When compared to general anaesthesia, regional anaesthesia – which numbs a larger area than local anaesthesia – could lead to better outcomes for patients, while also reducing costs. Despite this, largely due to a lack of adequate technology, only around one-third of anaesthesiologists are thought to regularly perform these procedures. Currently doing so requires anaesthesiologists to rely on their anatomical knowledge, and/or ultrasound interpretation skills, to locate the optimum site for injection. Philips, B. Braun and Oslo University Hospital partnered for the EU-supported INTUI-VIEW project which developed a needle tracking platform (Onvision) consisting of a portfolio of smart trackable needles, a point-of-care ultrasound system (Xperius) and a tracking module. The collaboration resulted in a market launch of this completely new solution, with the potential to revolutionise the field of regional anaesthesia. Overcoming adoption barriers One of the principle barriers to clinicians transferring from general to regional anesthesia, is its requirement for specific needle handling skills, with the use of ultrasound strongly advised. As many anesthesia departments do not have the required skills or equipment to perform peripheral nerve blocks, INTUI-VIEW set out to design a product that offered these. “We went through several design phases, each resulting in a prototype that was evaluated pre-clinically with clinicians for performance and ease of use. This learning became input for the next prototype, eventually leading to the final product specifications,” says Dr Henk Stapert. The Xperius system is a point-of-care ultrasound imager that uses ultrasound transducers, connected to a tablet via a USB. The system is operated through a touch screen, with the image quality superior, or equal, to competitors. Xperius comes with a linear and a curved transducer to enable the support of shallow and deep peripheral nerve blocks. For mobility, the system is mounted to a cart. The Onvision tracking system (developed by Philips) consists of a small hardware module integrated into the cart, along with a proprietary smart needle (developed by B. Braun). The tracking system uses ultrasound beams, alongside proprietary signal processing algorithms, to locate the needle in the field of view. Crucially, even though the imaging system is a 2D single plane image, Onvision can locate the needle outside of the ultrasound imaging plane, making it easier for users to align the needle with the ultrasound image. The system underwent extensive in-house laboratory tests by Philips, to assess critical to quality parameters and other functional and non-functional requirements. The technology was also trialled in human volunteers and patients by Oslo University Hospital, receiving positive feedback, especially relating to the increased control over the location of the needle tip. “This feedback from clinicians who liked the system, finding it helped them provide better patient care, was the most rewarding,” says Dr Stapert. Smarter patient care INTUI-VIEW will support easier access to safer and more patient-friendly anaesthesiology procedures, reducing hospital stays and associated healthcare costs. “Additionally, as this technology is new to the world, it underlines the power of European innovation, creating jobs ranging from marketing and sales, to service support and manufacturing,” says Dr Stapert. As only one needle type is currently available (100mm/20G), the team is working to release the entire needle portfolio (different lengths and gauge sizes). Additionally, the team is looking at other applications that could benefit from the Onvision technology, such as needles for vascular access.
INTUI-VIEW, general anaesthesia, regional anaesthesia, needle, ultrasound, transducer, nerves, patients