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Technical communication: First robotic ultrasound-guided nerve blocks in humans using the Magellan system
Thomas M Hemmerling1, Riccardo Taddei, Mohamad Wehbe
1Department of Anaesthesiology, McGill University, Montreal General Hospital, 1650 Cedar Avenue Montreal, Canada. thomas.hemmerling@mcgill.ca
Background:
Ultrasound-guided nerve blocks are becoming a standard of modern anesthesia. We developed a robotic system, Magellan, to perform nerve blocks using a remote control center.
Methods:
Thirteen patients were enrolled in this pilot study. The Magellan system consists of 3 main components: a joystick, a robotic arm, and a software control system. The joystick allows simulation of wrist or arm movements of the proceduralist. After localization of the sciatic nerve, 35 mL of bupivacaine 0.25% was injected. The success rate of sciatic nerve blocks and block performance times (performance time=interval of time from the start of the ultrasound search for the nerve to the end of the injection of the drug; robotic time=interval of time from the identification of the nerve to the end of the injection of the drug) were determined. Data are presented as median (25th, 75th; minimal, maximal) and categorical data.
Results:
Eight men and 5 women aged 34 years were included in this study. Nerve blocks were successful in all patients. A successful attempt was defined as the introduction of the needle into the nerve sheath; motor or sensory block was not used to determine the success rate. The nerve performance time was 189 seconds (150, 233; 90, 305), whereas the robotic time was 164 seconds (121, 210; 73, 271).
Conclusions:
We present the first human testing of a robotic ultrasound-guided nerve block system. The success rate was 100%. The total performance time was approximately 3 minutes to 4 minutes.
