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WO2013045119A1 - Dispositif pour la détermination d'une anesthésie régionale périphérique à l'aide d'une photopléthysmographie sans contact - Google Patents

Dispositif pour la détermination d'une anesthésie régionale périphérique à l'aide d'une photopléthysmographie sans contact Download PDF

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Publication number
WO2013045119A1
WO2013045119A1 PCT/EP2012/055147 EP2012055147W WO2013045119A1 WO 2013045119 A1 WO2013045119 A1 WO 2013045119A1 EP 2012055147 W EP2012055147 W EP 2012055147W WO 2013045119 A1 WO2013045119 A1 WO 2013045119A1
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WO
WIPO (PCT)
Prior art keywords
ppg
anaesthesia
light
matrix
sensitive sensor
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Ceased
Application number
PCT/EP2012/055147
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English (en)
Inventor
Aleksejs Miščuks
Renārs Erts
Uldis RUBĪNS
Jānis SPĪGULIS
Māris Mihelsons
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Institute of Solid State Physics University of Latvia
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Institute of Solid State Physics University of Latvia
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Publication of WO2013045119A1 publication Critical patent/WO2013045119A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient; User input means
    • A61B5/742—Details of notification to user or communication with user or patient; User input means using visual displays

Definitions

  • the invention is intended for use in anaesthesia, namely, for the determination of efficiency of human anaesthesia after the peripheral nerve plexus block in regional anaesthesia (RA).
  • RA regional anaesthesia
  • Anaesthesia One of the main objectives of anaesthesia is to ensure a patient relief from pain.
  • Classically motor, sensory and sympathetic blocks are considered as positive effects of RA.
  • the determination of the level of regional anaesthesia basically includes testing of sensory functions and determination of physiological responses. Testing of sensory functions is only possible if the patient is conscious and cooperative enough. For the present there is no direct, the ideal method known for the determination of presence of RA or its degree for an unconscious patient.
  • Sensing threshold and the effect of RA is traditionally determined by the minimal needle stabs in determining loss of sensation or, determining by loss of sensation of coldness, after the contacting with cold, for example, an ice cube (according to neuroscience standards).
  • These clinical "sensory" RA methods are undeniably simple, but subjective and based on the doctor/patient contact. Unfortunately, the contacts tend to be more difficult due to objective reasons.
  • the variable level of the patient's consciousness should be noted, which depends on numerous factors - stress, the presence and severity of injuries, unusual circumstances, mental characteristics of age, underlying conditions, drug background, level of premedication and sedation level and so on.
  • the second part involves the direct measurement reflecting the neurophysiological changes of brain associated with stress and pain.
  • the third part is associated with physiological changes in response to RA administration. After the administration of RA, by the occurrence of adequate anaesthesia, sensory, motor and sympathetic blocks are expected, according to compromised innervation zone. If the sensory block cannot directly be measured, the sympathetic effects can be attempt to assess, and then after it implicitly judge about the expected sensory effects.
  • the sympathetic effect is associated with prominent peripheral vasodilation, peripheral blood flow increase and, as a result, increase of peripheral skin temperature.
  • Routine monitoring of temperature is very effective, but limited to very small skin surface, i.e., the temperature is determined only in the place of a temperature sensor attachment.
  • a thermal camera should be noted, allowing perform a graphical visualization of the dynamics of indirect RA starting process.
  • WO 2010075997 which provides at least one electronic temperature sensor placement on the skin surface within at least single dermatome.
  • the device gives an optical and/or acoustic signal for the situation, when the temperature measurement results changes of 2-3 °C, indicating a positive result of anaesthesia.
  • PAINVISION PS-210 (osachi Ltd, 2003) for the quantitative monitoring of perception, where observation parameters of common standard anaesthesiology (ECG, LA, etc.) and adjustable electric stimulus are used.
  • Photoplethysmography is a non-invasive optical method for measuring the blood volume pulsations. Method is based on the ability of optical radiation to penetrate tissue for several millimeters in depth. Radiation is absorbed in the soft tissues and blood. Due to the functioning of the heart and breathing, as well as a result of vasomotion, blood volume periodically changes, and the radiation intensity in the subcutaneous tissue is modulated due to these processes. Blood volume changes can be measured by using a method of PPG contact based on one or more radiation sources and a photodiode, which detects the radiation passed through skin (tissue) or reflected. PPG method is used for the detection of blood pulse and blood oxygen levels in commercial medical monitoring systems.
  • the pulse of blood volume can be measured only in a small skin (tissue) area that is in direct contact with the sensor.
  • the method becomes a non-contact PPG.
  • the sensor of video camera with lens can be used.
  • the image of skin surface is focused on the sensor, and the PPG signal is recorded in each skin point. So a two-dimensional distribution of PPG signal from the skin surface is obtained.
  • This technique is known as photoplethysmography imaging (PPGI).
  • PPGI photoplethysmography imaging
  • a sympathetic effect induced by RA causes increase of peripheral blood flow, resulting in increase of PPG signal amplitude in skin until it reaches a certain threshold.
  • the starting point of PPG amplitude increase may be considered as successful effect of the RA.
  • the researcher T.Wung from Aachen (Germany) in 2003 has designed a PPGI pilot device for monitoring of skin perfusion [T. Wu. PPGI: New Developments in Noninvasive and Contactless Diagnosis of Dermal Perfusion Using Near InfraRed Light. . GCPD e.V., 1 (1): p. 17-24, 2003].
  • the device consists of an infrared LED source and video camera.
  • the video camera was connected to a computer, and was operated using a controller, which ensured the operation of video camera in real-time, as well as a display of video material on the screen of monitor.
  • a computer program made a variety of image processing calculations, such as motion compensation, median filtering and image segmentation.
  • the objective of the invention is to create a new non-invasive and contactless device, by means of which it is possible to quantify the success and failure of RA and exclude the subjectivity in determination of RA.
  • the skin surface being anaesthetized is illuminated by visible or near infrared spectral range of radiation, which being reflected from the skin surface is registered with the light-sensitive sensor-matrix. Due to heart functioning blood volume under the skin periodically changes; as a result the radiation in the subcutaneous tissue is modulated.
  • the average (median) value of intensity in each frame is calculated.
  • the PPG signal is distributed, corresponding to the changes of intensity in cardiac frequency range, the signal amplitude for each cardiac cycle is calculated, and the changes of the signal amplitude is calculated. Every minute the average (median) value of PPG amplitude and the value of standard deviation in minute interval is calculated.
  • the invention creates non-invasive and contactless possibility for using the peripheral circulatory changes in the upper limb after Plexus brachialis regional block, being detected by the contactless PPG signal obtained from the reflected light during video recording in order to detect success or failure of RA.
  • Fig. 1 shows the principal scheme of the contactless regional anaesthesia monitoring
  • Fig. 2 shows the chart of the recorded PPG signal amplitude and the moment, when its increase was determined, meaning that the regional anaesthetic effect is starting;
  • Fig. 3 shows the block diagram of the contactless regional anaesthesia monitoring device.
  • the device for the contactless regional anaesthesia monitoring containing:
  • the radiation source 1 such as operating lamp or LED searchlight, by which the anesthetized skin surface is irradiated
  • the radiation source can be is a white light, a green light, or a near-infrared spectrum radiation source
  • the digital (preferably, monochrome) light-sensitive sensor-matrix 3 (for example, video camera) being provided with a lens, adapted to convert image in digital form by conferring to each pixel certain digital value and store it in the memory unit 4,
  • the analysis unit 5 adapted for calculation from video signal the PPG amplitude for each cardiac cycle, and calculation the average (median) value of the signal in predefined time interval;
  • the output device 7 for example, graphic display or numeric indicator, displaying time chart or numerical values of PPG amplitude
  • control unit 8 which is connected with the light source 1, the light-sensitive sensor- matrix 3 and the analysis unit 5, and is adapted to control their operation.
  • the device operates as follows: the control unit 8 sends a signal to the radiation source 1 , which irradiates the anesthetized skin surface.
  • the digital light-sensitive sensor 3 makes an image of the irradiated anesthetized skin surface and converts it into digital format, assigning to each pixel certain digital value being stored in the memory unit 4.
  • the analysis unit 5 from the video signal calculates PPG amplitude and its average (median) value, and the value of standard deviation in pre-defined time periods (e.g. 1 minute interval).
  • the analysis block 6 registers changes of the signal in the standard deviation interval between these time periods.
  • the anaesthetic effect is defined in case, if the standard deviation of signal does not overlap.
  • PPG amplitude time chart or numerical value is displayed in the output device 7. Measurements were made in the same room (operating room certified according to the ISO2000 standard with controlled air temperature of 23.2 ⁇ 0.8 °C). The measurement reference point is two minutes before the start of the manipulation (after temperature stabilization). The measuring duration took place up to 30 minutes.

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  • Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Spectroscopy & Molecular Physics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Optics & Photonics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

L'invention concerne une anesthésie, et, en particulier, la détermination de l'efficacité d'une anesthésie humaine et l'enregistrement de celle-ci, à l'aide d'un équipement de photopléthysmographie (PPG) sans contact. Le dispositif pour une détermination sans contact en temps réel de l'effet d'une anesthésie régionale comprend une source de lumière conçue pour une exposition à une lumière blanche de la surface de la peau qui est anesthésiée, une matrice de capteur sensible à la lumière RVB trichrome, conçue pour une conversion d'image dans un format numérique, affectant à chaque pixel d'image la plage de valeurs RVB déterminée, une mémoire de dispositif, conçue pour le stockage de ladite plage de valeurs, une unité d'analyse conçue pour le calcul d'une amplitude de signal photopléthysmographique (PPG) à partir du signal vidéo de canal de couleur verte V à chaque cycle cardiaque, et pour le calcul de valeurs médianes moyennes de PPG à partir de celle-ci dans l'intervalle de temps spécifié, un bloc d'analyse conçu pour enregistrer l'effet de l'anesthésie selon des changements d'amplitude de PPG, un dispositif de sortie conçu pour afficher un graphique chronologique ou des valeurs numériques de l'amplitude de PPG, une unité de commande, qui est reliée à la source de lumière, à la matrice de capteur sensible à la lumière et à l'unité d'analyse, et conçue pour commander leur fonctionnement.
PCT/EP2012/055147 2011-09-30 2012-03-22 Dispositif pour la détermination d'une anesthésie régionale périphérique à l'aide d'une photopléthysmographie sans contact Ceased WO2013045119A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
LVP-11-129A LV14444B (lv) 2011-09-30 2011-09-30 Paņēmiens un ierīce perifērās reģionālās anestēzijas iedarbības noteikšanai, izmantojot bezkontakta fotopletizmogrāfiju
LVP-11-129 2011-09-30

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WO2013045119A1 true WO2013045119A1 (fr) 2013-04-04

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108697345A (zh) * 2016-03-03 2018-10-23 松下知识产权经营株式会社 生物体信息提取装置和生物体信息提取系统
JP2019505263A (ja) * 2016-01-15 2019-02-28 コーニンクレッカ フィリップス エヌ ヴェＫｏｎｉｎｋｌｉｊｋｅ Ｐｈｉｌｉｐｓ Ｎ．Ｖ． 対象のバイタルサイン情報を含むフォトプレチスモグラフ画像を生成するデバイス、システム、及び方法

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WO2010075997A1 (fr) 2009-01-03 2010-07-08 Andreas Penno Dispositif et procédé destinés à contrôler la réussite d'anesthésies rachidiennes
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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2019505263A (ja) * 2016-01-15 2019-02-28 コーニンクレッカ フィリップス エヌ ヴェＫｏｎｉｎｋｌｉｊｋｅ Ｐｈｉｌｉｐｓ Ｎ．Ｖ． 対象のバイタルサイン情報を含むフォトプレチスモグラフ画像を生成するデバイス、システム、及び方法
CN108697345A (zh) * 2016-03-03 2018-10-23 松下知识产权经营株式会社 生物体信息提取装置和生物体信息提取系统
EP3424415A4 (fr) * 2016-03-03 2019-03-13 Panasonic Intellectual Property Management Co., Ltd. Dispositif d'extraction d'informations biologiques et système d'extraction d'informations biologiques

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LV14444B (lv) 2012-02-20
LV14444A (lv) 2011-12-20

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