Surgery – Diagnostic testing – Detecting muscle electrical signal
Patent
1997-05-23
1999-09-28
Hindenburg, Max
Surgery
Diagnostic testing
Detecting muscle electrical signal
600547, 600554, A61B 500
Patent
active
059578602
DESCRIPTION:
BRIEF SUMMARY
The present invention pertains to a device for the monitoring and/or controlling of the neuromuscular block, especially that produced by muscle relaxant drugs used during anaesthesia.
Primarily, the new method and apparatus allow a quantification and control of the neuromuscular block by means of transcutaneous stimulation directly on the muscle, stimulating the intramuscular nerve pathways and the neural part of the motor plate without the need of having to stimulate a peripheral motor nerve.
The invention also allows a controlled administration of the blocker drug during the induction of the anaesthesia, as well as control of the neuromuscular block during the operation and control of the recovery when being awakened from the anaesthesia.
ANTECEDENTS OF THE INVENTION
It is known that major advances in surgery have come about from the application of muscle relaxant drugs during anaesthesia, which in addition to facilitating the work of the surgeon also allows a less traumatic intubation and facilitates mechanical respiration.
Likewise, muscle relaxation allows improved mechanical ventilation for intubated patients at intensive care wards.
It is also known that there are various factors which influence the duration and effect of the muscle relaxants, depending among other things on the body weight, the age, the physical condition and possible pathologies of the patient to whom this type of drug is being administered. In the event that the dose is insufficient, the intubation and the subsequent surgery might become more difficult; in the case of overdosage, the patient upon awakening from the anaesthesia might present respiratory insufficiency and a need for prolonged artificial respiration, which would delay their leaving the operating theater or their admission to a special care ward.
Other dangers of overdosage or poor reversal of the effects of muscle relaxants might be serious complications such as aspiration of vomit on account of faulty reflexes or respiratory failure, which complications may eventually cause the death of the patient.
In order to avoid these complications, at present, the status of the neuromuscular block is evaluated by means of stimulation of a peripheral motor nerve and measurement of the degree of motility of the muscle innervated by said nerve.
There are various methods and devices designed to stimulate peripheral nerves by means of transcutaneous electrodes, for example, the stimulators of Neuro Technology, Inc., Houston, Tex., U.S.A. The most important problem lies in the evaluation or measurement and monitoring of the neuromuscular block and the adequate administration of the muscle relaxant drug to maintain the desired level of blockage. At present, the evaluation of the block is done by evaluation of the electrical activity, the force or the movement of the muscle during its contraction. The methods used up to the present date are: the stimulation of the motor nerve which innervates it. The inexactitude and difficulty of quantification of the method are obvious, but its simplicity makes it the one which is used most frequently today. the evaluation is done by means of the perception through the hand of the anesthesiologist of the force of contraction of the patient after the stimulus. As in the preceding case, it is a subjective and inexact method, offering little guarantee of determining the exact degree of neuromuscular blockage. muscular electrical activity evoked by stimulating the motor nerve which innervates said muscle. There are various devices and apparatus on the market, which monitor the neuromuscular block by said technique, which is described, for example, in U.S. Pat. No. 4,291,705, among others. The primary problem which this technique entails is its difficulty of application and the sophistication of the equipment, so that it has only been used essentially in research, without coming to be used as a practical and routine technique. the thumb when the ulnar nerve is stimulated. Again, there are various devices on the market, such as the "Relaxograph" of Bi
REFERENCES:
patent: 3898983 (1975-08-01), Elam
patent: 4088133 (1978-05-01), Twentier
patent: 4291705 (1981-09-01), Severinghaus et al.
patent: 4432368 (1984-02-01), Russek
patent: 4848359 (1989-07-01), Bournonville
patent: 5016635 (1991-05-01), Graupe
patent: 5061234 (1991-10-01), Chaney
patent: 5092344 (1992-03-01), Lee
patent: 5131401 (1992-07-01), Westenskow et al.
patent: 5256156 (1993-10-01), Kern et al.
patent: 5304206 (1994-04-01), Baker, Jr. et al.
patent: 5327902 (1994-07-01), Lemmen
patent: 5333618 (1994-08-01), Lekhtman et al.
patent: 5354320 (1994-10-01), Schaldach et al.
patent: 5368042 (1994-11-01), O'Neal et al.
patent: 5374283 (1994-12-01), Flick
patent: 5397338 (1995-03-01), Grey et al.
patent: 5443494 (1995-08-01), Paolizzi et al.
patent: 5540235 (1996-07-01), Wilson
LandOfFree
Method and apparatus for monitoring and/or controlling the neuro does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Method and apparatus for monitoring and/or controlling the neuro, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Method and apparatus for monitoring and/or controlling the neuro will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-696632