{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T22:45:15Z","timestamp":1775256315038,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2018,10,23]],"date-time":"2018-10-23T00:00:00Z","timestamp":1540252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 103-2221-E-010 -009"],"award-info":[{"award-number":["MOST 103-2221-E-010 -009"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 104-2221-E-075 -002"],"award-info":[{"award-number":["MOST 104-2221-E-075 -002"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 105-2221-E-182-039"],"award-info":[{"award-number":["MOST 105-2221-E-182-039"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 106-2221-E-182-005"],"award-info":[{"award-number":["MOST 106-2221-E-182-005"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 107-2221-E-182 -075 -MY2"],"award-info":[{"award-number":["MOST 107-2221-E-182 -075 -MY2"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPD2G0331"],"award-info":[{"award-number":["CMRPD2G0331"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPD2H0041"],"award-info":[{"award-number":["CMRPD2H0041"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPD2F0103"],"award-info":[{"award-number":["CMRPD2F0103"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Purpose: Technology of reflectance spectroscopy incorporated with auto-fluorescence spectroscopy were employed to increase the safety of epidural placement in regional anesthesia which is generally used for surgery, epidural anesthesia, post-operative pain control and painless childbirth. Method: Ex vivo study of auto-fluorescence spectroscopy was performed for the para-vertebral tissues contained fat, interspinous ligament, supraspinous ligament and ligamentumflavum by multimode microplate reader at wavelength 405 nm for the purpose of tissue differentiation. A specially designed optic-fiber-embedded needle was employed to incorporate with both reflectance and autofluorescence spectroscopies in order to probe the epidural space as double assurance demands. In vivo study was carried out in a Chinese native swine weighted about 30 kg under intubated general anesthesia with ventilation support. The reflective (405 nm) and autofluorescence signals (\u03bb and \u03bb*) were recorded at 5 different sites by an oscilloscope during the needle puncture procedure from skin to epidural space in the back of the swine. Results: Study of either autofluorescence spectroscopy for tissue samples or ex vivo needle puncture in porcine trunk tissues indicates that ligmentumflavum has at least 10-fold higher fluorescence intensity than the other tissues. In the in vivo study, ligamentumflavum shows a double-peak character for both reflectance and autofluorescence signals. The epidural space is located right after the drop from the double-peak. Both peaks of reflectance and fluorescence are coincident which ensures that the epidural space is correctly detected. Conclusions: The fiber-optical technologies of double-assurance demands for tissue discrimination during epidural needle puncture can not only provide an objective visual information in a real-time fashion but also it can help the operator to achieve much higher success rate in this anesthesia procedure.<\/jats:p>","DOI":"10.3390\/s18113592","type":"journal-article","created":{"date-parts":[[2018,10,24]],"date-time":"2018-10-24T02:59:40Z","timestamp":1540349980000},"page":"3592","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Double Assurance of Epidural Space Detection Using Fiberoptics-Based Needle Design and Autofluorescence Technologies for Epidural Blockade in Painless Labor"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9414-3798","authenticated-orcid":false,"given":"Cihun-Siyong Alex","family":"Gong","sequence":"first","affiliation":[{"name":"Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Portable Energy System Group, Green Technology Research Center, College of Engineering, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huang-Chang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, School of Electrical and Computer Engineering, College of Engineering, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taoyuan 33302, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, National Yang-Ming University, Taipei 11221, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3156-8139","authenticated-orcid":false,"given":"Chien-Kun","family":"Ting","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 11221, Taiwan"},{"name":"School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Hsun","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taoyuan 33302, Taiwan"},{"name":"School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,10,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1111\/aas.12360","article-title":"Major complications of epidural anesthesia: A prospective study of 5083 cases at a single hospital","volume":"58","author":"Kang","year":"2014","journal-title":"Acta Anaesthesiol. 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