Apparatus and method for total intravenous anesthesia delivery and associated patient monitoring

• US 6,186,977 B1
• Filed: 04/24/1997
• Issued: 02/13/2001
• Est. Priority Date: 04/24/1997
• Status: Expired due to Term

• Current Assignee: Eithicon Endo-Surgery Incorporated, Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Joseph L. Riley Anesthesia Associates
• Inventors: Riley, James L., Guzzi, Louis M., Andrews, Thomas W., Hartson, David P.
• Primary Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US08/847,557
• Time in Patent Office: 1,391 Days
• Field of Search: 604/30, 604/31, 604/49, 604/50, 604/65-67, 604/246, 604/131, 128/DIG.12, 128/DIG.13
• US Class Current: 604/67
• CPC Class Codes: A61B 50/10 Furniture specially adapted for surgical or diagnostic appliances or instruments
• CPC Class Codes: A61M 16/021 operated by electrical means A61M16/202 – A61M16/205 take precedence

Abstract

An apparatus for total intravenous anesthesia includes at least one supply and infusion pump for an intravenous anesthesia agent carried by the apparatus housing, and at least one monitor for monitoring the characteristics of the patient during the total intravenous anesthesia. The at least one intravenous anesthesia agent preferably includes a first intravenous anesthesia agent, and more preferably, an analgesic, having a relatively quick offset so that the effects wears off relatively quickly upon stopping intravenous infusion. For monitoring the patient, the apparatus preferably includes at least one of an electrocardiogram, a blood oxygen monitor, a blood carbon dioxide monitor, inspiration/expiration oxygen, inspiration/expiration carbon dioxide, a blood pressure monitor, a pulse rate monitor, a respiration rate monitor, and a patient temperature monitor, for example. The first intravenous anesthesia agent may be an esterase metabolized opioid, such as remifentanil. A second supply of a second intravenous anesthesia agent carried by the housing may also be included. The second supply may be another anesthesia agent, such as propofol, for example. Method aspects of the invention are also disclosed.

Claims

1. An apparatus for administering total intravenous anesthesia to a patient, the apparatus comprising:

a housing;

at least one supply of at least one intravenous anesthesia agent carried by the housing;

intravenous delivery means carried by the housing for controllably intravenously delivering said at least one intravenous anesthesia agent to the patient so that total intravenous anesthesia is achieved in the patient and without an inhaled anesthesia agent;

said at least one intravenous anesthesia agent comprising a first intravenous anesthesia agent having a relatively quick offset so that effects thereof wear off relatively quickly upon stopping intravenous infusion; and

at least one monitor carried by said housing for monitoring at least one patient characteristic during total intravenous anesthesia of the patient, the at least one monitor comprising an electrocardiogram.

2. An apparatus according to claim 1 wherein said at least one monitor also comprises a blood oxygen monitor.

3. An apparatus according to claim 1 wherein said at least one monitor also comprises a blood carbon dioxide monitor.

4. An apparatus according to claim 1 wherein said at least one monitor also comprises one of an inspiration and expiration oxygen monitor.

5. An apparatus according to claim 1 wherein said at least one monitor also comprises one of an inspiration and expiration carbon dioxide monitor.

6. An apparatus according to claim 1 wherein said at least one monitor also comprises a blood pressure monitor.

7. An apparatus according to claim 1 wherein said at least one monitor also comprises a pulse rate monitor.

8. An apparatus according to claim 1 wherein said at least one monitor also comprises a respiration rate monitor.

9. An apparatus according to claim 1 wherein said at least one monitor also comprises a patient temperature monitor.

10. An apparatus according to claim 1 further comprising at least one recorder cooperating with said at least one monitor to provide a record of a respective monitored patient characteristic.

11. An apparatus according to claim 1 wherein aid at least one supply comprises at least one intravenous fluid bag;

and wherein said intravenous infusion means comprises at least one intravenous infusion pump.

12. An apparatus according to claim 1 wherein said first intravenous anesthesia agent comprises an analgesic.

13. An apparatus according to claim 1 wherein the relatively quick offset of said first intravenous anesthesia agent is defined by a relatively short biological half-life not greater than about 10 minutes.

14. An apparatus according to claim 1 wherein said first intravenous anesthesia agent comprises an esterase metabolized opioid.

15. An apparatus according to claim 1 wherein said first intravenous anesthesia agent comprises remifentanil.

16. An apparatus according to claim 1 further comprising telemetry means carried by said housing and cooperating with said at least one monitor for providing telemetry for the at least one patient characteristic.

20. An apparatus according to claim 1 further comprising a battery carried by said housing for powering the apparatus.

21. An apparatus according to claim 1 wherein said housing has an upper surface defining a horizontal work surface.

22. An apparatus according to claim 1 further comprising castor means on a lower portion of said housing to permit relocation of said housing.

23. An apparatus according to claim 1 wherein said at least one supply comprises a second supply of a second intravenous anesthesia agent carried said housing.

17. An apparatus for administering total intravenous- anesthesia to a patient, the apparatus comprising:

a housing;

at least one supply of at least one intravenous anesthesia agent carried by the housing;

intravenous delivery means carried by the housing for controllably intravenously delivering said at least one intravenous anesthesia agent to the patient so that total intravenous anesthesia is achieved in the patient and without an inhaled anesthesia agent;

said at least one intravenous anesthesia agent comprising a first intravenous anesthesia agent having a relatively quick offset so that effects thereof wear off relatively quickly upon stopping intravenous infusion;

at least one monitor carried by said housing for monitoring at least one patient characteristic during total intravenous anesthesia of the patient; and

telemetry means carried by said housing and cooperating with said at least one monitor for providing telemetry for the at least one patient characteristic, wherein said telemetry means comprises a wireless transceiver operable over a cellular telephone network.

18. An apparatus for administering total intravenous anesthesia to a patient, the apparatus comprising:

a housing;

at least one supply of at least one intravenous anesthesia agent carried by the housing;

intravenous delivery means carried by the housing for controllably intravenously delivering said at least one intravenous anesthesia agent to the patient so that total intravenous anesthesia is achieved in the patient and without an inhaled anesthesia agent;

said at least one intravenous anesthesia agent comprising a first intravenous anesthesia agent having a relatively quick offset so that effects thereof wear off relatively quickly upon stopping intravenous infusion;

at least one monitor carried by said housing for monitoring at least one patient characteristic during total intravenous anesthesia of the patient; and

voice channel means carried by said housing for providing a voice communications channel.

19. An apparatus according to claim 18 wherein said voice channel means comprises a wireless transceiver operable over a cellular telephone network.

24. An apparatus for administering total intravenous anesthesia to a patient, the apparatus comprising:

a housing;

at least one supply of at least one intravenous anesthesia agent carried by the housing;

intravenous delivery means carried by the housing for controllably intravenously delivering said at least one intravenous anesthesia agent to the patient so that total intravenous anesthesia is achieved in the patient and without an inhaled anesthesia agent;

said at least one intravenous anesthesia agent comprising a first intravenous anesthesia agent having a relatively quick offset so that effects thereof wear off relatively quickly upon stopping intravenous infusion; and

at least one monitor carried by said housing for monitoring at least one patient characteristic during total intravenous anesthesia of the patient;

wherein said at least one supply comprises a second supply of a second intravenous anesthesia agent carried by said housing, and wherein said first intravenous anesthesia agent comprises an analgesic, and wherein said second intravenous anesthesia agent comprises a relatively quick offset amnestic.

25. An apparatus for administering total intravenous anesthesia to a patient, the apparatus comprising:

a housing;

at least one supply of at least one intravenous anesthesia agent carried by the housing;

intravenous delivery means carried by the housing for controllably intravenously delivering said at least one intravenous anesthesia agent to the patient so that total intravenous anesthesia is achieved in the patient and without an inhaled anesthesia agent;

said at least one intravenous anesthesia agent comprising a first intravenous anesthesia agent having a relatively quick offset so that effects thereof wear off relatively quickly upon stopping intravenous infusion;

at least one monitor carried by said housing for monitoring at least one patient characteristic during total intravenous anesthesia of the patient; and

a storage cabinet associated with said housing for storing consumable materials for total intravenous anesthesia.

26. An apparatus for administering total intravenous anesthesia to a patient, the apparatus comprising:

a housing;

at least one supply of at least one intravenous anesthesia agent carried by the housing;

intravenous delivery means carried by the housing for controllably intravenously delivering said at least one intravenous anesthesia agent to the patient so that total intravenous anesthesia is achieved in the patient and without an inhaled anesthesia agent;

said at least one intravenous anesthesia agent comprising a first intravenous anesthesia agent having a relatively quick offset so that effects thereof wear off relatively quickly upon stopping intravenous infusion; and

telecommunication means carried by said housing for providing at least one of a telemetry channel and a voice communications channel during total intravenous anesthesia of the patient, wherein said telecommunications means comprises a wireless transceiver.

28. An apparatus according to claim 26 wherein said at least one supply comprises at least one intravenous fluid bag;

and wherein said intravenous infusion means comprises at least one intravenous infusion pump.

29. An apparatus according to claim 26 wherein said first intravenous anesthesia agent comprises an analgesic.

30. An apparatus according to claim 26 wherein the relatively quick offset of said first intravenous anesthesia agent is defined by a relatively short biological half-life not greater than about 10 minutes.

31. An apparatus according to claim 26 wherein said first intravenous anesthesia agent comprises an esterase metabolized opioid.

32. An apparatus according to claim 26 wherein said first intravenous anesthesia agent comprises remifentanil.

33. An apparatus according to claim 26 further comprising a battery carried by said housing for powering the apparatus.

34. An apparatus according to claim 26 wherein said housing has an upper surface defining a horizontal work surface.

35. An apparatus according to claim 26 further comprising castor means on a lower portion of said housing to permit relocation of said housing.

36. An apparatus according to claim 26 wherein said at least one supply comprises a second supply of a second intravenous anesthesia agent carried by said housing.

27. An apparatus according to claim 27 wherein said wireless transceiver comprises a cellular telephone network transceiver.

37. An apparatus for administering total intravenous anesthesia to a patient, the apparatus comprising:

a housing;

at least one supply of at least one intravenous anesthesia agent carried by the housing;

intravenous delivery means carried by the housing for controllably intravenously delivering said at least one, intravenous anesthesia agent to the patient so that total intravenous anesthesia is achieved in the patient and without an inhaled anesthesia agent;

said at least one intravenous anesthesia agent comprising a first intravenous anesthesia agent having a relatively quick offset so that effects thereof wear off relatively quickly upon stopping intravenous infusion; and

telecommunication means carried by said housing for providing at least one of a telemetry channel and a voice communications channel during total intravenous anesthesia of the patient;

wherein said at least one supply comprises a second supply of a second intravenous anesthesia agent carried by said housing, and wherein said first intravenous anesthesia agent comprises an analgesic, and wherein said second intravenous anesthesia agent comprises a relatively quick offset amnestic.

38. An apparatus for administering total intravenous anesthesia to a patient, the apparatus comprising:

a housing;

at least one supply of at least one intravenous anesthesia agent carried by the housing;

intravenous delivery means carried by the housing for controllably intravenously delivering said at least one intravenous anesthesia agent to the patient so that total intravenous anesthesia is achieved in the patient and without an inhaled anesthesia agent;

said at least one intravenous anesthesia agent comprising a first intravenous anesthesia agent having a relatively quick offset so that effects thereof year off relatively quickly upon stepping intravenous infusion;

telecommunication means carried by said housing for providing at least one of a telemetry channel and a voice communications channel during total intravenous anesthesia of the patient; and

a storage cabinet associated with said housing for storing consumable materials for total intravenous anesthesia.

39. A method for administering total intravenous anesthesia to a patient, the method comprising the steps of:

providing a housing carrying at least one supply of at least one intravenous anesthesia agent, at least one infusion pump for delivering said at least one intravenous anesthesia agent, and at least one patient characteristic monitor, the at least one monitor comprising at least an electrocardiogram;

controllably intravenously delivering said at least one intravenous anesthesia agent to the patient from the at least one respective supply carried by the housing and using the at least one infusion pump also carried by the housing so that total intravenous anesthesia is achieved in the patient, said at least one intravenous anesthesia agent comprising a first intravenous anesthesia agent having a relatively quick offset so that effects thereof wear off relatively quickly upon stopping intravenous infusion of said first intravenous anesthesia agent; and

monitoring at least one patient characteristic using the at least one patient characteristic monitor carried by the housing during total intravenous anesthesia of the patient.

40. A method according to claim 39 wherein the step of monitoring comprises monitoring at least one of the patient'"'"'s heart activity, blood oxygen level, carbon dioxide blood level, inspiration oxygen level, expiration oxygen level, inspiration carbon dioxide level, expiration carbon dioxide level, blood pressure, pulse rate, respiration rate and temperature.

42. A method according to claim 39 further comprising the step of recording at least one of the monitored patient characteristics.

43. A method according to claim 39 wherein the said first intravenous anesthesia agent comprises an analgesic.

44. A method according to claim 39 wherein the relatively quick offset of said first intravenous anesthesia agent is defined by a relatively short biological half-life not greater than about 10 minutes.

45. A method according to claim 39 wherein said first intravenous anesthesia agent comprises remifentanil.

41. A method for administering total intravenous anesthesia to a patient, the method comprising the steps of:

providing a housing carrying at least one supply of at least one intravenous anesthesia agent, at least one infusion pump for delivering said at least one intravenous anesthesia agent, and at least one patient characteristic monitor;

controllably intravenously delivering said at least one intravenous anesthesia agent to the patient from the at least one respective supply carried by the housing and using the at least one infusion pump also carried by the housing so that total intravenous anesthesia is achieved in the patient, said at least one intravenous anesthesia agent comprising a first intravenous anesthesia agent having a relatively quick offset so that effects thereof wear off relatively quickly upon stooping intravenous infusion of said first intravenous anesthesia agent; and

monitoring at least one patient characteristic using the at least one patient characteristic monitor carried by the housing during total intravenous anesthesia of the patient;

wherein the step of providing further comprises the step of providing the housing having a wireless telecommunications transceiver carried by the housing; and

further comprising the step of using the wireless telecommunications transceiver for providing at least one of a telemetry channel and a voice communications channel during total intravenous anesthesia of the patient.