双臂触觉硬膜外插针模拟器的设计与评估

IF 2.4 3区计算机科学 Q2 COMPUTER SCIENCE, CYBERNETICS

IEEE Transactions on Haptics Pub Date : 2023-09-07 DOI:10.1109/TOH.2023.3312666

Nitsan Davidor;Yair Binyamin;Tamar Hayuni Kosovsky;Ilana Nisky

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引用次数: 1

摘要

麻醉医师的病例经验是导致意外硬膜穿刺和硬膜外麻醉失败的主要原因之一，而硬膜外麻醉是分娩镇痛最常见的并发症。我们设计了一种双臂触觉模拟器来培训麻醉医师并优化硬膜外镇痛技能的掌握。我们对来自以色列多家医院的 22 名不同能力水平的麻醉师进行了评估研究。我们的模拟器模拟了一只手握住硬膜外（Touhy）针和另一只手握住失去阻力（LOR）注射器所受的力。阻力是根据硬膜外区域层的模型计算出来的，该模型以病人的体重为参数。我们测量了两个触觉装置的动作，并量化了结果率（硬膜外麻醉的成功率、失败率和硬膜穿刺率）、插入策略以及参与者对模拟逼真度感知问卷的回答。我们通过证明模拟器能够区分现实生活中的新手和专家，证明了其良好的构造效度。通过研究用户对模拟器的真实性和目的性的印象，我们检验了表面效度和内容效度。我们发现不同级别的麻醉师在策略上存在差异，因此建议在高级培训阶段采用以学员为基础的教学方法。

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Design and Assessment of a Bimanual Haptic Epidural Needle Insertion Simulator

The case experience of anesthesiologists is one of the leading causes of accidental dural punctures and failed epidurals-the most common complications of epidural analgesia used for pain relief during delivery. We designed a bimanual haptic simulator to train anesthesiologists and optimize epidural analgesia skill acquisition. We present an assessment study conducted with 22 anesthesiologists of different competency levels from several Israeli hospitals. Our simulator emulates the forces applied to the epidural (Touhy) needle, held by one hand, and those applied to the Loss of Resistance (LOR) syringe, held by the other one. The resistance is calculated based on a model of the epidural region layers parameterized by the weight of the patient. We measured the movements of both haptic devices and quantified the results' rate (success, failed epidurals, and dural punctures), insertion strategies, and the participants' answers to questionnaires about their perception of the simulation realism. We demonstrated good construct validity by showing that the simulator can distinguish between real-life novices and experts. Face and content validity were examined by studying users' impressions regarding the simulator's realism and fulfillment of purpose. We found differences in strategies between different level anesthesiologists, and suggest trainee-based instruction in advanced training stages.

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来源期刊

IEEE Transactions on Haptics COMPUTER SCIENCE, CYBERNETICS-

CiteScore

5.90

自引率

13.80%

发文量

109

审稿时长

>12 weeks

期刊介绍： IEEE Transactions on Haptics (ToH) is a scholarly archival journal that addresses the science, technology, and applications associated with information acquisition and object manipulation through touch. Haptic interactions relevant to this journal include all aspects of manual exploration and manipulation of objects by humans, machines and interactions between the two, performed in real, virtual, teleoperated or networked environments. Research areas of relevance to this publication include, but are not limited to, the following topics: Human haptic and multi-sensory perception and action, Aspects of motor control that explicitly pertain to human haptics, Haptic interactions via passive or active tools and machines, Devices that sense, enable, or create haptic interactions locally or at a distance, Haptic rendering and its association with graphic and auditory rendering in virtual reality, Algorithms, controls, and dynamics of haptic devices, users, and interactions between the two, Human-machine performance and safety with haptic feedback, Haptics in the context of human-computer interactions, Systems and networks using haptic devices and interactions, including multi-modal feedback, Application of the above, for example in areas such as education, rehabilitation, medicine, computer-aided design, skills training, computer games, driver controls, simulation, and visualization.