Body insertion tube with anesthetic jacket

• US 5,389,074 A
• Filed: 10/27/1993
• Issued: 02/14/1995
• Est. Priority Date: 10/27/1993
• Status: Expired due to Fees

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Pazevic, Brian S., Parker, James N.
• Primary Examiner(s): Rosenbaum, C. Fred
• Assistant Examiner(s): WILKENS, FRANK
• Application Number:
  US08/143,872
• Time in Patent Office: 475 Days
• Field of Search: 128/207.14, 128/207.15, 604/27, 604/28, 604/35, 604/43, 604/54, 604/96-103, 604/266, 604/268, 604/280, 604/119
• US Class Current: 604/103.01
• CPC Class Codes: A61J 15/0003 Nasal or oral feeding-tubes, e.g. tube entering body through nose or mouth
• CPC Class Codes: A61J 15/0049 Inflatable Balloons balloon catheters A61M25/10
• CPC Class Codes: A61J 15/0073 Multi-lumen tubes
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0409 with mean for closing the oesophagus
• CPC Class Codes: A61M 16/0456 one cuff within another
• CPC Class Codes: A61M 16/0479 above the cuff, e.g. giving access to the upper trachea
• CPC Class Codes: A61M 16/0481 through the cuff wall
• CPC Class Codes: A61M 16/0486 Multi-lumen tracheal tubes
• CPC Class Codes: A61M 19/00 Local anaesthesia syringes therefor A61M5/00; Hypothermia A61M5/42 takes precedence; cooling blood in a bypass of the arterial system A61M1/36
• CPC Class Codes: A61M 2025/0057 Catheters delivering medicament other than through a conventional lumen, e.g. porous walls or hydrogel coatings

Abstract

A body insertion tube can be configured as a nasogastric (NG) tube or endotracheal (ET) tube. When the tube is an NG tube, the tube has a distal segment positionable in the esophagus and a stomach segment connected to the distal segment and positionable in the stomach for aspirating fluids therefrom. An inflatable perforated jacket is positioned around a substantial portion of the distal segment such that anesthetic can be directed into the jacket and out of the perforations to anesthetize substantially all of the nasal passages and throat during intubation. When the tube is an ET tube, the tube has a distal segment positionable in the trachea, and an inflatable cuff is positioned around the distal segment of the tube. An inflatable perforated jacket surrounds a substantial segment of the tube such that anesthetic can be directed through the jacket to anesthetize substantially all of the throat and vocal cords during intubation.

Claims

1. A device engageable with a source of anesthetic fluid, the device being advanceable into a patient for establishing a pathway for fluid communication through the patient'"'"'s pharynx while reducing patient discomfort, comprising:

a source of pressure;

an elongated flexible tube defining a lumen in fluid communication with the source of pressure, the tube having a distal segment positionable in a body passage of the patient that is distal to the pharynx, the tube being made of plastic such that the tube has sufficient strength to substantially prevent deformation of the tube when the source of pressure is activated; and

a jacket surroundingly engaged with the distal segment of the tube along at least five centimeters (5 cm) of the distal segment, the jacket being formed with a plurality of perforations along its entire length and circumference, wherein anesthetic fluid from the source of anesthetic fluid can be directed out of the perforations of the jacket onto the body passage of the patient to anesthetize a substantial portion of the body passage.

2. The device of claim 1, wherein the jacket has distal and proximal end portions each attached to the tube, and the end portions are faired into the surface of the tube to facilitate easily advancing the distal segment of the tube with jacket in the body passage of the patient.

3. The device of claim 1, wherein the body passage is the trachea, the tube is an endotracheal (ET) tube, and the device further comprises an inflatable cuff positioned around a portion of the distal segment of the tube distal to the jacket.

4. The device of claim 3, wherein the jacket includes a cuff extension surrounding the cuff.

5. The device of claim 3, wherein the jacket comprises a distal extension located distal of the cuff, a proximal section located proximal to the cuff, and a connecting lumen extending therebetween for establishing a passageway for anesthetic communication from the proximal section of the jacket to the distal section of the jacket.

6. The device of claim 3, wherein the tube defines a lumen, the source of pressure is a respiratory support system, the tube includes a hollow connector engageable with the respiratory support system, and wherein the tube is made of a plastic material sufficiently strong to prevent expansion of the lumen when oxygen is directed from the support system through the lumen into the patient'"'"'s lungs.

7. The device of claim 6, wherein the jacket has a distal end positioned on the tube adjacent the cuff and a proximal end, and the distance between the ends of the jacket is between approximately five centimeters and fifteen centimeters (5-15 cm).

8. The device of claim 7, wherein the distance between the ends of the jacket is approximately seven centimeters (7 cm).

9. The device of claim 1, wherein the body passage includes the nasopharynx, pharynx, and esophagus and the tube is a nasogastric (NG) tube, and the NG tube includes a stomach segment extending distally away from the distal segment, wherein the stomach segment is formed with a plurality of axially-spaced openings for aspirating stomach fluid therethrough, and the tube is made of a plastic material sufficiently strong to prevent collapse of the lumen when stomach fluids are aspirated therethrough.

10. The device of claim 9, further comprising a hollow connector having a proximal end engageable with an NG support system tube, a distal end engageable with the NG tube, and a midpoint therebetween, wherein the connector is radially tapered inwardly from the midpoint to each end to facilitate engaging the NG tube and support system tube.

11. The device of claim 10, wherein the NG tube includes a main lumen in communication with the openings of the stomach segment and a vacuum break lumen in communication with the openings.

12. An endotracheal (ET) tube assembly, comprising:

a source of respiratory oxygen;

an ET tube defining a lumen in fluid communication with the source of oxygen and having a distal segment;

an inflatable cuff positioned around the distal segment of the ET tube for establishing a fluid seal between the tube and the trachea when the cuff is inflated with fluid; and

a jacket surroundingly engaged with the distal segment of the ET tube and having a plurality of perforations along its entire length and circumference, wherein the jacket has a distal end positioned on the tube adjacent the cuff and a proximal end, wherein the distance between the ends of the jacket is between five centimeters and fifteen centimeters (5-15 cm), the distal segment of the ET tube being positionable in a patient'"'"'s pharynx to establish a pathway for fluid communication between the source of oxygen and the patient'"'"'s lungs, and wherein the ET tube is made of material sufficiently strong to prevent swelling of the ET tube when oxygen from the source is directed through the lumen to the patient'"'"'s lungs.

13. The ET tube assembly of claim 12, further comprising a source of anesthetic liquid in fluid communication with the jacket for anesthetizing a substantial portion of the body passage.

14. The assembly of claim 13, wherein the jacket has distal and proximal end portions each attached to the tube, and the end portions are faired into the surface of the tube to facilitate easily advancing the tube with jacket in the body passage of the patient.

15. The assembly of claim 14, wherein the jacket includes a cuff extension surrounding the cuff.

16. The assembly of claim 14, wherein the jacket comprises a distal extension located distal of the cuff, a proximal section located proximal to the cuff, and a connector tube extending therebetween for establishing a passageway for anesthetic communication from the proximal section of the jacket to the distal section of the jacket.

17. The assembly of claim 14, wherein the tube defines a lumen and includes a hollow connector engageable with a respiratory support system, and wherein the tube is made of a plastic material sufficiently strong to prevent expansion of the lumen when oxygen is directed from the support system through the lumen into the patient'"'"'s lungs.

18. A nasogastric (NG) tube assembly, comprising:

a source of vacuum for aspirating fluid from a patient'"'"'s stomach;

an NG tube having a stomach segment formed with a plurality of axially-spaced openings for aspirating stomach fluid therethrough and a proximal segment defining a lumen in fluid communication with the source of vacuum; and

a jacket surroundingly engaged with the NG tube proximal to the axially-spaced openings and having a plurality of perforations along its entire length and circumference through which anesthetic can be directed against substantially all of the patient'"'"'s nasal passages, pharynx, and proximal portion of the esophagus in which the assembly is intubated, wherein

the tube is made of a plastic material sufficiently strong to prevent collapse of the lumen when the source of vacuum is activated to aspirate stomach fluid.

19. The assembly of claim 18, further comprising:

a source of anesthetic liquid in fluid communication with the jacket.

20. The assembly of claim 19, wherein the jacket has distal and proximal end portions each attached to the NG tube, and the end portions are faired into the surface of the tube to facilitate easily advancing the distal segment of the tube with jacket in a body passage of the patient.

21. The assembly of claim 20, further comprising a hollow connector having a proximal end engageable with an NG support system tube, a distal end engageable with the tube, and a midpoint therebetween, wherein the connector is radially tapered inwardly from the midpoint to each end to facilitate engaging the tube and support system tube.

22. The device of claim 21, wherein the tube includes a main lumen in communication with the openings of the stomach segment and a vacuum break lumen in communication with the openings.

23. A method for establishing a pathway for fluid communication from a patient'"'"'s throat to a body passage of the patient in communication with the throat, while minimizing patient discomfort, comprising the steps of:

(a) providing a body insertion tube made of plastic and defining a lumen, the body insertion tube being sufficiently strong to substantially prevent deformation of the body insertion tube when the body insertion tube is pressurized or evacuated;

(b) surrounding a segment of the tube with a perforated anesthetic jacket, the jacket having a proximal end and a distal end axially spaced from the proximal end a distance of at least five centimeters (5 cm), such that when the tube is properly positioned, anesthetic fluid can be directed through the perforations against substantially all of the patient'"'"'s throat tissue which is adjacent the tube;

(c) advancing the tube into the body passage;

(d) engaging the tube with a source of pressure such that the lumen of the tube is in fluid communication with the source; and

(e) directing anesthetic fluid through the perforations of the jacket to anesthetize the throat.

24. A device advanceable into a patient for establishing a pathway for fluid communication through the patient'"'"'s pharynx while reducing patient discomfort, comprising:

a source of anesthetic fluid;

a source of pressure;

an elongated flexible tube defining a lumen and having a distal segment

positionable in a body passage of the patient that is distal to the pharynx and a proximal segment configured for establishing fluid communication between the source of pressure and the lumen of the tube, the tube having sufficient strength to substantially prevent deformation of the tube when the source of pressure is activated; and

a jacket surroundingly engaged with the distal segment of the tube along at least five centimeters (5 cm) of the length of the distal segment, the jacket being formed with a plurality of perforations along its entire length and circumference, wherein anesthetic fluid from the source can be directed out of the perforations of the jacket onto the body passage of the patient to anesthetize a substantial portion of the body passage.