Regional anesthetic

• US 8,027,718 B2
• Filed: 03/07/2006
• Issued: 09/27/2011
• Est. Priority Date: 03/07/2006
• Status: Active Grant

• Current Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic)
• Original Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic)
• Inventors: Martin, David P., Spinner, Robert J., Conrad, Timothy R.
• Primary Examiner(s): Lucchesi; Nicholas D
• Assistant Examiner(s): SHUMATE, VICTORIA PEARL
• Application Number:
  US11/370,967
• Publication Number:
  US 20070213771A1
• Time in Patent Office: 2,030 Days
• Field of Search: 604/272, 604/20, 604/93.01, 604/264, 604/500, 607/2, 607/46, 607/47, 607/63, 607/72
• US Class Current: 604/20
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• 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: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36021 for treatment of pain

Abstract

A method and apparatus are disclosed for anesthetizing a region of a patient'"'"'s body. The method includes identifying a target nerve which, upon activation, anesthetizes a region of a patient'"'"'s body including a surgical site. The target nerve is located and an active site of a nerve blocking apparatus is placed in proximity to the nerve. The nerve blocking apparatus is activated to block neural propagation along the nerve. The activation of the nerve blocking apparatus is maintained during a surgical procedure at the surgical site.

Claims

1. A method of anesthetizing a region of a patient'"'"'s body, comprising:

identifying a target nerve which, upon anesthetization, anesthetizes a region of a patient'"'"'s body including a surgical site;

locating the target nerve;

placing an electrode of a nerve blocking apparatus in proximity to the nerve;

connecting the electrode to an external power source via a conductive path inserted through the patient'"'"'s skin;

anesthetizing the region of the patient'"'"'s body by activating the electrode at a frequency of at least 5,000 Hz to block neural propagation of afferent pain signals along the nerve; and

retaining the activated electrode of the nerve blocking apparatus in proximity to the nerve during a surgical procedure at the site.

2. The method of claim 1 wherein activating the electrode includes creating a field near the desired target location with parameters selected to at least partially block neural activity within the field.

3. The method of claim 1 wherein locating the target nerve includes activating an electrical stimulation at a suspected location of the nerve and observing a physiologic response to the stimulation confirming the suspected location.

4. The method of claim 3 wherein locating the target nerve includes placing a needle through a skin of the patient with the electrode positioned on the needle and advanced to the suspected location, and activating the electrode with a stimulation signal selected to induce action potentials in a nerve in close proximity to the electrode.

5. The method of claim 1, further comprising advancing the electrode through a needle to the nerve and connecting the electrode to a source of a nerve blocking signal.

6. The method of claim 5, further comprising withdrawing the needle while leaving the electrode at the nerve.

7. The method of claim 1 wherein the electrode is carried by a catheter having a deployable, tissue-penetrating tip, and wherein placing the electrode includes advancing the catheter through the patient'"'"'s tissue while the tip projects from the catheter, and withdrawing the tip into the catheter after penetrating through the patient'"'"'s tissue.

8. The method of claim 7 wherein locating the target nerve includes activating the electrode in accordance with a first mode to stimulate adjacent tissue, and wherein anesthetizing the region of the patient'"'"'s body includes activating the electrode in accordance with a second mode different than the first mode.

9. The method of claim 1 wherein placing an electrode includes delivering the electrode percutaneously.

10. A method for treating a patient, comprising:

identifying a target nerve which, upon anesthetization, anesthetizes a region of a patient'"'"'s body including a surgical site;

locating the target nerve;

placing an electrode of a nerve blocking apparatus in proximity to the nerve;

connecting the electrode to an external power source via a conductive path inserted through the patient'"'"'s skin;

anesthetizing the region of the patient'"'"'s body by activating the electrode at a frequency of at least 5,000 Hz to block neural propagation of afferent pain signals along the nerve;

retaining the activated electrode of the nerve blocking apparatus in proximity to the nerve during a surgical procedure at the surgical site; and

blocking neural propagation of afferent pain signals after the surgical procedure by activating the electrode at a frequency of at least 5,000 Hz after the surgical procedure.

11. The method of claim 10 wherein blocking neural propagation of afferent pain signals after the surgical procedure includes blocking the pain signals during patient recovery from surgery.

12. The method of claim 10 wherein blocking neural propagation of afferent pain signals after the surgical procedure includes blocking the pain signals to treat chronic patient pain.

13. The method of claim 10 wherein placing an electrode includes delivering the electrode percutaneously.

14. The method of claim 10 wherein placing an electrode includes placing the active electrode surgically.

15. The method of claim 10 wherein anesthetizing the region of the patient'"'"'s body includes anesthetizing the region during knee surgery.

16. The method of claim 10 wherein blocking neural propagation of afferent pain signals after the surgical procedure includes blocking neural propagation of afferent pain signals for days after the surgical procedure.

17. The method of claim 10, further comprising:

implanting a pulse generator; and

coupling the pulse generator to the electrode.

18. A method for treating a patient, comprising:

identifying a target nerve which, upon anesthetization, anesthetizes a region of a patient'"'"'s body including a surgical site;

locating the target nerve;

placing an electrode of a nerve blocking apparatus in proximity to the nerve;

connecting the electrode to an external power source via a conductive path inserted through the patient'"'"'s skin;

anesthetizing the region of the patient'"'"'s body by activating the electrode at a frequency of at least 5,000 Hz to block neural propagation of afferent pain signals along the nerve;

retaining the activated electrode of the nerve blocking apparatus in proximity to the nerve during a surgical procedure at the surgical site; and

blocking neural propagation of afferent pain signals after the surgical procedure by activating an electrode of the nerve blocking apparatus at a frequency of at least 5,000 Hz after the surgical procedure to treat chronic pain experienced by the patient.

19. The method of claim 18 wherein the nerve blocking apparatus includes multiple electrodes, and wherein activating the electrode in proximity to the nerve includes activating a first electrode, and wherein activating an electrode after the surgical procedure to treat chronic pain experienced by the patient includes activating a second electrode.

20. The method of claim 19 wherein at least one of the electrodes is positioned at the patient'"'"'s spinal column.

21. The method of claim 19 wherein at least one of the electrodes is positioned in the patient'"'"'s epidural space.

22. The method of claim 19, further comprising:

implanting a pulse generator; and

coupling the pulse generator to the second electrode.

23. The method of claim 18 wherein placing an electrode includes delivering the electrode percutaneously.

24. The method of claim 18 wherein placing an electrode includes placing the electrode surgically.

25. The method of claim 18 wherein anesthetizing the region of the patient'"'"'s body includes anesthetizing the region during knee surgery.

26. The method of claim 18 wherein blocking neural propagation of afferent pain signals after the surgical procedure includes blocking neural propagation of afferent pain signals for days after the surgical procedure.

27. The method of claim 18, further comprising:

implanting a pulse generator; and

coupling the pulse generator to the electrode.