CN107361830B - Brachial plexus blocking needle sleeve under ultrasonic guidance and using method thereof - Google Patents
Brachial plexus blocking needle sleeve under ultrasonic guidance and using method thereof Download PDFInfo
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- CN107361830B CN107361830B CN201710825566.1A CN201710825566A CN107361830B CN 107361830 B CN107361830 B CN 107361830B CN 201710825566 A CN201710825566 A CN 201710825566A CN 107361830 B CN107361830 B CN 107361830B
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- 210000003461 brachial plexus Anatomy 0.000 title claims abstract description 23
- 238000000034 method Methods 0.000 title abstract description 12
- 230000000903 blocking effect Effects 0.000 title abstract description 11
- 239000011148 porous material Substances 0.000 claims description 6
- 239000007787 solid Substances 0.000 claims description 2
- 210000005036 nerve Anatomy 0.000 abstract description 25
- 239000003589 local anesthetic agent Substances 0.000 abstract description 4
- 230000000694 effects Effects 0.000 abstract 1
- 210000004204 blood vessel Anatomy 0.000 description 4
- 210000003205 muscle Anatomy 0.000 description 4
- 210000001519 tissue Anatomy 0.000 description 4
- 230000006378 damage Effects 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 210000004191 axillary artery Anatomy 0.000 description 2
- 210000002048 axillary vein Anatomy 0.000 description 2
- 230000007547 defect Effects 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 230000030214 innervation Effects 0.000 description 2
- 230000014759 maintenance of location Effects 0.000 description 2
- 230000007383 nerve stimulation Effects 0.000 description 2
- 206010033675 panniculitis Diseases 0.000 description 2
- 210000004304 subcutaneous tissue Anatomy 0.000 description 2
- 206010018852 Haematoma Diseases 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 239000000853 adhesive Substances 0.000 description 1
- 230000001070 adhesive effect Effects 0.000 description 1
- 210000001367 artery Anatomy 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 230000018109 developmental process Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 238000002347 injection Methods 0.000 description 1
- 239000007924 injection Substances 0.000 description 1
- 231100000862 numbness Toxicity 0.000 description 1
- 239000011505 plaster Substances 0.000 description 1
- 230000000638 stimulation Effects 0.000 description 1
- 238000002604 ultrasonography Methods 0.000 description 1
- 210000003462 vein Anatomy 0.000 description 1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3401—Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3413—Needle locating or guiding means guided by ultrasound
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3454—Details of tips
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Anesthesiology (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
The invention discloses an brachial plexus nerve blocking needle sleeve under ultrasonic guidance and a using method thereof. The using method combines the inserted sheath needle core and the sheath needle to be arranged outside the brachial plexus nerve sheath; the inner core needle sleeved with the flow placing tube is inserted into the outer sheath needle and fixedly spliced with the outer sheath needle; after the target nerve is punctured and confirmed, local anesthetic is injected, and if multiple nerve blocks are needed, the operation can be repeated; the flow tube is left. The invention greatly reduces the puncture pain of the patient, has accurate tube placement and can realize the effect of continuous retardation.
Description
Technical Field
The invention relates to an brachial plexus blocking needle sleeve under ultrasonic guidance and a using method thereof.
Background
Currently used neurostimulation blocking needles are mainly divided into two types:
firstly, an outer target needle, namely a bevel needle (the needle point is an acute angle less than 20 degrees), has the defects of being easy to cause cutting injury of nerve vessels, and easily causing more unnecessary injuries when the outer target needle walks in tissues, such as cutting of the tissues, puncturing of blood vessels (hematoma is easy to appear in arteries and extravasated blood is easy to appear in veins), and puncturing or cutting of nerves can cause numbness of skin in a corresponding innervation area of the nerves and weakness of corresponding innervation muscles when the nerves are heavy;
and secondly, the inner core needle, namely the side hole needle (the needle point is a round-thorn needle point), has the defects of troublesome skin puncture process, large puncture force and large pain of a patient, and meanwhile, in the puncture process, a needle tube with smaller outer diameter is selected as much as possible in order to avoid possible damage to nerves and blood vessels. Because the needle body is thin, when the deep puncture is carried out, the needle body is easy to deform along with the movement of human tissues such as muscles, the needle point is displaced, and the distance between the needle point and nerves deviates.
When the indwelling catheter is placed through the sheath needle, the position of the indwelling catheter is inaccurate, and the continuous blocking effect cannot be ensured.
Disclosure of Invention
The invention provides an brachial plexus blocking needle sleeve under ultrasonic guidance and a using method thereof, aiming at solving the technical problems, and the invention greatly relieves the puncture pain of a patient, has accurate tube placement and can realize the continuous blocking effect.
In order to achieve the purpose, the invention adopts the following technical scheme:
an brachial plexus nerve block needle kit under ultrasonic guidance comprises an outer sheath needle, an outer sheath needle core, an inner core needle, a indwelling tube and an indwelling tube connector, wherein the outer sheath needle core is matched with the outer sheath needle, when the outer sheath needle core is inserted and clamped in the outer sheath needle, the head of the outer sheath needle core is flush with a needle head of the outer sheath needle, the indwelling tube is sleeved on a needle body of the inner core needle, a side hole to a needle point of the inner core needle is exposed out of the indwelling tube, when the inner core needle sleeved with the indwelling tube is inserted and clamped in the outer sheath needle, the tail end of the indwelling tube extends out of the needle head of the outer sheath needle, and the indwelling tube connector is matched with the indwelling tube.
The outer sheath needle is an inclined surface thick needle, the outer sheath needle comprises a thick needle body, the tail end of the thick needle body is fixedly inserted into the handle part, the handle part is provided with a pore passage communicated with the through hole of the thick needle body, the handle part of the outer sheath needle is additionally provided with a pressing part used for pressing the tail end of the indwelling tube or an opening which corresponds to the tail part of the indwelling tube.
The pressing part is a transparent elastic body arranged on the handle part of the sheath needle.
The inner core needle is a side hole fine needle, the inner core needle comprises a fine needle body, the fine needle body is fixedly inserted into the handle part, and the handle part is provided with a pore canal communicated with the pore cavity of the fine needle body.
The handle part of the sheath needle and the handle part of the inner core needle are in a splicing structure.
The handle part of the sheath needle is provided with a slot, and the handle part of the inner core needle is provided with a bulge matched with the slot.
The sheath needle core comprises a tube body and a holding part, the head end of the tube body is closed, the tail end of the tube body is fixedly inserted into the holding part, the head of the tube body is sealed and used for blocking the needle head of the sheath needle, the tube body and the holding part are parallel and level, and the holding part of the sheath needle core is provided with an inserting piece matched with the slot of the sheath needle.
The indwelling tube is also matched with a fixator.
A method for using an ultrasonic-guided brachial plexus nerve block needle kit comprises the steps of firstly inserting a needle core of an outer sheath needle into the outer sheath needle, puncturing skin and subcutaneous tissues together, staying outside an brachial plexus nerve sheath, pulling out the needle core of the outer sheath needle, placing the inner core needle sleeved with a indwelling tube into the outer sheath needle, enabling a handle part of the inner core needle to be matched with a handle part of the outer sheath needle in a clamping manner, enabling the inner core needle to be fixed with the outer sheath needle, enabling a needle point of the inner core needle to extend out of a needle head hole of the outer sheath needle, holding the handle part of the inner core needle to adjust a puncturing angle, avoiding axillary artery and axillary vein, puncturing the brachial plexus nerve sheath, opening a nerve stimulation instrument after a target nerve is reached, confirming that muscle movement governed by the corresponding brachial plexus nerve is performed, finishing local anesthetic injection, holding a handle of the outer sheath needle if multiple nerve blocks are required, withdrawing the needle point of the inner core needle out of the brachial plexus nerve sheath, then adjusting the angle, carrying out next nerve positioning, after the nerve positioning is completed, pressing the pressing part or the opening of the sheath needle by hands, pressing the indwelling tube, pulling out the inner core needle, then using the head of the needle core of the sheath needle to prop against the tail end pipe orifice of the indwelling tube, pushing the indwelling tube downwards and simultaneously pulling out the sheath needle, staying the indwelling tube on the body, then connecting the indwelling tube connector at the tail end of the indwelling tube, carrying out next administration operation, and finishing the puncture. .
The invention has the beneficial effects that: firstly, the outer target needle and the needle core of the outer target needle are combined for puncture, the needle point is kept at a position 2 cm away from the nerve through ultrasonic observation, the puncture force is small due to the inclined needle point, the pain of a patient is small, a puncture channel can be quickly established, and the nerve and the blood vessel can be prevented from being damaged due to the long distance from the nerve. The needle core of the outer target needle is pulled out, and then the inner core needle penetrates through the needle tube of the outer target needle, and the front section of the inner core needle is provided with an ultrasonic development design, so that the inner core needle can be obviously distinguished from the needle body of the outer needle under the ultrasonic condition, and then the inner core needle goes deep to perform the nerve stimulation blocking operation. Under the coordination of ultrasound, the inner core needle is guided to approach the nerve and the needle point is moved to the target area, and the needle point of the side hole of the inner core needle is designed to effectively prevent the nerve and the blood vessel from being cut and damaged; the remaining tube is arranged in the inner core needle sleeve, and can be directly and accurately left near the target nerve after puncture administration, so that the subsequent continuous blocking effect is ensured; compared with the traditional indwelling tube, the indwelling tube is much shorter than the traditional indwelling tube exposed outside the skin, so that the problem of replacing the indwelling tube again cannot occur, a fixer is arranged on the external wall of the indwelling tube outside the skin and the indwelling tube connector till now, and medical adhesive plaster is used for fixing the fixer on the skin to prevent the indwelling tube from displacing.
Drawings
FIG. 1 is a schematic view of the combination structure of the sheath needle and the core of the sheath needle of the present invention.
Fig. 1A is a schematic structural view of the sheath needle in fig. 1.
Fig. 1B is a schematic structural view of the needle core of the sheath needle in fig. 1.
Fig. 1C is a schematic structural view of another embodiment of the sheath needle.
Fig. 2A is a schematic structural view of the indwelling catheter.
Fig. 2B is a schematic structural view of the inner core pin.
FIG. 2 is a schematic view of the structure of the indwelling cannula of the present invention mounted on the stylet.
FIG. 3 is a schematic view of the assembly of the sheath needle, the core needle and the indwelling catheter of the present invention.
FIG. 4 is a schematic view of the retention tube in combination with the holder and retention tube connector of the present invention.
1: sheath needle, 11: thick needle body, 111: needle, 12: handle portion, 121: pressing portion, 122: duct, 123: opening, 124: slot, 2: sheath needle core, 21: a pipe body, 211: head, 22: grip portion, 221: inserting sheet, 3: inner core needle, 31: fine needle body, 32: handle portion, 321: projection, 322: duct, 311: side hole, 4: flow placing pipe, 41: holder, 5: a flow tube placing connector.
Detailed Description
As shown in fig. 1 to 4, an ultrasonic-guided brachial plexus block needle kit comprises an outer sheath needle 1, an outer sheath needle core 2, an inner core needle 3, a indwelling tube 4 and an indwelling tube connector 5, wherein the outer sheath needle core 2 is matched with the outer sheath needle 1, when the outer sheath needle core 2 is inserted into the outer sheath needle 1, the head 211 of the outer sheath needle core 2 is flush with the needle head 111 of the outer sheath needle 1, the indwelling tube 4 is sleeved on the thin needle body 31 of the inner core needle 3, the side hole 311 of the inner core needle 3 to the needle point is exposed out of the indwelling tube 4, when the inner core needle 3 sleeved with the indwelling tube 4 is inserted into the outer sheath needle 1, the tail end of the indwelling tube 4 extends out of the needle head 111 of the outer sheath needle 1, and the indwelling tube connector 5 is matched with the indwelling tube 4.
As shown in fig. 1A, the sheath needle 1 is a bevel thick needle, the sheath needle 1 includes a thick needle body 11, the tail of the thick needle body 11 is inserted into the handle portion 12, the handle portion 12 is provided with a hole 122 communicating with the hole of the thick needle body 11, the handle portion 12 of the sheath needle 1 is further provided with a pressing portion 121 for pressing the tail of the indwelling catheter 4 or the handle portion 12 of the sheath needle 1 is provided with an opening 123 (as shown in fig. 1C), the tail of the indwelling catheter 4 is directly pressed by hand through the opening 123, and the handle portion 12 of the sheath needle 1 is provided with a slot 124.
The pressing portion 121 is a transparent elastic body provided in the handle portion 12 of the sheath needle 1.
The sheath needle 1 is matched with a sheath needle core 2, and aims to prevent the tissue from being damaged in the puncture process;
as shown in fig. 1B, the sheath needle core 2 includes a tube 21 and a holding portion 22, the holding portion 21 of the sheath needle core 2 and the handle portion 12 of the sheath needle 1 are in a plug-in structure, the tube 21 is a solid tube, the tail portion of the tube 21 is inserted into the holding portion 22, the head portion 211 of the tube 21 seals the needle head 111 of the sheath needle 1, the two are flush, and the outer diameter of the tube 21 is equal to the inner diameter of the needle body 11 of the sheath needle 1; the holding part 22 of the outer sheath needle core 2 is provided with a plug piece 221 matched with the slot 124.
The handle part 12 of the sheath needle 1 and the handle part 32 of the inner core needle 3 are in a plug structure.
As shown in fig. 2B, the stylet 3 is a side-hole thin stylet, the stylet 3 includes a thin stylet body 31, one end of the thin stylet body 31 is fixedly inserted into the handle portion 32, the handle portion 32 is provided with a hole 322 communicated with the cavity of the thin stylet body 31, the handle portion 32 is further provided with a protrusion 321 matching with the slot 124; the tail end of the thin needle body 31 of the inner core needle 3 is connected with a lead, and the other end of the lead is connected with a nerve electrical stimulation instrument (not shown in the figure).
As shown in fig. 2A, the flow tube 4 is a schematic structural diagram.
As shown in FIG. 2, the flow-placing tube 4 is sleeved on the thin needle body 31 of the inner core needle 3 along the length direction thereof, and the side hole 311 of the thin needle body 31 is exposed to the needle point.
As shown in fig. 3, the stylet 3, which is sleeved with the flow-placing tube 4, is inserted into the cavity of the thick needle body 11 of the sheath needle 1 through the duct 122 of the sheath needle 1 and extends out of the needle head 111 of the sheath needle 1, and the protrusion 321 of the handle part 32 of the stylet 3 is inserted into the slot 124 of the handle part 12 of the sheath needle 1.
The needle point of the inner core needle 3 extends out of the needle head 111 of the outer sheath needle 1, and the extending length of the needle head is about 1 cm.
As shown in FIG. 4, in order to prevent the displacement of the flow tube 4, a holder 41 is further fitted to the indwelling tube 4 outside the skin, the holder 41 is fixed to the skin by a medical tape, then the flow tube connector 5 is screwed to the rear end of the flow tube 4, and the flow tube connector 5 is connected to a catheter for the next administration treatment.
The using process of the brachial plexus nerve block needle set under ultrasonic guidance is roughly summarized into four steps;
the first step is as follows: the inserted sheath needle core and the sheath needle are combined and arranged outside the brachial plexus nerve sheath;
the second step is that: the inner core needle sleeved with the flow placing tube is inserted into the outer sheath needle and fixedly spliced with the outer sheath needle;
the third step: after the target nerve is punctured and confirmed, local anesthetic is injected, and if multiple nerve blocks are needed, the operation can be repeated;
a fourth step of: the flow tube is left.
The method of using the ultrasonic-guided brachial plexus block needle set is described in detail below: firstly, inserting the needle core of the outer sheath needle into the outer sheath needle, puncturing the skin and subcutaneous tissues together, staying outside an brachial plexus nerve sheath, pulling out the needle core of the outer sheath needle, placing the inner core needle sleeved with the indwelling tube into the outer sheath needle, enabling the handle part of the inner core needle to be matched with the handle part of the outer sheath needle in a clamping manner, enabling the inner core needle to be fixed with the outer sheath needle, at the moment, extending the needle point of the inner core needle out of the needle head hole of the outer sheath needle, holding the handle part of the inner core needle to adjust the puncture angle, avoiding axillary artery plexus and axillary vein, puncturing the brachial plexus nerve sheath, then opening a nerve electrical stimulator after reaching a target nerve, confirming that muscle movement dominated by corresponding brachial plexus nerve is performed, after injecting local anesthetic, if a plurality of nerve blocks are needed, holding the handle of the outer sheath needle, withdrawing the needle point of the inner core needle out of the brachial plexus nerve sheath, then adjusting the angle, performing next nerve location, and after, the pressing part or the opening of the sheath needle is pressed by a hand, the indwelling tube is pressed, the inner core needle is pulled out, then the head of the needle core of the sheath needle is used for propping against the tube orifice at the tail end of the indwelling tube, the indwelling tube is pushed downwards, the sheath needle is pulled out, the indwelling tube is stayed on the body, then the indwelling tube connector is connected at the tail end of the indwelling tube, the next administration operation is carried out, and the puncture is finished.
Claims (3)
1. An ultrasonic-guided brachial plexus block needle kit, characterized in that: the sheath needle is a bevel thick needle, the sheath needle comprises a thick needle body, the tail end of the thick needle body is fixedly inserted into a handle part, the handle part is provided with a pore channel communicated with a through hole of the thick needle body, the handle part of the sheath needle is additionally provided with a pressing part for pressing the tail end of the remaining tube or is provided with an opening corresponding to the tail part of the remaining tube, the handle part of the sheath needle is provided with a slot, the sheath needle core is matched with the sheath needle, when the sheath needle core is inserted and clamped in the sheath needle, the head part of the sheath needle core is flush with the needle head of the sheath needle, the sheath needle core comprises a tube body and a holding part, the tube body is a solid tube body, the head end of the tube body is closed, and the tail end of the tube body is fixedly inserted into the holding part, the head of the tube body is sealed to block the needle head of the sheath needle, the needle head and the needle head are parallel and level, the holding part of the needle core of the sheath needle is provided with an inserting piece matched with the slot of the sheath needle, the indwelling tube is sleeved on the needle body of the inner core needle, the inner core needle is a side hole thin needle, the inner core needle comprises a thin needle body, the thin needle body is fixedly inserted into the handle part, the handle part is provided with a pore channel communicated with the pore channel of the thin needle body, the handle part of the sheath needle and the handle part of the inner core needle are in an inserting structure, so that the inner core needle and the outer sheath needle are fixed, the side hole to the needle point part of the inner core needle is exposed out of the indwelling tube, when the inner core needle sleeved with the indwelling tube is inserted and clamped in the sheath needle, the tail end of the indwelling tube extends out of the needle head of the sheath needle, the indwelling tube connector is matched with the indwelling tube, and the indwelling tube is also matched with.
2. The ultrasonically guided brachial plexus block needle kit according to claim 1, wherein: the pressing part is a transparent elastic body arranged on the handle part of the sheath needle.
3. The ultrasonically guided brachial plexus block needle kit according to claim 2, wherein: the handle part of the inner core needle is provided with a bulge matched with the slot.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710825566.1A CN107361830B (en) | 2017-09-14 | 2017-09-14 | Brachial plexus blocking needle sleeve under ultrasonic guidance and using method thereof |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710825566.1A CN107361830B (en) | 2017-09-14 | 2017-09-14 | Brachial plexus blocking needle sleeve under ultrasonic guidance and using method thereof |
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| CN107361830A CN107361830A (en) | 2017-11-21 |
| CN107361830B true CN107361830B (en) | 2020-02-14 |
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| CN109662761A (en) * | 2019-02-20 | 2019-04-23 | 上海市肺科医院 | Multi-angle puncture and injection of medicine device in ultrasonic guidance lower plane |
| CN111773523A (en) * | 2020-08-10 | 2020-10-16 | 华中科技大学同济医学院附属协和医院 | Multifunctional drainage tube and use method thereof |
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| US5232442A (en) * | 1989-12-11 | 1993-08-03 | Brigham And Women's Hospital | Method and apparatus for inducing anesthesia |
| CN2832183Y (en) * | 2005-11-15 | 2006-11-01 | 徐旭仲 | Ultrasonic guided brachial plexus block trocar |
| CN204428123U (en) * | 2015-01-04 | 2015-07-01 | 青岛市市立医院 | A kind of new type nerve blockage puncture pin |
| CN208551957U (en) * | 2017-09-14 | 2019-03-01 | 北京积水潭医院 | A kind of brachial plexus nerve block needle guard part of ultrasound guidance |
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Address after: 100035 No. 31 East Xinjiekou street, Beijing, Xicheng District Patentee after: Beijing Jishuitan Hospital Affiliated to Capital Medical University Address before: 31 Xinjiekou East Road, Xicheng District, Beijing, 100035 Patentee before: BEIJING JISHUITAN Hospital |