Boby George

Department of Electrical Engineering

Mohanasankar Sivaprakasam

Biswarup Mukherjee

anesthesia

article

clinical article

EXTRAOCULAR MUSCLE

feedback system

Human

medical education

OPHTHALMIC ANESTHESIA

PERIBULBAR ANESTHESIA

priority journal

REGIONAL ANESTHESIA

Simulation

skill

Anesthesiology

AUDIOVISUAL EQUIPMENT

CLINICAL COMPETENCE

Education

local anesthesia

NERVE BLOCK

OPHTHALMOLOGY

procedures

SIMULATION TRAINING

ANESTHESIA, LOCAL

EDUCATION, MEDICAL, GRADUATE

EDUCATIONAL MEASUREMENT

Humans

INTERNSHIP AND RESIDENCY

MANIKINS

IIT Madras is a public technical and research university located in Chennai, Tamil Nadu. Founded in 1959, it is recognised as an Institute of National Importance.

IIT Madras has been ranked as the top engineering institute in India for four years in a row by the National Institutional Ranking Framework of the MHRD

It currently offers undergraduate, postgraduate and research degrees across 16 disciplines in Engineering, Sciences, Humanities and Management. About 596 faculty belonging to science and engineering departments and centres of the Institute are engaged in teaching, research and industrial consultancy.

IIT Madras

Ophthalmology

Recently, a training mannequin suitable for ophthalmic blocks has been developed. It provides a new feature of visual feedback to the trainee. A validation of the efficacy of this training system with needle angle visualization, ocular structure proximity, and procedural warning features was conducted in an evaluative study with 41 participants; 21 post graduate trainees and 20 ophthalmic consultants from a tertiary ophthalmic care facility in Chennai, India. The participant's performance was evaluated and analyzed using an appropriate scoring scheme in two sessions with and without visual feedback. The participants were also requested to provide feedback on the anatomical likeness and usage. A two tailed signed rank Wilcoxon test verified the statistical significance of the visual feedback (Pz(4.55, 0.05)= 0.9999, P &lt; 0.001). The mean score of the participants showed an increase 58.86% and 25.5% for graduate trainee and consultants respectively and a mean reduction of 85.41% in the warning indications provided was also substantiated the efficacy of the visual feedback. © 2018 IEEE.

2018 9th Cairo International Biomedical Engineering Conference, CIBEC 2018 - Proceedings

Visual Feedback Enabled Training Mannequin for Ophthalmic Blocks: An Evaluative Study

Ophthalmic anesthesia training simulators require the evaluation of the proper procedure of (i) orbital needle block followed by (ii) ocular digital massage (ODM). In this paper, to implement digital massage training, an elastic silicone eye mount that articulates the anatomical features of the eye and allows lateral, axial, and compressive movements is presented. An inbuilt permanent magnet in conjunction with four Hall-sensors enables measurements, not only on the movements of the eyeball during digital compression but enables simultaneous measurement of the applied force on the eyeball. Thus, the evaluation of whether the trainee had performed ocular digital compression correctly is feasible. A virtual instrumentation interface developed, measures both the force applied and the movements of the eyeball and issues appropriate warnings to the trainee as part of the training. In the previously developed camera-based system, erroneous output was observed when the eyeball position changed due to compression. The proposed system is designed such that a weak perspective image projection-based methodology itself is adequate to correct this issue. The proposed technique was experimentally validated through results obtained from a prototype unit built and tested. A worst-case error less than 2.0% in the measurement of lateral and axial movements and less than 0.4% error in the computation of compressive force is achieved. © 2001-2012 IEEE.

IEEE Sensors Journal

A Sensor System to Assess the Ocular Digital Massage in an Ophthalmic Anaesthesia Training System

Local anesthesia administration prior to ophthalmic surgery involves inserting a syringe needle into a confined intraorbital space at the proper position, angle and depth. During this procedure ocular structures must remain unhurt and systemic complications must be avoided while achieving quick akinesia and analgesia. Animal cadavers do not emulate human anatomy accurately and human subject based training entails risk to the patient. Therefore, a training system that closely replicates the human ocular and orbital anatomy and provides the trainee with real-time feedback on the safety and effectiveness of the block administered would help reduce risks involved with real life procedures. This paper presents an anatomically accurate, rapid-prototyped manikin based training system for ophthalmic anesthetic blocks. The depth of penetration of the needle, the proximity of the needle to extraocular muscles and the touch of the needle to the muscles or optic nerve is detected by a multi-electrode electric field/capacitive sensing system. The eye structure of the manikin does not have any electrical connections to it, rendering it replaceable, thus, enabling the emulation of anatomical variations due to pathologies of the eye. A virtual instrument measures and computes the position of the needle and displays it to the trainee through an intuitive GUI with a 3D display of the orbital anatomy. The proposed capacitive sensing scheme has been validated by tests performed on a prototype system, thus demonstrating its usefulness for practical training purposes. © 2014 IEEE.

IEEE Transactions on Biomedical Circuits and Systems

A multi-electrode electric field based sensing system for ophthalmic anesthesia training

Regional anesthesia delivery for ocular surgery involves insertion of a syringe needle into the orbital space at the proper position and orientation such that ocular structures remain undamaged while avoiding adverse systemic reactions. Additionally, anesthetic fluid must be injected at an appropriate rate to achieve painless and rapid akinesia. Training on human subjects is risky and animal cadavers do not emulate human ocular anatomy. Thus, a training system, which closely replicates human ocular anatomical structure and provides real-time qualitative feedback on the effectiveness and safety of the anesthetic procedure would significantly mitigate risks associated with real life procedures. This paper presents a rapid prototyped, anatomically precise training manikin that detects the proximity and touch of syringe needle to the extraocular muscles and alarms the trainee to avoid injury. The proximity of the needle to the muscle structure is detected using capacitive sensors integrated in the manikin. A Hall-effect sensor-based measurement scheme for detection of rate of injection from a syringe has been developed. The specially designed syringe piston provides illusion of fluid flow inside the manikin for the trainee while reducing anesthesia wastage. A virtual instrument developed measures the output from capacitive sensing electrodes and Hall-effect sensor and displays it to the trainee through a graphical user interface. The proposed capacitive touch and proximity detection schemes have been validated by tests performed on the prototype system. The rate of injection was measured in real time on a prototype syringe, demonstrating the practical use of the system for medical training purposes. © 1963-2012 IEEE.

IEEE Transactions on Instrumentation and Measurement

An ophthalmic anesthesia training system using integrated capacitive and hall effect sensors

Safe administration of regional anesthesia in the eye involves insertion of syringe needle into the intra-orbital space at the correct position and angle to avoid injury to ocular structures. A training manikin which emulates human ocular anatomy and provides feedback on the quality of anesthetic procedure would considerably help to reduce the risks involved in real life procedures. This paper presents an anatomically accurate training manikin that has been developed employing rapid prototyping techniques. The system detects and alarms the trainee when a needle is in close proximity of the ocular muscles to avoid injury. Additionally it also apprises the trainee on whether the muscles have been touched by the needle. Proximity of needle is detected by a capacitive sensing scheme. A Virtual Instrument developed measures output from capacitive sensing electrodes and presents it through an intuitive graphical user interface. The proposed touch and proximity detection schemes have been validated by tests performed on a prototype training manikin developed, thus demonstrating its use for practical purposes. © 2013 IEEE.

Conference Record - IEEE Instrumentation and Measurement Technology Conference

An intelligent ophthalmic regional anesthesia training system based on capacitive sensing

Restorative Dentistry & Endodontics

Statistical notes for clinical researchers: A one-way repeated measures ANOVA for data with repeated observations

Ophthalmic Surgery Simulator Training Improves Resident Performance of Capsulorhexis in the Operating Room

Evaluation of an ophthalmic anesthesia simulation system for regional block training

Journal	Data powered by TypesetOphthalmology
Publisher	Data powered by TypesetElsevier Inc.
ISSN	01616420
Open Access	No