesiologist to titrate drugs, and prevent awareness. ⋯ A steady-state index was obtained using a wavelet analysis technique for trend detection. This tool may be used in the future to model the drug's combined effect on the hypnosis indices, and also to bring some insight on disturbances not related to drug changes.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
Randomized Controlled TrialEffect of remifentanil on the nonlinear electroencephalographic entropy parameters in propofol anesthesia.
Nonlinear electroencephalographic entropy parameters have been proposed for the assessment of depth of anesthesia. The influence of remifentanil, a commonly used intraoperative opioid, on these parameters, namely approximate entropy (ApEn), sample entropy (SampEn), and permutation entropy (PeEn), during induction of propofol anesthesia was studied. ⋯ No consistent influence on PeEn was observed. However, this may have been due to strong interindividual variation in PeEn values.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
Validation of a graphic measurement of heart rate variability to assess analgesia/nociception balance during general anesthesia.
The optimization of analgesic drugs delivery during general anesthesia (GA) requires to evaluate the pain/analgesia balance. Heart Rate Variability (HRV) analysis has long been shown to measure the autonomic nervous system tone, which is strongly influenced by anesthetic drugs. ⋯ Measurements on simulated RR series showed that the graphic assessment is independent from respiratory rate, while LF and HF spectral measurements are over- and underestimated for respiratory rates lower than 12 cycles min Clinical measurements on 49 patients during GA showed that normalized HF power was strongly related to hemodynamic responsiveness during GA, and was strongly correlated with normalized EnvTOT measurements. A real time computation of the RR series could therefore help medical staff to anticipate hemodynamic responsiveness and the analgesia/nociception balance during GA.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2009
Ultrasound guided robotic biopsy using augmented reality and human-robot cooperative control.
Ultrasound-guided biopsy is a proficient mininvasive approach for tumors staging but requires very long training and particular manual and 3D space perception abilities of the physician, for the planning of the needle trajectory and the execution of the procedure. In order to simplify this difficult task, we have developed an integrated system that provides the clinician two types of assistance: an augmented reality visualization allows accurate and easy planning of needle trajectory and target reaching verification; a robot arm with a six-degree-of-freedom force sensor allows the precise positioning of the needle holder and allows the clinician to adjust the planned trajectory (cooperative control) to overcome needle deflection and target motion. Preliminary tests have been executed on an ultrasound phantom showing high precision of the system in static conditions and the utility and usability of the cooperative control in simulated no-rigid conditions.