OSA's Digital Library

Virtual Journal for Biomedical Optics

Virtual Journal for Biomedical Optics


  • Editor: Gregory W. Faris
  • Vol. 5, Iss. 10 — Jul. 19, 2010

Technique of fiber optics used to localize epidural space in piglets

Chien-Kun Ting and Yin Chang  »View Author Affiliations

Optics Express, Vol. 18, Issue 11, pp. 11138-11147 (2010)

View Full Text Article

Enhanced HTML    Acrobat PDF (1335 KB) Open Access

Browse Journals / Lookup Meetings

Browse by Journal and Year


Lookup Conference Papers

Close Browse Journals / Lookup Meetings

Article Tools



Technique of loss-of-resistance in epidural block is commonly used for epidural anesthesia in humans with approximately 90% successful rate. However, it may be one of the most difficult procedures to learn for anesthesia residents in hospital. A two-wavelength (650 nm and 532 nm) fiber-optical method has been developed according to the characteristic reflectance spectra of ex-vivo porcine tissues, which are associated with the needle insertion to localize the epidural space (ES). In an in-vivo study in piglets showed that the reflected lights from ES and its surrounding tissue ligamentum flavum (LF) are highly distinguishable. This indicates that this technique has potential to localize the ES on the spot without the help of additional guiding assistance.

© 2010 OSA

OCIS Codes
(120.0120) Instrumentation, measurement, and metrology : Instrumentation, measurement, and metrology
(170.0170) Medical optics and biotechnology : Medical optics and biotechnology

ToC Category:
Medical Optics and Biotechnology

Original Manuscript: March 1, 2010
Revised Manuscript: April 13, 2010
Manuscript Accepted: April 19, 2010
Published: May 11, 2010

Virtual Issues
Vol. 5, Iss. 10 Virtual Journal for Biomedical Optics

Chien-Kun Ting and Yin Chang, "Technique of fiber optics used to localize epidural space in piglets," Opt. Express 18, 11138-11147 (2010)

Sort:  Author  |  Year  |  Journal  |  Reset  


  1. C. K. Ting, M. Y. Tsou, P. T. Chen, K. Y. Chang, M. S. Mandell, K. H. Chan, and Y. Chang, “A new technique to assist epidural needle placement: fiberoptic-guided insertion using two wavelengths,” Anesthesiology 112(5), 1128–1135 (2010). [CrossRef] [PubMed]
  2. P. R. Bromage, “Epidural Analgesia” (W. B. Saunders, 1978).
  3. M. J. Cousins, and B. T. Veering, “Epidural neural block,” in Neural Blockade in Clinical Anesthesia and Management of Pain, 3rd ed., M. J. Cousins, P. O. Bridenbaugh, eds. (Lippincott-Raven, 1998), pp. 243–321.
  4. J. R. Rigg, K. Jamrozik, P. S. Myles, B. S. Silbert, P. J. Peyton, R. W. Parsons, K. S. Collins, and MASTER Anaethesia Trial Study Group, “Epidural anaesthesia and analgesia and outcome of major surgery: a randomized trial,” Lancet 359(9314), 1276–1282 (2002). [CrossRef] [PubMed]
  5. M. Curatolo, A. Orlando, A. M. Zbinden, P. Scaramozzino, and F. S. Venuti, “A multifactorial analysis to explain inadequate surgical analgesia after extradural block,” Br. J. Anaesth. 75(3), 274–281 (1995). [PubMed]
  6. P. H. Pan, T. D. Bogard, and M. D. Owen, “Incidence and characteristics of failures in obstetric neuraxial analgesia and anesthesia: a retrospective analysis of 19,259 deliveries,” Int. J. Obstet. Anesth. 13(4), 227–233 (2004). [CrossRef] [PubMed]
  7. G. R. de Filho, H. P. Gomes, M. H. da Fonseca, J. C. Hoffman, S. G. Pederneiras, and J. H. Garcia, “Predictors of successful neuraxial block: a prospective study,” Eur. J. Anaesthesiol. 19(6), 447–451 (2002). [PubMed]
  8. J. Sprung, D. L. Bourke, J. Grass, J. Hammel, E. Mascha, P. Thomas, and I. Tubin, “Predicting the difficult neuraxial block: a prospective study,” Anesth. Analg. 89(2), 384–389 (1999). [CrossRef] [PubMed]
  9. D. D. Hood and D. M. Dewan, “Anesthetic and obstetric outcome in morbidly obese parturients,” Anesthesiology 79(6), 1210–1218 (1993). [CrossRef] [PubMed]
  10. C. Konrad, G. Schüpfer, M. Wietlisbach, and H. Gerber, “Learning manual skills in anesthesiology: is there a recommended number of cases for anesthetic procedures?” Anesth. Analg. 86(3), 635–639 (1998). [CrossRef] [PubMed]
  11. A. M. Dogliotti, “Segmental peridural spinal anesthesia: a new method of block anesthesia,” Am. J. Surg. 20, 107–118 (1993). [CrossRef]
  12. T. Nagaro, T. Yorozuya, M. Kamei, N. Kii, T. Arai, and S. Abe, “Fluoroscopically guided epidural block in the thoracic and lumbar regions,” Reg. Anesth. Pain Med. 31(5), 409–416 (2006). [PubMed]
  13. B. C. Tsui, P. Tarkkila, S. Gupta, and R. Kearney, “Confirmation of caudal needle placement using nerve stimulation,” Anesthesiology 91(2), 374–378 (1999). [CrossRef] [PubMed]
  14. T. J. Lechner, M. G. van Wijk, A. J. Maas, F. R. van Dorsten, R. A. Drost, C. J. Langenberg, L. J. Teunissen, P. H. Cornelissen, and J. van Niekerk, “Clinical results with the acoustic puncture assist device, a new acoustic device to identify the epidural space,” Anesth. Analg. 96(4), 1183–1187 (2003). [CrossRef] [PubMed]
  15. M. P. Lewis, P. Thomas, L. F. Wilson, and R. C. Mulholland, “The ‘whoosh’ test,” Anaesthesia 47(1), 57–58 (1992). [CrossRef] [PubMed]
  16. B. C. Tsui, C. Guenther, D. Emery, and B. Finucane, “Determining epidural catheter location using nerve stimulation with radiological confirmation,” Reg. Anesth. Pain Med. 25(3), 306–309 (2000). [PubMed]
  17. M. K. Karmakar, X. Li, A. M. Ho, W. H. Kwok, and P. T. Chui, “Real-time ultrasound-guided paramedian epidural access: evaluation of a novel in-plane technique,” Br. J. Anaesth. 102(6), 845–854 (2009). [CrossRef] [PubMed]
  18. Ghia Jn, M. Arora Sk, Castillo, and Mukherji Sk, “Confirmation of location of epidural catheters by epidural pressure waveform and computed tomography cathetergram,” Reg. Anesth. Pain Med. 26(4), 337–341 (2001). [PubMed]
  19. P. H. Lennox, H. S. Umedaly, R. P. Grant, S. A. White, B. G. Fitzmaurice, and K. G. Evans, “A pulsatile pressure waveform is a sensitive marker for confirming the location of the thoracic epidural space,” J. Cardiothorac. Vasc. Anesth. 20(5), 659–663 (2006). [CrossRef] [PubMed]
  20. T. Grau, R. W. Leipold, R. Conradi, and E. Martin, “Ultrasound control for presumed difficult epidural puncture,” Acta Anaesthesiol. Scand. 45(6), 766–771 (2001). [CrossRef] [PubMed]
  21. S. F. Chen, Y. Chang, and J. C. Wu, “The spatial distribution of macular pigment in humans,” Curr. Eye Res. 23(6), 422–434 (2001). [CrossRef]
  22. F. P. Bolin, L. E. Preuss, R. C. Taylor, and R. J. Ference, “Refractive index of some mammalian tissues using a fiber optic cladding method,” Appl. Opt. 28(12), 2297–2303 (1989). [CrossRef] [PubMed]
  23. M. Sand, T. Gambichler, G. Moussa, F. G. Bechara, D. Sand, P. Altmeyer, and K. Hoffmann, “Evaluation of the epidermal refractive index measured optical coherence tomography,” Skin Res. Technol. 12(2), 114–118 (2006). [CrossRef] [PubMed]
  24. H. Li and S. Xie, “Measurement method of the refractive index of biotissue by total internal reflection,” Appl. Opt. 35(10), 1793–1795 (1996). [CrossRef] [PubMed]
  25. M. Irie, “Evaluation of porcine fat with fiber-optic spectroscopy,” J. Anim. Sci. 77(10), 2680–2684 (1999). [PubMed]
  26. G. A. Mook, O. W. Van Assendelft, and W. G. Zijlstra, “Wavelength dependency of the spectrophotometric determination of blood oxygen saturation,” Clin. Chim. Acta 26(1), 170–173 (1969). [CrossRef] [PubMed]
  27. J. Reichman, “Determination of absorption and scattering coefficients for nonhomogeneous media. 1: Theory,” Appl. Opt. 12(8), 1811–1815 (1973). [CrossRef] [PubMed]
  28. R. L. Longini and R. Zdrojkowski, “A note on the theory of backscattering of light by living tissue,” IEEE Trans. Biomed. Eng. BME-15(1), 4–10 (1968). [CrossRef]
  29. W. F. Cheong, S. A. Prahl, and A. J. Welch, “A review of the optical properties of biological tissues,” IEEE J. Quantum Electron. 26(12), 2166–2185 (1990). [CrossRef]
  30. L. T. Perelman, V. Backman, M. Wallace, G. Zonios, R. Manoharan, A. Nusrat, S. Shields, M. Seiler, C. Lima, T. Hamano, I. Itzkan, J. Van Dam, J. Crawford, and M. Feld, “Observation of periodic fine structure in reflectance from biological tissue: a new technique for measuring nuclear size distribution,” Phys. Rev. Lett. 80(3), 627–630 (1998). [CrossRef]
  31. A. H. Hielscher, J. R. Mourant, and I. J. Bigio, “Influence of particle size and concentration on the diffuse backscattering of polarized light from tissue phantoms and biological cell suspensions,” Appl. Opt. 36(1), 125–135 (1997). [CrossRef] [PubMed]
  32. A. K. Popp, M. T. Valentine, P. D. Kaplan, and D. A. Weitz, “Microscopic origin of light scattering in tissue,” Appl. Opt. 42(16), 2871–2880 (2003). [CrossRef] [PubMed]
  33. R. D. Miller, “Miller's Anesthesia,” 7th ed., (Churchill Livingstone, 2009).
  34. H. Ellis, “The anatomy of the epidural space,” Anaesth. Intensive Care Med. 7(11), 402–404 (2006). [CrossRef]

Cited By

Alert me when this paper is cited

OSA is able to provide readers links to articles that cite this paper by participating in CrossRef's Cited-By Linking service. CrossRef includes content from more than 3000 publishers and societies. In addition to listing OSA journal articles that cite this paper, citing articles from other participating publishers will also be listed.

« Previous Article  |  Next Article »

OSA is a member of CrossRef.

CrossCheck Deposited