APPARATUS AND METHOD FOR THE APPLICATION OF A CONTINUOUS SOMATIC NERVE BLOCK

• US 3,854,477 A
• Filed: 04/06/1973
• Issued: 12/17/1974
• Est. Priority Date: 04/06/1973
• Status: Expired due to Term

• Current Assignee: Stuart L. Smith
• Original Assignee: Stuart L. Smith
• Inventors: Smith, Stuart L.
• Primary Examiner(s): Pace, Channing L.
• Application Number:
  US05/348,611
• Time in Patent Office: 620 Days
• Field of Search: 128/1R,213,33R,348,35R
• US Class Current: 604/512
• CPC Class Codes: A61M 25/0069 Tip not integral with tube
• CPC Class Codes: A61M 25/09 Guide wires

Abstract

A method of applying an analgesic for controlling postoperative pain, where somatic nerves in the patient'"'"''"'"'s body are severed, as during an operation. A stylette is used to thread a porous infusion tube through the patient'"'"''"'"'s body wall along a course which traverses the nerves to be blocked After the infusion tube is properly located, analgesic delivered into the tube will pass through the wall of the tube into the patient'"'"''"'"'s body at the nerve locations. The stylette is a curved rod whose diameter is the same as the infusion tube. The point at the leading end is rounded. A stub at the trailing end connects with the infusion tube, all in an arrangement to permit effective threading and placement of the tube.

Claims

1. A method for placing the porous section of an infusion tube, having a porous section and a non-porous section, in the body wall of a patient, for applying an analgesic to control postoperative pain where somatic nerves are severed by an incision in the patient'"'"''"'"'s body wall, which includes the steps of:

a. locating the paths of the nerves severed by the incision and selecting a course in the patient'"'"''"'"'s body wall which traverses the severed nerves between the spinal column and the points of severance, which is spaced from the incision in undamaged tissue and which is located between layers of fascia and/or muscle adjacent to the somatic nerves to minimize disruption of body tissue and the amounts of analgesic needed to reach the nerves;

b. implanting the porous section of the infusion tube in the patient'"'"''"'"'s body wall at the selected course and alongside the severed nerves, with the non-porous section of the tube extending from the patient'"'"''"'"'s body wall at one end of the course; and

c. delivering fluid analgesic into the tube whereby the same will flow into the porous section within the patient'"'"''"'"'s body wall and thence to tissue including nerves alongside the porous section of the tube.

2. In the method set forth in claim 1, wherein:

said course is within the fascia forming the sheath of the rectus muscle.

3. In the method set forth in claim 1, wherein:

said course is in the cleft between the internal oblique muscles and the transversus abdominus muscles.

4. In the method set forth in claim 1, wherein the infusion tube is implanted in the patient'"'"''"'"'s body wall by the steps of:

a. connecting one end of the tube to the stub end of a stylette having substantially the same diameter as the external diameter of the tube, a Curvature generally correlated with the selected course through the body wall and a length greater than the course by a short distance sufficient to facilitate handling the stylette;

b. inserting the point of the stylette into the patient'"'"''"'"'s body wall at one end of said course, threading the same through the course at a depth which permits the stylette to lie alongside the severed nerves and projecting the point of the stylette from the body wall at the opposite end of the course; and

c. pulling the stylette through the selected course in the patient'"'"''"'"'s body wall whereby to pull the infusion tube into place.

5. In the method defined in claim 1, wherein the steps of implanting the infusion tube in the patient'"'"''"'"'s body wall are performed during the operation while the incision in the patient'"'"''"'"'s body wall is open, whereby to facilitate guiding the stylette along the selected course by reaching into the incision.

6. In the method defined in claim 5, including the step of:

nicking the skin of the patient'"'"''"'"'s body wall at the point where threading of the stylette commences and nicking the skin at the patient'"'"''"'"'s body wall at the opposite end of the course where the point of the stylette projects from the patient'"'"''"'"'s body.

7. In the method defined in claim 1, wherein:

the analgesic is administered by the step of connecting a syringe carrying the analgesic to the tube.

8. In the method defined in claim 1, wherein:

the analgesic is administered by the step of connecting a bottle containing the analgesic to the tube.

9. A stylette for threading a small diameter infusion tube through a selected distance along a curving course of a patient'"'"''"'"'s body wall such as within the fascia forming the sheath of the rectus muscle and comprising, in combination with the tube:

a. a slender, smooth, rod-like member having a diameter substantially the same as the external diameter of the infusion tube, having a length in excess of the aforesaid selected distance sufficient to handle the stylette while inserting it into the patient'"'"''"'"'s body and a curvature which is generally correlated with the curvature of the patient'"'"''"'"'s body wall along the selected distance;

b. a dulled point at one end of the stylette; and

c. an abutment at the opposite end of the stylette to abut with an end of the tube and a means at this opposite abutment end to securely connect the abutting end of the tube thereto.

10. In the stylette defined in claim 9, where the curvature is essentially a segment of an elipse with the smaller radius of curvature being at the point end of the same.

11. In the stylette defined in claim 9, wherein the point is smooth and rounded to minimize the chance of the point piercing or cutting a vein or a nerve.

12. In the stylette defined in claim 9, wherein:

the point of the stylette is generally chisel-shaped with all edges being rounded at a radius from between 1/64 - 1/32 inch.