Surgery – Instruments – External pressure applicator
Patent
1997-12-04
1999-08-03
Buiz, Michael
Surgery
Instruments
External pressure applicator
A61B 500
Patent
active
059318538
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
This invention pertains to physiologic tourniquets for use in surgery. In particular, the invention pertains to an electrically powered tourniquet having a configuration register for optimizing, customizing, simplifying, and reducing the time required for configuring tourniquet pressure settings, elapsed time limits and other parameters of tourniquet operation. The invention also pertains to a physiologic tourniquet having an event register for registering predetermined events during surgery concerning the application of pressure to a limb for occluding blood flow and for maintaining intravenous regional anesthesia, in order to help improve patient outcomes and reduce recurrences of tourniquet-related events associated with injuries to patients.
BACKGROUND OF THE INVENTION
This invention pertains to tourniquets for facilitating surgical procedures performed on upper and lower limbs. Surgical tourniquets are generally employed to establish a bloodless operative field in a limb distal to an encircling cuff by regulating a pressure applied to the limb by the cuff near a pressure sufficient to stop arterial blood flow past the cuff during the surgical procedure. Surgical tourniquets of the prior art typically include an inflatable cuff for encircling a limb, an automatic pressure regulator for inflating the cuff to maintain a pressure applied by the cuff to the limb near a reference pressure selected by an operator or determined automatically, an elapsed time indicator to indicate the duration of application of pressure to the limb and an operator interface to facilitate operator control and interaction. A typical pneumatic tourniquet of the prior art is disclosed by McEwen in U.S. Pat. No. 4,469,099.
A "physiologic tourniquet" is generally considered to be a tourniquet which has the capability of maintaining the pressure applied by the cuff to the limb near the minimum pressure required to stop the flow of arterial blood past the cuff during the surgical procedure. This minimum pressure is affected by variables related to the physiology of the surgical patient, the type of surgical procedure to be performed and its likely duration, the type of cuff employed and its location and snugness on the limb, the technique employed by the surgeon and the anesthetist, and other factors. Tourniquet apparatus useful in automatically estimating and employing such a minimum pressure is disclosed by McEwen in U.S. Pat. No. 4,479,494, in U.S. Pat. No. 4,770,175 and in a pending U.S. Divisional patent application having Ser. No. 08/128,478 filed on Sep. 28, 1993.
Surgical tourniquets are typically employed as follows. A suitable inflatable cuff is first selected by an operator and applied snugly to the limb on which surgery is to be performed so that the cuff is located between the heart and the operative site on the limb. Considerations involving the design, selection and application of cuffs have been described by McEwen, for example in U.S. Pat. No. 4,605,010, in U.S. Pat. No. 5,181,522 and in U.S. Pat. No. 5,312,431. After application of a suitable cuff, the portion of the limb distal to the cuff is then exsanguinated, often by wrapping the limb with an elastic bandage, beginning at the end of the limb and wrapping tightly towards the heart up to the cuff location. While the limb is thus exsanguinated, the tourniquet instrument is typically used to inflate the cuff and maintain it at a predetermined cuff pressure sufficient to stop the inflow of arterial blood past the cuff. The elastic bandage is then removed and surgery proceeds. The pressure applied by the cuff may be changed periodically or continuously during the surgical procedure in an effort to maintain a bloodless surgical site while employing the minimum cuff pressure required to do so, as explained more fully below. Upon completion of the surgical procedure, the cuff is depressurized and removed from the patient, allowing arterial blood to flow freely into the limb.
During certain surgical procedures performed under intravenous regiona
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Jameson Michael
McEwen James A.
Buiz Michael
Trinh Vikki
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