Obstetric Analgesia System

• US 20070233203A1
• Filed: 01/26/2007
• Published: 10/04/2007
• Est. Priority Date: 02/01/2006
• Status: Active Grant

• Current Assignee: Convergent Engineering, Inc., University of Florida Research Foundation, Incorporated (State University System of Florida)
• Original Assignee: University of Florida Research Foundation, Incorporated (State University System of Florida)
• Inventors: Marossero, Dorothee, Euliano, Tammy, Euliano, Neil, Principe, Jose
• Granted Patent: US 7,942,818 B2
• Time in Patent Office: Days
• US Class Current: 607/46
• CPC Class Codes: A61B 5/033 Uterine pressure
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/4356 Assessing uterine contractions A61B5/033 takes precedence
• CPC Class Codes: A61B 5/7221 Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61N 1/36021 for treatment of pain

Abstract

The present invention relates to systems and methods for providing a short-acting analgesic agent in the management of pain during labor, wherein the system enables efficient, real-time prediction of contractions for the coordinated administration of analgesia such that the peak effectiveness of the analgesic coincides with the intermittent pain of labor.

Claims

1. A maternal labor pain management system comprising:

a) at least one pain management means;

b) a system for administering the pain management means; and

c) a system for analyzing uterine activity in the prediction of labor contractions to establish time of contraction pain relevant for use in coordinating the administration of the pain management means, wherein the system for analyzing uterine activity provides at least one signal regarding the time of contraction pain and wherein the system for analyzing uterine activity is operably connected to the system for administering the pain management means.

2. The maternal labor pain management system of claim 1, wherein at least two pain management means are provided.

3. The maternal labor pain management system of claim 1, wherein the pain management means is selected from the group consisting of:

analgesics, anesthetics, sedatives, tranquilizers, narcotic antagonist combinations, and electrical stimulation devices.

4. The maternal labor pain management system of claim 3, wherein the pain management means is an intravenous analgesic that is highly titratable with a rapid and predictable onset and short duration of bioactivity.

5. The maternal labor pain management system of claim 4, wherein the analgesic is Remifentanil.

6. The maternal labor pain management system of claim 1, wherein the system for administering the pain management means is a patient controlled system.

7. The maternal labor pain management system of claim 1, wherein the signal(s) regarding time of contraction pain is provided audibly, visibly or tactilely.

8. The maternal labor pain management system of claim 1, wherein the system for administering the pain management means is responsive to the signal regarding the time of contraction pain to automatically initiate and cease the delivery of the pain management means.

9. The maternal labor pain management system of claim 1, wherein the system for analyzing uterine activity comprises:

a) at least two surface sensors to receive a mixture of maternal and fetal vital signals; and

b) a computing means for analyzing the mixture of maternal and fetal vital signals from the sensors, said computing means including hardware and software, wherein said software comprises a function to separate maternal from fetal vital signals;

a quality assessing function for establishing the quality of the separated maternal and fetal vital signals;

an EHG extraction function; and

a function for assessing distress in relation to the pain management delivery.

10. The maternal labor pain management system of claim 1, wherein the system for analyzing uterine activity is any one or combination selected from the group consisting of:

maternal sensation, an intrauterine pressure catheter, a tocodynamometer, and a uterine electromyogram.

11. A method for administering an analgesic to an obstetric patient, where said method comprises:

a) utilizing a system for analyzing uterine activity in the prediction of labor contractions to establish time of contraction pain and optimal time of analgesic administration, said system comprising;

i) at least two surface sensors to receive a mixture of maternal and fetal vital signals, each sensor generating an output signal; and

ii) a computing means for analyzing the mixture of maternal and fetal vital output signals from the sensors, said computing means including hardware and software, wherein said software comprises a function to separate maternal from fetal vital signals;

a quality assessing function for establishing the quality of the separated maternal and fetal vital signals;

an EHG extraction function; and

a function for assessing distress in relation to the pain management delivery, and

b) receiving into the computing means at least one of the signals;

c) implementing the computing means, without clinician input, to evaluate the at least one output signal to determine the appropriate time for administering the analgesic to the patient; and

d) recommending, without clinician input, a time for administering the analgesic based on the evaluation of the at least one output signal by the computing means, wherein said administration time is appropriate for the patient at that particular contraction.

12. The method of claim 11, further comprising providing an analgesic delivery means adapted to supply the analgesic to a patient, wherein the analgesic delivery means is operatively connected to the computing means and connected to the patient, and wherein the analgesic delivery means includes at least one control for delivering the analgesic to the patient, wherein each control controls a parameter relating to the supply of the analgesic to the patient.

13. The method of claim 12, further comprising the step of automatically delivering the analgesic to the patient based on the recommendation derived from step (d).

14. The method of claim 12, wherein the analgesic delivery means further includes a gas mixing valve for a volatile anesthetic or gas.

15. The method of claim 14, wherein the volatile gas is nitrous oxide.

16. The method of claim 11, wherein the analgesic is an intravenous analgesic.

17. The method of claim 16, wherein the analgesic is Remifentanil.

18. The method of claim 11, further comprising the step of signaling the appropriate time for administering the analgesic to the patient.

19. The method of claim 18, wherein the signal is an audible signal.

20. The method of claim 18, wherein the signal is a visible signal.

21. The method of claim 18, wherein the signal is a tactile signal.

22. The method of claim 11, wherein the system for analyzing uterine activity can further include any one or combination selected from the group consisting of:

maternal sensation, an intrauterine pressure catheter, a tocodynamometer, and a uterine electromyogram.

23. The method of claim 11, wherein the computing means further comprises a neural network.

24. The method of claim 11, further comprising the step of administering electrical stimulation.