Apparatus for intravenous regional anesthesia

• US 5,352,195 A
• Filed: 08/27/1992
• Issued: 10/04/1994
• Est. Priority Date: 01/29/1990
• Status: Expired due to Term

• Current Assignee: Abatis Medical Technologies Limited, Zimmer Orthopaedic Surgical Products (Zimmer Biomet Holdings, Inc.)
• Original Assignee: IVRA Systems, Inc.
• Inventors: McEwen, James A.
• Primary Examiner(s): NOT, DEFINED
• Application Number:
  US07/935,785
• Time in Patent Office: 768 Days
• Field of Search: 604/30, 604/31, 604/65-67, 606/201-203, 128/677, 128/686, 128/783, 128/744, 128/DIG. 12, 128/DIG. 13
• US Class Current: 604/66
• CPC Class Codes: A61B 17/1355 Automated control means therefor
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 5/02255 the pressure being controlled by plethysmographic signals, e.g. derived from optical sensors
• CPC Class Codes: A61B 5/1106 to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia
• CPC Class Codes: A61B 5/6828 Leg
• CPC Class Codes: A61B 5/6829 Foot or ankle
• CPC Class Codes: A61B 5/6885 Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• CPC Class Codes: A61B 8/488 involving Doppler signals
• CPC Class Codes: Y10S 128/12 Pressure infusion
• CPC Class Codes: Y10S 128/13 Infusion monitoring

Abstract

Apparatus for assisting in the administration of anesthesia in a portion of a patient'"'"'s limb distal to a cuff comprises in combination: applied pressure transducing means for generating an applied pressure signal representative of a pressure applied to a limb by a cuff which encircles the limb and applies pressure to the limb; anesthetic pressure sensing means for sensing the pressure of anesthetic liquid in a vein distal to the cuff and for generating an anesthetic liquid pressure signal indicative of the pressure; and alarm means for producing an alarm signal when the difference between the pressures corresponding to the applied pressure signal and the anesthetic liquid pressure signal is less than a preassigned safety limit. The apparatus may include anesthetic control means responsive to the alarm signal for stopping the introduction of anesthetic liquid when the difference is less than a preassigned limit, anesthetic concentration sensing means for estimating the concentration of anesthetic liquid in the blood, and anesthetic level estimation means for estimating the level of anesthesia in the portion of the limb distal to the cuff.

Claims

1. Apparatus for monitoring the administration of liquid anesthesia in a portion of a patient'"'"'s limb distal to a cuff, comprising in combination:

(a) applied pressure transducing means for generating an applied pressure signal representative of a pressure applied to a limb by a cuff which encircles the limb and applies pressure to the limb;

(b) anesthetic pressure sensing means for sensing the pressure of anesthetic liquid in a vein distal to the cuff and for generating an anesthetic liquid pressure signal indicative of the pressure;

(c) alarm mean for determining the difference between the pressures corresponding to the applied pressure signal and the anesthetic liquid pressure signal, for comparing the difference therebetween to a preassigned safety limit, and for producing an alarm signal when the difference is less than the preassigned safety limit; and

anesthetic delivery means for introducing anesthetic liquid into the vein in the limb, the anesthetic delivery means being responsive to the alarm signal for stopping the introduction of anesthetic liquid when the alarm signal is produced.

2. Apparatus for administering anesthesia in a portion of a patient'"'"'s limb distal to a cuff, comprising in combination:

(a) a cuff for encircling a limb and applying pressure to the encircled limb to restrict flow past the cuff proximally of liquid in a vein in the portion of the limb distal to the cuff;

(b) applied pressure transducing means for generating an applied pressure signal representative of a pressure applied to the vein by the cuff;

(c) anesthetic delivery means for introducing anesthetic liquid into the vein distal to the cuff and for generating a delivery pressure signal indicative of the pressure at which the liquid is introduced into the vein; and

(d) alarm means for determining the difference between the pressures corresponding to the applied pressure signal and the delivery pressure signal, for comparing the difference therebetween to a preassigned safety limit, and for producing an alarm signal when the difference is less than the preassigned safety limit.

3. Apparatus for controlling the containment and release of anesthetic liquid in a vein of a patient'"'"'s limb distal to a pressurizing cuff comprising:

(a) a pressurizing cuff for substantially encircling a limb and applying pressure to a vein in the encircled limb to restrict flow past the cuff proximally of anesthetic liquid contained in a vein from the portion of the limb distal to the cuff;

(b) anesthetic concentration sensing means for estimating the concentration of anesthetic liquid in blood and for producing an anesthetic concentration signal indicative of the concentration; and

(c) cuff pressure control means responsive to the anesthetic concentration signal for controlling the pressure applied by the cuff to the limb.

4. Apparatus as defined in claim 3, and including alarm means for comparing the concentration represented by the anesthetic concentration signal to a preassigned concentration safety limit and for generating an alarm signal when the concentration exceeds the concentration safety limit.

5. Apparatus as defined in claim 3, wherein the anesthetic concentration sensing means comprises:

(a) heart rate sensing means for sensing the heart rate of the patient and for producing a heart rate signal indicative of the patient'"'"'s heart rate;

(b) resistance sensing means for sensing the change in electrical resistance between two electrodes located at predetermined locations on the limb and for producing a resistance change signal representative of the change in electrical resistance; and

(c) signal generating means for producing an anesthetic concentration signal which is inversely proportional to the heart rate signal and directly proportional to the resistance change signal.

6. Apparatus as defined in claim 3, wherein the anesthetic concentration sensing means estimates the concentration of anesthetic liquid in blood distal to the cuff.

7. Apparatus as defined in claim 3, wherein the anesthetic concentration sensing means estimates the concentration of anesthetic liquid in blood proximal to the cuff.

8. Apparatus as defined in claim 7, wherein the cuff pressure control means restricts flow proximally past the cuff of anesthetic liquid to maintain the concentration of anesthetic liquid below a preassigned concentration.

9. Apparatus as defined in claim 7, wherein the cuff pressure control means permits flow proximally past the cuff of anesthetic liquid sufficient to increase the concentration of anesthetic liquid to a concentration near a preassigned concentration.

10. Apparatus for establishing a desired level of anesthesia in a portion of a limb, comprising:

(a) a pressurizing cuff for substantially encircling a limb and applying pressure to a vein in the encircled limb to restrict flow past the cuff proximally of liquid in the vein in the portion of the limb distal to the cuff;

b) anesthetic drug delivery means for introducing an anesthetic liquid into a vein distal to the cuff;

(c) anesthetic level estimation means for estimating a level of anesthesia in the limb and for producing an anesthetic level signal representative of the estimated level of anesthesia; and

(d) anesthetic control means responsive to the anesthetic level signal for determining the difference between the anesthetic level signal and a reference signal and for producing the anesthetic delivery signal when the difference is determined to be greater than a predetermined difference threshold.

11. Apparatus as defined in claim 10 and including anesthetic level alarm means responsive to the anesthetic level signal for comparing the level of anesthesia represented by the anesthetic level signal to a preassigned safety limit and for producing an anesthetic alarm signal when the level of anesthesia exceeds the preassigned safety limit.

12. Apparatus as defined in claim 10, wherein the anesthetic level estimation means estimates a level of anesthesia in the portion of the limb proximal to the cuff.

13. Apparatus as defined in claim 10, wherein the anesthetic level estimation means estimates a level of anesthesia in the portion of the limb distal to the cuff.

14. Apparatus as defined in claim 13, wherein the anesthetic level estimation means comprises:

(a) stimulating means for stimulating the limb at a first predetermined location on the limb at a predetermined stimulus time;

(b) detecting means to be positioned at a second predetermined location on the limb for producing a stimulation response signal representative of both the magnitude and the delay in time from the predetermined stimulus time of the response of the limb at the second predetermined location to the stimulating means; and

(c) signal generating means responsive to the stimulation response signal for producing an anesthetic level signal which is inversely proportional to the magnitude of the response and which is directly proportional to the delay in time from the predetermined stimulus time of the response of the limb at the second predetermined location to the stimulating means.

15. Apparatus for controlling the containment and release of anesthetic liquid in a vein of a patient'"'"'s limb, comprising:

(a) pressure application means for applying pressure to a vein in a limb to restrict flow proximally past the pressure application means of anesthetic liquid contained in the vein in the portion of the limb distal to the pressure application means;

(b) anesthetic concentration sensing means for estimating the concentration of anesthetic liquid in blood proximal to the cuff and for producing an anesthetic concentration signal indicative of the concentration; and

(c) applied pressure control means responsive to the anesthetic concentration signal for controlling the pressure applied by pressure application means to the vein in the limb.

16. Apparatus as defined in claim 15, wherein the applied pressure control means restricts flow proximally past the pressure application means of anesthetic liquid in order to maintain the concentration represented by the anesthetic concentration signal below a preassigned concentration.

17. Apparatus as defined in claim 15, wherein the applied pressure control means permits flow proximally past the pressure application means of anesthetic liquid sufficient to increase the concentration of anesthetic liquid to a concentration near a preassigned concentration.

18. Apparatus as defined in claim 15, and including alarm means for comparing the concentration represented by the anesthetic concentration signal to a preassigned concentration safety limit and for generating an alarm signal when the concentration exceeds the concentration safety limit.