Method and system for monitoring sedation, paralysis and neural-integrity

• US 6,725,086 B2
• Filed: 11/20/2001
• Issued: 04/20/2004
• Est. Priority Date: 01/17/2001
• Status: Expired due to Term

• Current Assignee: Dragerwerk AG & Company KGaA (FPS Vermögensverwaltung GmbH)
• Original Assignee: Draeger Medical Systems Incorporated (Dragerwerk AG)
• Inventors: Marinello, Stephen
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US09/991,360
• Publication Number:
  US 20020095098A1
• Time in Patent Office: 882 Days
• Field of Search: 607/1, 607/2, 600/544, 600/545, 600/546
• US Class Current: 600/544
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 5/1106 to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia
• CPC Class Codes: A61B 5/377 using evoked responses
• CPC Class Codes: A61B 5/378 Visual stimuli
• CPC Class Codes: A61B 5/38 Acoustic or auditory stimuli
• CPC Class Codes: A61B 5/383 Somatosensory stimuli, e.g. electric stimulation
• CPC Class Codes: A61B 5/4821 Determining level or depth of anaesthesia A61B5/1106 takes precedence

Abstract

The present invention relates to a method and system in which a small stimulator unit which is designed to be mounted near the patient. A single cable connects the stimulator unit to the patient monitor. This cable both provides power to the stimulator unit, as well as 2-way data communication between the stimulator unit and the patient monitor. The patient monitor provides the user interface for the present invention, as well as other parameters such as heart rate and blood pressure.

Claims

1. An adaptive system for monitoring neurological electrical activity, comprising:

an electrical stimulation signal generator;

an acoustic stimulation signal generator;

a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes, said electrical signals representing neurological electrical activity at least partially generated in response to at least one of (a) electrical muscular stimulation and (b) said acoustic stimulation; and

a processing network adaptively configured for processing conditioned electrical signals derived from neurological activity in response to said electrical muscular stimulation differently to electrical signals derived in response to said acoustic stimulation.

2. The adaptive system according to claim 1 wherein said electrical stimulation signal generator is formed of one or more separate units and each of said units serves a different stimulus modality.

3. The adaptive system according to claim 1 wherein said electrical stimulation signal generator is formed of one or more separate units and each of said units is located to provide stimulus for a different body location.

4. The adaptive system according to claim 1 wherein said acoustic stimulation signal generator is formed of one or more separate units and each of said units serves a different stimulus modality.

5. The adaptive system according to claim 1 wherein said acoustic stimulation signal generator is formed of one or more separate units and each of said units is located to provide stimulus for a different body location.

6. The adaptive system according to claim 1, wherein said adaptive system also monitors neuromuscular activity and

said conditioning network conditions electrical signals representing muscular activity,

said processing network is adaptively configured for processing conditioned electrical signals derived by electrical stimulation of muscle.

7. The adaptive system according to claim 1 wherein said electrical stimulation signal generator is a single electrical stimulation signal generator for monitoring both neuromuscular transmission monitoring and somatosensory evoked potential.

8. The adaptive system according to claim 1 wherein said electrodes are a single pair of electrodes for monitoring both NMT and SEP.

9. The adaptive system according to claim 1 wherein said probes are a single pair of stimulator probes to evoke SEP and NMT signals either independently or concurrently.

10. The adaptive system according to claim 1 wherein said electrodes coupled to said conditioning network are a single pair of electrodes for monitoring muscle and neurological electrical activity of a patient.

11. An adaptive system for monitoring neurological electrical activity, comprising:

an electrical stimulation signal generator;

an acoustic stimulation signal generator;

a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes, said electrical signals representing neurological electrical activity at least partially generated in response to at least one of (a) electrical muscular stimulation and (b) said acoustic stimulation; and

a processing network adaptively configured for processing conditioned electrical signals derived from neurological activity in response to said electrical muscular stimulation differently to electrical signals derived in response to acoustic stimulation,

wherein said adaptive system is adapted to auto-configure itself for at least one of (a) neuromuscular transmission monitoring (b) somatosensory evoked potential stimulation and (c) auditory evoked potential stimulation when connected to an EEG module and to a neuromuscular transmission monitoring device only when not connected to said EEG module.

12. An adaptive system for monitoring neurological electrical activity, comprising:

an electrical stimulation signal generator;

an acoustic stimulation signal generator;

a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes, said electrical signals representing neurological electrical activity at least partially generated in response to at least one of (a) electrical muscular stimulation and (b) said acoustic stimulation;

a processing network adaptively configured for processing conditioned electrical signals derived from neurological activity in response to said electrical muscular stimulation differently to electrical signals derived in response to acoustic stimulation; and

a digital serial interface for sending trigger information from an evoked potential stimulator to an EEG device for synchronization with a spontaneous EEG signal.

13. The adaptive system according to claim 12 further comprising a single trigger line for transmitting a combined time-of-occurrence and ID code in order to differentiate among different stimulation modes or sites when triggering an EEG device.

14. An adaptive system for monitoring neurological electrical activity, comprising:

an electrical stimulation signal generator;

a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes in response to said electrical stimulation, said electrical signals representing at least one of (a) neurological electrical activity and (b) muscular activity; and

a processing network adaptively configured for processing conditioned electrical signals derived from muscular activity response differently to electrical signals derived in from neurological electrical activity.

15. The adaptive system according to claim 14 wherein said electrical stimulation signal generator is formed of one or more separate units and each of said units serves a different stimulus modality.

16. The adaptive system according to claim 14 wherein said electrical stimulation signal generator is formed of one or more separate units and each of said units is located to provide to stimulus for a different body location.

17. The adaptive system according to claim 14 wherein said electrical stimulation signal generator is formed of one or more separate units and each of said units serves a different stimulus modality.

18. The adaptive system according to claim 14 wherein said electrical stimulation signal generator is formed of one or more separate units and each of said units is located to provide stimulus for a different body location.

19. The adaptive system according to claim 14, wherein said conditioning network conditions electrical signals representing muscular stimulation activity, and said processing network is adaptively configured for processing conditioned electrical signals derived by neurological electrical stimulation.

20. The adaptive system according to claim 14 wherein said electrical stimulation signal generator is a single electrical stimulation generator for monitoring both neuromuscular transmission monitoring and somatosensory evoked potential.

21. The adaptive system according to claim 14 wherein said electrodes are a single pair of electrodes for monitoring both NMT and SEP signals.

22. The adaptive system according to claim 14 wherein said probes are a single pair of stimulator probes to evoke SEP and NMT either independently or concurrently.

23. The adaptive system according to claim 14 wherein said electrodes coupled to said conditioning network are a single pair of electrodes for monitoring muscle and neurological electrical activity of a patient.

24. An adaptive system for monitoring neurological electrical activity, comprising:

an electrical stimulation signal generator;

a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes in response to said electrical stimulation, said electrical signals representing at least one of (a) neurological electrical activity and (b) muscular activity; and

a processing network adaptively configured for processing conditioned electrical signals derived from muscular activity response to differently to electrical signals derived from neurological electrical activity,

wherein adaptive system is adapted to auto-configure itself for at least one of (a) neuromuscular transmission monitoring (b) somatosensory evoked potential stimulation and (c) auditory evoked potential stimulation when connected to an EEG module and to a neuromuscular transmission monitoring device only when not connected to said EEG module.

25. An adaptive system for monitoring neurological electrical activity, comprising:

an electrical stimulation signal generator;

a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes in response to said electrical stimulation, said electrical signals representing at least one of (a) neurological electrical activity and (b) muscular activity;

a processing network adaptively configured for processing conditioned electrical signals derived from muscular activity response to differently to electrical signals derived from neurological electrical activity,

a digital serial interface for sending trigger information from an evoked potential stimulator to an EEG device for synchronization with a spontaneous EEG signal.

26. An adaptive system for monitoring neurological electrical activity, comprising:

an electrical stimulation signal generator;

a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes in response to said electrical stimulation, said electrical signals representing at least one of (a) neurological electrical activity and (b) muscular activity; and

a processing network adaptively configured for processing conditioned electrical signals derived from muscular activity response to differently to electrical signals derived from neurological electrical activity,

a single trigger line for transmitting a combined time-of-occurrence and ID code therethrough in order to differentiate among different stimulation modes or sites when triggering an EEG device.

27. A method for monitoring neurological electrical activity, the steps comprising:

generating an electrical stimulation signal;

generating an acoustic stimulation signal;

providing a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes, said electrical signals representing neurological electrical activity at least partially generated in response to at least one of (a) said electrical muscular stimulation and (b) said acoustic stimulation; and

being adaptively configured for processing conditioned electrical signals derived from neurological activity in response to said electrical muscular stimulation differently to electrical signals derived in response to acoustic stimulation.

28. The method according to claim 27 wherein said electrical stimulation signal is generated by an electrical stimulator formed of one or more separate units to each said unit serving a different stimulus modality.

29. The method according to claim 27 wherein said electrical stimulation signal is generated by an electrical stimulator formed of one or more separate units wherein each said unit is located at and provides stimulus for a different body location.

30. The method according to claim 27 wherein said acoustic stimulation signal is generated by an acoustic stimulator unit formed of one or more separate units wherein each said unit serves a different stimulus modality.

31. The method according to claim 27 wherein said acoustic stimulation signal is generated by an acoustic stimulator unit formed of one or more separate units wherein each said unit is located to provide stimulus for a different body location.

32. The method according to claim 27 further comprising the step of conditioning electrical signals representing acoustic stimulation activity, and processing conditioned electrical signals derived by acoustic stimulation.

33. The method according to claim 27 further comprising the step of monitoring both neuromuscular transmission monitoring and somatosensory evoked potential by means of a single electrical stimulation generator circuit.

34. The method according to claim 27 further comprising the step of monitoring both NMT and SEP signals by means of a pair of electrodes.

35. The method according to claim 27 further comprising the step of eliciting SEP or NMT signals either independently or concurrently by means of a single pair of stimulator probes.

36. The method according to claim 27 further comprising the step of monitoring muscle and neurological electrical activity of a patient by means of a single pair of electrodes coupled to a conditioning network.

37. A method for monitoring neurological electrical activity, the steps comprising:

generating an electrical stimulation signal;

generating an acoustic stimulation signal;

providing a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes, said electrical signals representing neurological electrical activity at least partially generated in response to at least one of (a) electrical muscular stimulation and (b) said acoustic stimulation; and

being adaptively configured for processing conditioned electrical signals derived from neurological activity in response to said electrical muscular stimulation differently to electrical signals derived in response to acoustic stimulation; and

automatically configuring said conditioning network for (a) neuromuscular transmission monitoring, (b) somatosensory evoked potential stimulation and (c) auditory evoked potential stimulation when connected to an EEG module and to a neuromuscular transmission monitoring device only when not connected to said EEG module.

38. A method for monitoring neurological electrical activity, the steps comprising:

generating an electrical stimulation signal;

generating an acoustic stimulation signal;

providing a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes said electrical signals representing neurological electrical activity at least partially generated in response to at least one of (a) electrical muscular stimulation and (b) said acoustic stimulation; and

being adaptively configured for processing conditioned electrical signals derived from neurological activity in response to said electrical muscular stimulation differently to electrical signals derived in response to acoustic stimulation; and

sending trigger information through a digital serial interface from an evoked potential stimulator to an EEG device for synchronization with a spontaneous EEG signal.

39. A method for monitoring neurological electrical activity, the steps comprising:

generating an electrical stimulation signal;

generating an acoustic stimulation signal;

providing a conditioning network for coupling to electrodes and for conditioning electrical signals received via electrodes, said electrical signals representing neurological electrical activity at least partially generated in response to at least one of (a) electrical muscular stimulation and (b) said acoustic stimulation; and

being adaptively configured for processing conditioned electrical signals derived from neurological activity in response to said electrical muscular stimulation differently to electrical signals derived in response to acoustic stimulation; and

transmitting a combined time-of-occurrence and ID code therethrough in order to differentiate among different stimulation modes or sites when triggering an EEG device by means of a single trigger line.