Method and system for spinal cord stimulation prior to and during a medical procedure

• US 20020193843A1
• Filed: 08/09/2002
• Published: 12/19/2002
• Est. Priority Date: 09/26/2000
• Status: Active Grant

• Current Assignee: James R. Keogh, Michael R.S. Hill, Scott E. Jahns
• Original Assignee: James R. Keogh, Michael R.S. Hill, Scott E. Jahns
• Inventors: Keogh, James R., Jahns, Scott E., Hill, Michael R.S.
• Granted Patent: US 6,690,973 B2
• Time in Patent Office: Days
• US Class Current: 607/43
• CPC Class Codes: A61N 1/36014 External stimulators, e.g. with patch electrodes external pacemakers A61N1/3625
• CPC Class Codes: A61N 1/36021 for treatment of pain
• CPC Class Codes: A61N 1/3625 External stimulators
• CPC Class Codes: A61N 1/385 Devices for inducing an abnormal cardiac function, e.g. fibrillation

Abstract

A method of performing a medical procedure, such as surgery, is provided. The spinal cord is stimulated in order to control at least one physiological function. The medical procedure is performed and stimulation of the spinal cord is stopped.

Claims

1. A method of performing a medical procedure, comprising:

stimulating a spinal cord to control at least one physiological function;

performing the medical procedure; and

stopping stimulation of the spinal cord.

2. The method of claim 1 wherein the physiological function is a function of the lungs.

3. The method of claim 1 wherein the physiological function is a function of the heart.

4. The method of claim 1 wherein the physiological function is reducing pain.

5. The method of claim 1 wherein the spinal cord is stimulated intermittently.

6. The method of claim 1 further comprising:

delivering at least one drug during the medical procedure.

7. The method of claim 6 wherein the drug is selected from the group consisting of:

a beta-blocker, a cholinergic agent, a cholinesterase inhibitor, a calcium channel blocker, a sodium channel blocker, a potassium channel agent, adenosine, an adenosine receptor agonist, an adenosine deaminase inhibitor, dipyridamole, a monoamine oxidase inhibitor, digoxin, digitalis, lignocaine, a bradykinin agent, a serotoninergic agonist, an antiarrythmic agent, a cardiac glycoside, a local anesthetic, atropine, a calcium solution, an agent that promotes heart rate, an agent that promotes heart contractions, dopamine, a catecholamine, an inotrope glucagon, a hormone, forskolin, epinephrine, norepinephrine, thyroid hormone, a phosphodiesterase inhibitor, prostacyclin, prostaglandin and a methylxanthine.

8. The method of claim 6 wherein the drug is naturally occurring

9. The method of claim 6 wherein the drug is chemically synthesized.

10. The method of claim 1 wherein the medical procedure is selected from the group consisting of:

surgical procedures, non-surgical procedures, endoscopic procedures, fluoroscopic procedures, stent delivery procedures, aortic aneurysm repairs, cranial aneurysm repairs, delivery of drugs, delivery of biological agents, cardiac surgery with cardiopulmonary bypass circuits, cardiac surgery without cardiopulmonary bypass circuits, brain surgery, cardiograms, heart valve repair, heart valve replacement, MAZE procedures, revascularization procedures, transmyocardial revascularization, percutaneous myocardial revascularization, CABG procedures, anastomosis procedures, beating heart surgery, vascular surgery, neurosurgery, brain surgery, electrophysiology procedures, diagnostic procedures, therapeutic procedures, ablation procedures, ablation of arrhythmias, endovascular procedures, treatment of the liver, treatment of the spleen, treatment of the heart, treatment of the lungs, treatment of major blood vessels, non-invasive procedures, invasive procedures, port-access procedures, imaging procedures, CAT scan procedures, MRI procedures, gene therapy procedures, cellular therapy procedures, cancer therapy procedures, radiation therapy procedures, transplantation procedures, coronary angioplasty procedures, atherectomy procedures, atherosclerotic plaque removal procedures and birthing procedures.

11. The method of claim 1 wherein the spinal cord is accessed in an access method selected from the group consisting of:

intrathecal access, epidural access, and transcutaneous access.

13. The system of claim 12 further comprising:

drug delivery means for delivering at least one drug during the medical procedure.

14. The system of claim 12 wherein the drug delivery means are selected from the group consisting of:

a spray, a cream, an ointment, a medicament, a pill, a patch, a catheter, a cannula, a needle and syringe, a pump, and an iontophoretic drug delivery device.

15. The system of claim 12 wherein the nerve stimulator stimulates a nerve from the group consisting of:

vagus nerve fibers, hypoglossal nerve fibers, phrenic nerve fibers, parasympathetic nerve fibers, and sympathetic nerve fibers.

16. The system of claim 12 wherein the nerve stimulator stimulates a nerve selected from the group consisting of:

a vagal nerve, a carotid sinus nerve, a fat pad.

17. The system of claim 12 wherein the spinal stimulator comprises at least one electrode.

18. The system of claim 17 wherein the electrode is selected from the group consisting of:

spinal stimulation electrodes, balloon-type electrodes, basket-type electrodes, umbrella-type electrodes, suction-type electrodes, guided catheters, guided electrodes, steerable catheters, and steerable electrodes.

19. The system of claim 12 wherein the nerve stimulator comprises at least one electrode.

20. The system of claim 19 wherein the electrode is selected from the group consisting of:

nerve stimulation electrodes, endotracheal electrodes, endoesophageal electrodes, intravascular electrodes, transcutaneous electrodes, intracutaneous electrodes, balloon-type electrodes, basket-type electrodes, umbrella-type electrodes, tape-type electrodes, suction-type electrodes, screw-type electrodes, barb-type electrodes, bipolar electrodes, monopolar electrodes, metal electrodes, wire electrodes, patch electrodes, cuff electrodes, clip electrodes, needle electrodes and probe electrodes.

21. The system of claim 12 wherein the cardiac stimulator comprises at least one electrode.

22. The system of claim 20 wherein the electrode is selected from the group consisting of:

cardiac stimulation electrodes, clip electrodes, needle electrodes, probe electrodes, pacing electrodes, epicardial electrodes, patch electrodes, intravascular electrodes, balloon-type electrodes, basket-type electrodes, tape-type electrodes, umbrella-type electrodes, suction-type electrodes,endotracheal electrodes, endoesophageal electrodes, transcutaneous electrodes, intracutaneous electrodes, screw-type electrodes, barb-type electrodes, bipolar electrodes, monopolar electrodes, metal electrodes, wire electrodes and cuff electrodes.

24. The method of claim 23 further comprising:

stopping stimulation of the nerve before stimulating the heart.

26. The device of claim 25 further comprising:

a cardiac stimulation electrode operatively connected to the processor, wherein the processor processes output from the spinal stimulation electrode and adjusts output from the cardiac stimulation electrode based on output from the spinal stimulation electrode.

12. A system for performing a medical procedure, comprising:

a spinal stimulator to reduce pain during the medical procedure;

a nerve stimulator in communication with the spinal stimulator to inhibit beating of the heart; and

a cardiac stimulator in communication with the spinal stimulator to stimulate beating of the heart.

23. A method of performing heart surgery, comprising:

stimulating a spinal cord to control pain;

stimulating a nerve to reduce beating of a heart;

operating on the heart;

reducing stimulation of the nerve;

stimulating the heart to cause beating of the heart;

re-stimulating the nerve to re-inhibit beating of the heart; and

continuing the surgery.

25. A device for controlling pain during a medical procedure comprising:

a processor;

a spinal stimulation electrode, the spinal stimulation electrode operatively connected to the processor; and

a nerve stimulation electrode operatively connected to the processor, wherein the processor processes output from the spinal stimulation electrode and adjusts output from the nerve stimulation electrode based on output from the spinal stimulation electrode.

27. A method of delivering a baby comprising the steps of:

stimulating the spinal cord to control pain;

delivering the baby; and

stopping stimulation of the spinal cord.