Methods and apparatus for administering local anesthetic

• US 9,895,510 B2
• Filed: 01/21/2016
• Issued: 02/20/2018
• Est. Priority Date: 01/26/2011
• Status: Active Grant

• Current Assignee: Avent Incorporated (Avanos Medical, Inc.)
• Original Assignee: Avent Incorporated (Avanos Medical, Inc.)
• Inventors: Guzman, Michael F.
• Primary Examiner(s): LAURITZEN, AMANDA L
• Application Number:
  US15/002,465
• Publication Number:
  US 20160136381A1
• Time in Patent Office: 761 Days
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 17/3401 Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia local anaesthesia A61M19/00
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 46/00 Surgical drapes
• CPC Class Codes: A61B 46/20 specially adapted for patients
• CPC Class Codes: A61B 5/1106 to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia
• CPC Class Codes: A61B 5/4821 Determining level or depth of anaesthesia A61B5/1106 takes precedence
• CPC Class Codes: A61B 8/0841 for locating instruments
• 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 2005/1726 the body parameters being measured at, or proximate to, the infusion site
• CPC Class Codes: A61M 2025/0007 Epidural catheters
• CPC Class Codes: A61M 2025/0681 Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
• CPC Class Codes: A61M 2210/1003 Spinal column
• CPC Class Codes: A61M 2210/1017 Peritoneal cavity
• CPC Class Codes: A61M 2210/1021 Abdominal cavity
• CPC Class Codes: A61M 25/06 Body-piercing guide needles or the like
• CPC Class Codes: A61M 25/065 Guide needles
• CPC Class Codes: A61M 25/0662 Guide tubes
• CPC Class Codes: A61M 25/0668 splittable, tear apart
• CPC Class Codes: A61M 29/00 Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00
• CPC Class Codes: A61M 5/142 : Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/158 : Needles for infusions; Accessories therefor, e.g. for inserting infusion needles, or for holding them on the body
• CPC Class Codes: A61M 5/1723 : using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61M 5/42 : having means for desensitising skin, for protruding skin to facilitate piercing, or for locating point where body is to be pierced
• CPC Class Codes: A61M 5/427 : Locating point where body is to be pierced, e.g. vein location means using ultrasonic waves, injection site templates
• CPC Class Codes: A61M 5/46 : having means for controlling depth of insertion

Abstract

Apparatus for administering certain nerve blocks includes a sheath constructed from a flexible ultrasound echogenic material, a more rigid introducer/dilator for introducing the sheath into the patient, and an ultrasound echogenic catheter for inserting through the sheath once the distal end of the sheath is in place adjacent the nerve(s) to be blocked and the introducer/dilator has been withdrawn. The catheter has provisions at its proximal end for connecting to a source of local anesthetic. Methods for use of this apparatus are also described.

Claims

1. A method for administering a transversus abdominis plane (TAP) block to a patient, the method comprising distending the patient'"'"'s abdomen, while the patient'"'"'s abdomen is distended, penetrating the exterior wall of the abdomen with a needle sheathed within a sheath having an open distal end through which a distal end of the needle projects, advancing the sheathed needle to the belly of the transversus abdominis muscle by penetrating the transversus abdominis muscle, administering an amount of a local anesthetic, viewing the peritoneum for a bulge adjacent the location where the local anesthetic is being administered, removing the needle from the sheath, inserting a catheter through the sheath until the catheter extends from a distal end of the sheath, removing the sheath, connecting a proximal end of the catheter to a source of local anesthetic, and commencing anesthesia, wherein a tip of the catheter remains in the belly of the transversus abdominus muscle during administration of the TAP block.

2. The method of claim 1 wherein viewing the peritoneum for a bulge adjacent the location where the local anesthetic is being administered comprises viewing the peritoneum using one or more laparoscopic cameras and one or more monitors.

3. The method of claim 1 wherein advancing the sheathed needle to the belly of the transversus abdominis muscle further comprises penetrating the patient'"'"'s skin, fat, external oblique muscle, and internal oblique muscle, wherein the sheathed needle is slid in a plane parallel to and outside the patient'"'"'s peritoneum.

4. The method of claim 1 wherein connecting the proximal end of the catheter to the source of local anesthetic comprises attaching an adapter to an external end of the catheter and attaching the adapter to an infusion pump.

5. The method of claim 1, wherein the catheter is a multi-orifice catheter and anesthesia is delivered locally from the catheter while the catheter is left in place.

6. A method for administering a transversus abdominis plane (TAP) block to a patient, the method comprising penetrating an exterior wall of a patient'"'"'s abdomen with a needle sheathed within a sheath having an open distal end through which a distal end of the needle projects, advancing the sheathed needle to the transversus abdominis muscle by penetrating the transversus abdominis muscle, administering an amount of a local anesthetic, removing the needle from the sheath, inserting a catheter through the sheath until the catheter extends from a distal end of the sheath, removing the sheath, connecting a proximal end of the catheter to a source of local anesthetic, and commencing anesthesia, wherein a tip of the catheter remains inside the transversus abdominus muscle during administration of the TAP block.

7. The method of claim 6, further comprising viewing the peritoneum for a bulge adjacent the location where the local anesthetic is being administered, wherein viewing the peritoneum for a bulge comprises viewing the peritoneum using one or more laparoscopic cameras and one or more monitors.

8. The method of claim 6 wherein the sheathed needle is advanced to the belly of the transversus abdominis muscle by also penetrating the patient'"'"'s skin, fat, external oblique muscle, and internal oblique muscle wherein the sheathed needle is slid in a plane parallel to and outside the patient'"'"'s peritoneum.

9. The method of claim 6 wherein connecting the proximal end of the catheter to the source of local anesthetic comprises attaching an adapter to an external end of the catheter and attaching the adapter to an infusion pump.

10. The method of claim 6, wherein the catheter is a multi-orifice catheter and anesthesia is delivered locally from the catheter while the catheter is left in place.