CN1177467A - Double-pole charge pulser convenient for positioning nerre for use in periphery nerve blocking operation - Google Patents
Double-pole charge pulser convenient for positioning nerre for use in periphery nerve blocking operation Download PDFInfo
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- CN1177467A CN1177467A CN 97118553 CN97118553A CN1177467A CN 1177467 A CN1177467 A CN 1177467A CN 97118553 CN97118553 CN 97118553 CN 97118553 A CN97118553 A CN 97118553A CN 1177467 A CN1177467 A CN 1177467A
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Abstract
An electronic positioning device for positioning anaesthetized nerve includes a needle module with a grounding tube; a nonconductive tube covered on the needle tube; and a conductive layer plated on the nonconductive tube. The two conductors are connected with a stimulator and the stimulator produces alternant high-charge pulse and low-charge pulse by a constant low current. When the needle is inserted into the body of the patient, the high-charge pulse causes obvious muscle twitch and the amplitude of the muscle twitch caused by the high-charge pulse will reach a peak value; as the needle is close to targeting nerve, the low-charge pulse makes the muscle twitch become obvious; after the positioning, the twitch caused by high-charge and low-charge pulse is difficult to distinguish.
Description
The present invention relates to a kind of device that is used for locating a nerve effectively and then carries liquor-saturated dose of seat to this nerve.
Many medical surgeries all need patient is carried out local anesthesia at least.For many medical surgeries, regional anesthesia or nerve block are better than general anesthesia.For example, regional anesthesia or nerve block are less to the wound that the patient who undergos surgery causes usually, and the post-operative recovery time is short.
Regional anesthesia or nerve block need position supplying with narcotic nerve.There have been some to be used to locate neural method in the prior art.In this class existent method of great majority, the doctor utilizes general human dissection to gain knowledge generally to locate the target nerve.According to a kind of existent method, a conductive pad is placed on the patient body on the skin with the neural position at a distance of certain distance of target.For example, if the target nerve is positioned at shoulder, then conductive pad can be fixed to the end of arm.Couple together with the stimulation box of a lead with conductive pad and prior art, as the back will further be explained, described stimulation box can produce electric current.Then, along waiting that the roughly direction of supplying with narcotic nerve is inserted into an electric insulation needle tubing that has on-insulated conductive pinpoint in skin and the subcutaneous tissue.By a lead pin of this prior art and the electricity irritation box of this prior art are coupled together.
The electricity irritation box of prior art was driven by electricity and can produce the current impulse that can regulate in the persistent period of about 100 to 200 microseconds (" μ s ").This current impulse is set on the level of about 1.0-5.0 milliampere (" mA ") at first.In syringe needle being placed into tissue with the neural approaching position of target in the time, this current level is enough to stimulate the target nerve.This thorn is goaded into action in the body part (for example finger) by the neural control of target and is caused tangible muscle twitch.Then, electric current slowly reduces, and disappears up to ballism.Then, push the syringe needle of this prior art to the target nerve lentamente, up to occurring ballism once more.The syringe needle of this prior art continues to repeat this process, up to can cause tangible muscle twitch with the current level of about 0.2-0.3 milliampere till.At this moment can think just that the syringe needle of this prior art is enough near waiting to execute narcotic nerve.Then, when syringe needle continues to produce current impulse, directly by this syringe needle dispensing anesthetis.Usually the termination of muscle twitch is regarded as the successfully neural sign in location.
Electronics localization method in the prior art can be guaranteed accurately to place and is used to apply narcotic syringe needle.But there are several shortcomings in the apparatus and method that are used for electronics location target nerve in the prior art.For example, the electronic position-fixing device that comprises the prior art of electricity irritation box is a not only huge but also expensive difficult sterilization and a reusable device.Therefore, in the gnotobasis of operating room, use this electronic position-fixing device to have some problems.Generally need finish the operation sequence of this prior art by two technical staff, that is, first technical staff operates and grasps syringe needle under gnotobasis, and second technical staff separates with first technical staff, under non-sterile condition, work, current level is reduced gradually.Need be with two technical staff than higher cost, and also requiring can have reasonable coordination and contact between these two technical staff.
The second, when syringe needle had been on the position that is suitable for injecting narcotic, the electronic position-fixing device of this prior art can not provide a clear and definite indication.The attending doctor must determine when syringe needle is in the optimum position with judgement and experience.
The 3rd, because the distance between the conductive pad of insulating needle and prior art is long, need generation to reach required current level than higher voltage.In the electronic position-fixing device of prior art, adopt the voltage of at least 25 volts (" V ") usually.High like this voltage has limited the application of the device of prior art.For example, high like this voltage can influence the operation of pacemaker and other implanted electronic installation.Therefore, the electronic position-fixing device of prior art can not be used on one's body the patient who has the implanted electronic installation usually.
In addition, might starting arc than higher energy.Therefore, the electronic position-fixing device of prior art can not be applied to for example can not use in the environment that will use oxygen in many surgical environments, but because fire hazard or blast.High current level also may damage near the tissue the syringe needle.
The purpose of this invention is to provide and a kind ofly accurately reach effective localized electronic position-fixing device discharging narcotic nerve.This device adopts enough low energy to avoid the damage that may cause organizing, and has patient under the situation of implanted electronic installation and can use this device.And this device volume is little, makes low cost of manufacture for disposable (single use) uses, and can sterilize fully, in the gnotobasis for use in operating room.In addition, only need a technical staff just can use this device.
As mentioned above, the needed voltage of electronic position-fixing device be two between the conductor distance and the function of patient's contact resistance.In order to reduce this distance significantly, the present invention is provided with two conductors on needle tubing.Or rather, electronic position-fixing device of the present invention can adopt a needle assembly with conductor of a pair of coaxial setting.This inner wire to coaxial conductor can be a pin.Can put a nonconducting overcoat or pipe in this inner wire outside then, provide one deck to play the conductive material of outer conductor effect by electroplating (plate), coating (coate), compound (coextrud) or other means again.Can form an inclined-plane or wedge angle (bevel or chamfer) at the end of nonconducting pipe.This inclined-plane can be made of the nonconducting binding agent of one deck at the end of pipe.The binding agent that forms the inclined-plane plays fixing tube and is convenient to needle assembly and is inserted into the intravital effect of patient.Distance (spacing) between two conductors of this electronic position-fixing device determines that by tip edge (the distal edge of the bevel) to the distance of the shell of conduction on inclined-plane this distance preferably is a bit larger tham 1.0 millimeters (" mm ").Because this distance is very little, so can produce required electric current with low-down voltage.The inventor believes that of the present invention this makes this electronic position-fixing device be suitable for wearing the patient of pacemaker one class implanted electronic installation on the one hand.And, because energy is lower, make electronic position-fixing device of the present invention to use effectively in all operating room environments, comprise that those can cause incendiary environment by the electronic position-fixing device of prior art.In addition, low-voltage has been simplified circuit, thereby can provide sort circuit easily with very little plug-in unit.
As mentioned above, the electronic position-fixing device of prior art needs two technical staff, that is, first technical staff handles pin carefully, and second technical staff changes electric current carefully.Electronic position-fixing device of the present invention adopts the diverse structure with diverse principle work, therefore, only needs a technical staff just can use this device.The advanced part of this electronic position-fixing device is, utilizes electric charge rather than utilizes electric current to measure the threshold values of the electrical quantity that produces muscle twitch more accurately.Electric charge is the product of electric current and time, therefore, both can also can change electric charge by changing the persistent period by changing electric current.In first preferred embodiment, electronic position-fixing device of the present invention produces constant current impulse; But consecutive pulses alternately occurred with a long persistent period and a relatively shorter persistent period.In this manner, successive constant current pulses alternately occurs between than higher electric charge and lower electric charge.In second embodiment, this electronic position-fixing device alternately transmits than higher current impulse (for example 0.5mA) and lower current impulse (for example 0.1-0.2mA).Each pulse can have the same persistent period (for example 0.1-0.2 millisecond (" mS ")) and can be with uniform interval 0.25-2.0 second for example) produce these pulses.
Use a method of electronic position-fixing device of the present invention, comprise the step of shifting onto pin in the patient body and making pin alignment targets nerve.After skin is penetrated (for example, when needle point during), describedly will on the neural position of target, cause muscle twitch than higher charge pulse from the neural approximately 1.0cm of target.And lower charge pulse can not produce the electric charge that is enough to cause muscle twitch on this initial position.For example, these pulses may be separated by the interval with about half (back is referred to as " 1/2 " or " 0.5 ") second.Therefore, the doctor sees the muscle twitch that takes place with about one second interval in first meeting, and this interval is corresponding with high charge pulse.
Along with pin being shifted to the target nerve, the doctor can observe, and the amplitude of the initial viewed muscle twitch that is caused by high charge pulse has increase slightly.Simultaneously, the doctor also will begin to observe the little muscle twitch that is caused by the low charge pulse of following in each high charge pulse back.Like this, utilize the example of front, the doctor can see, locates a less ballism that is caused by low charge pulse in 0.5 second a big ballism back that is caused by high charge pulse, then, the big ballism that after 0.5 second, has another to cause again by high charge pulse.
The big ballism that is caused by high charge pulse will reach a peak value rapidly, and therefore, pin obviously increases towards amplitude or the intensity that being moved further of target nerve can not make the ballism that is caused by high charge pulse.
Along with pin continues to approach to the target nerve, the amplitude and the intensity of the ballism that is caused by low charge pulse can increase gradually.The amplitude of low electric charge ballism and these variations of intensity are easy to be observed by the doctor of contact pin.Along with needle point approaches to the target nerve, big and little ballism will become and be difficult to differentiate, and the doctor can only observe the same basically muscle twitch that the twice of the interval that arrives with about 0.5 second interval or with original observed takes place.This shows Xiang the doctor that just needle point has been in and has been suitable for discharging on the specific narcotic position.Can push anesthetis to the target nerve by this pin then.Subsequently, dopey nerve will stop ballism, give clear and definite indication of doctor whereby: arrived target nerve and anesthetis and produced its expected effect.Then, the doctor only need pull a switch on the little control panel of this electronic position-fixing device to stop flowing to the electric current of pin.
Done description substantially although just utilize the principle that produces the alternative charge pulse of height herein, those skilled in the art should understand, can also be according to concrete application requirements, electronic position-fixing device described in the invention and ingredient are configured to produce the form of multiple gradual charge pulse (gradedcharge pulse).For example, anatomy according to the neural peripheral region that will look for, perhaps can confirm, approach along with neurophilic, repeat to produce the charge pulse that steadily reduces than along with neurophilic approach produce pure high charge pulse and the pure low alternative pulse train of charge pulse superior.In other words, can make described device and corresponding parts not produce the alternative charge pulse series of height, and produce the repetitive sequence of gradual charge pulse, make the amplitude of each pulse be reduced to a selected minimum charge pulse from the highest selected charge pulse.Concerning some region of anatomy, this mode make the operator in a wider context the clinical observation nerve for the concrete reaction of charge pulse, thereby understand the method that nerve is positioned with this device more accurately.The pulse of other shape also can be adopted.
Describe the present invention in conjunction with the embodiments with reference to the accompanying drawings in detail.
Fig. 1 is the perspective view of bipolar electronics location of the present invention (bipolar electrolocation) device;
Fig. 2 is the sectional elevation of the pin (needle) among the present invention;
Fig. 3 is the block diagram that produces the circuit ingredient of suitable charge pulse by the pin (needle) among Fig. 2 of the present invention;
Fig. 4 is the example that some the circuit ingredients in the block diagram shown in Figure 3 are combined;
Fig. 5 illustrates pulse generation form of the present invention.
In Fig. 1, represent whole electronics location of the present invention (electrolocation) device with numeral 10.Device 10 comprises a needle assembly 12 (needle assembly), and 14 and one of stimulators (stimulator) are used for the narcotic pipe 16 by needle assembly 12 dispensings one dosage.
Clearly show that as Fig. 2 needle assembly 12 comprises an elongated needle tubing 20, needle tubing 20 has 22, one far-ends 24 of a near-end and a chamber (lumen) 26 that stretches continuously between near-end 22 and far-end 24.Needle tubing 20 is made by a kind of conductive material, is preferably made by rustless steel.The proximal part 20 of needle tubing 20 is fixed in the stimulator 14 reliably, and the near-end of needle tubing (proximal) and far-end (distal) are positioned at the relative both sides of stimulator.24 one-tenth oblique sharpenings of the far-end of needle tubing 20, so that enter the target nerve by tissue is pierced through.
On the external peripheral surface of pipe 28 one deck conductive layer 36 is arranged, can form this conductive layer 36 with the mode of coating or plating.Layer 36 is gold preferably, and is distributed to the far-end 32 of pipe 28 with the thickness of about 550 dusts continuously from managing 28 near-end 30 always.As hereinafter described, needle assembly 12 plays the effect of a pair of coaxial conductor.Specifically, rustless steel needle tubing 20 plays inner wire, and the gold layer 36 of managing on 28 plays outer conductor.Managing 28 is that the nonconducting insulating barrier of one deck separates with inner wire and the outer conductor that will be determined by rustless steel needle tubing 20 and gold layer 36 respectively.
As described above, rustless steel needle tubing 20 runs through stimulator 14 continuously, thereby the near-end 22 of needle tubing 20 is positioned at a side of stimulator 14, and far-end 24 then is positioned at the opposite side of stimulator 14.The near-end 30 of plastic tube 28 is in the stimulator 14.Consequently, rustless steel needle tubing 20 and gold layer 36 all expose in stimulator 14, so that electrically contact.
Box body 38 has multiple function, is included as needle assembly 12 structural support is provided, and is convenient to the electronic component that holds needle assembly 12 and seal electronic position-fixing device 10 safely.
Comprise an on/off switch 48 and a light emitting diode (LED) 50 in the electronic circuit of stimulator 14, can get at and/or visible these two devices from the outside of box body 38.The effect of on/off switch 48 is to connect other component that battery and back will be described, and perhaps also can be used to carry out the conversion between the high quantity of electric charge and the low quantity of electric charge.The effect of LED50 is along with each electrical energy pulse produces a light pulse, makes the technical staff or the doctor in charge energy pulse and patient's muscle twitch on one's body can be done a comparison.
Fig. 3 represents to be used for the circuit of stimulator 14.Those skilled in the art can understand, a way implementing sort circuit be with the CMOS technology as active device with its digitized.Other implementing method, it also is feasible for example adopting traditional integrated circuit (" ICs ").Herein, on/off switch 48 links to each other with one 3 volts lithium battery (lithium cell battery) 52.Under off-state, quiescent current is lower than 1 microampere (" μ A "), and therefore battery life has guaranteed that this electronic position-fixing device 10 has enough shelf lifes more than 8 years.Under on-state, the agitator sum counter that the back will be described is activated, and battery can use about 100 hours for stimulator.
The burst length width modulated is realized by enumerator 54.Utilize the output of enumerator 54 can produce a short pulse as 122 μ S.Because the output of enumerator 54 is periodic signals, timing is selected door network 56 selections one-period output signal and it is added on the current source network 58.In the embodiment shown in fig. 3, alternately low charge pulse of gating or high charge pulse of door network 56.As shown in Figure 5, stimulator 14 can alternately produce the pulse of a short pulse width and the pulse of a long pulse width.The current value of all these pulses all is constant, but the persistent period difference.For example, stimulator 14 can take place by a persistent period is the 0.2mA electric current of 122 μ S so that produce one 24.4 Na Ku (nanocoulombs) (" nC ")) the lower quantity of electric charge, 0.2mA electric current that a persistent period is about 488 μ S then takes place to produce the higher quantity of electric charge of a 97nC.Those skilled in the art can analyze out, and along with the difference of selecting to be used to produce the assembly of pulse, the pulse duration also can change in the regular hour scope, for example, herein, this scope can be the persistent period approximately+/-20%.Also can replace high electric charge and the low electric charge that occurs to producing with other constant-current pulse with various durations.
Also circuit design shown in Figure 3 can be become produce the form of the synthetic constant persistent period pulse of current amplitude.For example, the 0.2mA electric current that can take place be 122 μ S a persistent period to be to produce the lower electric charge of a 24.4nC, and the 0.8mA high-current pulse that then take place is 122 μ S a persistent period is to produce the higher electric charge of a 97nC.It should be noted that the electric charge that is produced by the current level modulation scheme equals the electric charge that the persistent period modulation scheme produces.
Fig. 3 is the block diagram of the set of circuits element in the stimulator 14, and its effect is the suitable charge pulse that produces by bipolar pin (bipolar needle) 12, and Fig. 4 is the composition example of the component in the square frame of Fig. 3.As shown in Figure 3, the on/off controller 51 that is started by switch 48 has an output to be used for control generator 53 so that enumerator 54 starts, and another output of on/off controller 51 then is used for activation and forbids enumerator 54 countings.The 3rd output is fed to control circuit 55, and control circuit 55 receives from the output of enumerator 54 and excites the constant current of an electrode (20 or 36) that is connected in bipolar pin 12 to absorb circuit (constant current sink) 58.The indicator circuit 57 that is used for driven for emitting lights diode 50 receives the input that comes from agitator 53, enumerator 54 and power supply V+, and described power supply V+ is connected on another electrode (36 or 20) of described bipolar pin 12 by an electric charge limiter 59.The time of this charge pulse and amplitude are by regularly selecting door part 56 modulation, and this regularly selects door part 56 to link to each other with control circuit 55.
See the circuit details among Fig. 4 again, on/off controller 51 can comprise an on/off switch 48, this switch 48 with the voltage V+ of battery 52 with comprise that (R1, C3) circuit of combination is connected for a trigger A1B and a RC.When needs operative installations 10, switch 48 is placed on-position and keep on-state to prevent on pin, occurring any current fluctuation (surges).The timing of trigger A1B control generator 53, agitator 53 can comprise a schmitt trigger A3A, and control counter 54 is carried out counting and is stopped counting, enumerator 54 can be the enumerator A2 of a 12bit, and absorber control circuit (sink control circuit) 55 can comprise a trigger A1A.When A1B connected, output lead 12 was low or 0, and resetting of enumerator A2 finished, thereby can count, and resetting of A1A finished, thereby can at random change state.Correspondingly, the output lead 13 of A1B is high or just, thereby agitator A3A work, for example with 4.096 kilo hertzs (" kHz ") vibration, makes enumerator A2 counting, makes 1 foot of A2 change a next state in per 1/2 second subsequently, and 15 feet uprised (positively) once in per 1/2 second.Therefore, 15 feet change state with the speed that doubles 1 foot.When A1B disconnected, line 13 step-downs A3A is no longer exported, and line 12 uprised, and A2 and A1A are resetted.
When 15 feet of A2 uprised (positive), the output lead 1 that mails to the clock enabling signal A1A of A1A uprised.By means of voltage V+, transmit base current by resistance R 4 and R5 to audion Q3, Q3 is switched on, thus closed from battery V+ through capacitor C 4, resistance R 7 to ground and the current path of the described pin 12 of flowing through.If be added in voltage on the R7 greater than 0.55V, then come the base stage of driving transistors Q2 by resistance R 6, cause transistor Q2 conducting, this will reduce to flow to the electric current of transistor Q3 base stage, thereby make the voltage that is added in resistance R 7 two ends remain on 0.55V.Therefore, the electric current by pin 12 keeps constant substantially.When the current path of pin is short-circuited or during fault (failure), then maximum amount of charge and the restriction current level effect of playing an electric charge limiter of capacitor C 4 by charging to a preliminary election.
The time of current impulse and waveform are to utilize regularly to select door part 56 to determine, described timing selects door part 56 to comprise A3B, A3C and three doors of A3D, these parts 56 receive and come from the input of agitator A3A sum counter A2, and a trigger A1A who exports to absorber control circuit 55 is provided.Door A3B control sequential short pulse shown in Figure 5.Can see, work during to the input pin 10 of enumerator A2 in negative pulse, so that be output as when negative when the 3rd foot of A3A, the 15th foot of A2 just is output as, and as previously mentioned, connects current path by described pin with driving A1A.The 3rd foot output of A3A also is provided for the 6th input pin of an A3B, and another input pin the 5th foot of door A3B is accepted the output of the 1st foot of A2.If the 1st foot signal of A2 be the signal of the 5th foot of height thereby A3B for high, then when 6 feet of A3B when being high, an A3B can work.If 1 foot of A2 is low or is 0 that then the 5th foot of door A3B also is low, and the effect of door A3B unable to get up.The operation of door A3B can be used for controlling replacing of short charge pulse and long charge pulse.When the 1st foot of A2 when being high, then produce short pulse.
Say that more properly when the 3rd foot step-down of A3A, enumerator 54 will enter its NextState.15 feet uprise and will make electric current begin to flow through described pin, so and since 1 foot of A2 be the 5th foot of height A3B for high, this moment, the 6th foot of A3B became low along with 3 feet of A3A or 0.Then the output of the 4th foot of A3B will be 1, and this output will input to the input pin 13 of an A3D.When the input pin 12 of door A3D when being high, then the output of its output pin 11 will be 0.At this moment, when the 3rd foot of agitator A3A is output as when high, enumerator A2 does not change state, but the 5th foot of A3B and the 6th foot will all be high, thereby the output of the 4th foot will be 0, promptly cause A3B the 13rd foot be input as 0.If the input of the 12nd foot still is high, then A3D will be height in the output of the 11st foot.High signal on A3D the 11st foot is connected to the reset terminal of trigger A1A by capacitor C 2, will make the 1st foot output of this trigger become 0, cuts off constant current sink 58 and flows through the electric current of pin 12.The persistent period of short current impulse will be 122 microseconds.
In order to produce long pulse, make an A3C job, and an A3B is not worked.Since have only when the 1st foot of A2 when being high A3B could work, so make the signal step-down on the 1st foot promptly close A3B.Under this condition, the reset function of A1A is only controlled by A3C.Can control the output of A3C according to the impulse ratio table that is positioned at the A3C next door among Fig. 4.The combination of the foot by the enumerator A2 that will list among the input A (8) of A3C and B (9) and the figure suitably couples together, and can obtain short pulse shown in the left hurdle of this table and the time scale between the long pulse, thereby realizes the pulse width modulation of charge pulse.
In order to realize the electrical pulse amplitudes modulation, the input A of A3C can be linked to each other with the 10th foot of A2 with B, to produce 1 to 1 burst length ratio, the pulse duration is 122 μ S.By with switch SW 1 closure, make constant current absorb circuit connection between the emitter stage of first foot of resistance R 10 and A2 in the circuit 58 and transistor Q3.When first foot when being high, electric current flows to ground by resistance R 10 and R7.Owing to the voltage on the R7 keeps the constant electric current that passes through R7 from two power supplys, so diminish by the electric current in the current path of pin 12.Therefore, the amplitude of the current impulse by pin 12 becomes a lower current impulse.When the 1st foot of A2 when low, promptly during ground connection, with regard to ground connection, R10 is in parallel with R7, therefore, reduces by the resistance on the current path of R7 and R10.Because the voltage at the contact place at them as described above remains on 0.55V, need more electric current by these two resistance.Therefore, it is big that the amplitude of the current impulse by pin 12 becomes, and produces one than higher current impulse.So, utilize this circuit can realize pulse amplitude modulation.
In case of necessity, can switch in the circuit, realize pulse width and pulse amplitude dual modulation by the impulse ratio in the strobe pulse schedule of proportion and with resistance R 10.
At last, whenever producing a pulse, no matter which kind of modulation format it is, indicating circuit 57 all starts, to produce the indication of a simple on-off.So when charge pulse occurred, LED50 was glittering, perhaps, buzzer 60 will send the sound along with the sequential and the change of state of the 15th foot of the 3rd foot of A3A and A2.
As mentioned above, the near-end 22 of rustless steel needle tubing 20 entirely reaches outside the shell 38 of stimulator 14.As shown in Figure 1, the near-end 22 of rustless steel needle tubing 20 links to each other with a flexible pipe 16 (flexible tubling), flexible pipe 16 reach one can with joint (hub) that the narcotic syringe that is used for injecting selected dosage links to each other on.In an alternative embodiment, the near-end 22 of rustless steel needle tubing 20 directly can be installed on the needle adapter that can connect the narcotic syringe that is used for injecting selected dosage.
In use, anesthetist or nurse anaesthetist insert the distal tip of splaying most advanced and sophisticated 24 of rustless steel needle tubing 20 in the patient body and push the target nerve to.Without conductive pad and lead.Among the constant current embodiment described herein, following step is to connect switch 48 on the stimulator 14, to produce the constant current pulses of low electric energy.LED50 is along with each corresponding energy pulse produces a corresponding light pulse, and is working properly to confirm electronic position-fixing device (electrolocation apparatus) 10.Produced an energy pulse at interval every 1/2 second.Persistent period is the electric charge that the high charge pulse of the 0.2mA of 488 μ S will produce a 97nC.Low charge pulse is the electric current of 0.2mA equally, but only continues 122 μ S, thereby only produces the electric charge of a 24.4nC.After skin is penetrated by gold layer (gold layer) 34, the higher charge pulse of 97nC is enough to cause at the body surface position can observable muscle twitch, and the low charge pulse of 24.4nC can not cause any muscle twitch that can see at a distance of the position of this distance with nerve at first.Therefore, anesthetist or nurse anaesthetist can see the muscle twitch that takes place with about 1 second interval, and this interval is consistent with the generation of high charge pulse.
Needle assembly (needle assembly) 12 is further advanced towards nerve.This propelling of needle assembly 12 will cause that the amplitude of the ballism that takes place with 1 second interval strengthens gradually.But these will reach peak value rapidly by the ballism that high electric charge causes.Then, anesthetist or nurse anaesthetist can see at two significantly a muscle twitch by a small margin between the ballism.Like this, just can be easy to observe the alternative ballism of magnitude of size.
Along with needle assembly 12 is further pushed in the patient body, the amplitude of muscle twitch by a small margin will be increased to the amplitude near the muscle twitch significantly that reaches peak value that is caused by high charge pulse.When the distal tip tip 24 of rustless steel needle tubing 20 during near target nerve (targeted nerve), the muscle twitch that is caused by the low charge pulse muscle twitch that is difficult to and is caused by high charge pulse that will become makes a distinction.So anesthetist or nurse anaesthetist can see the same basically muscle twitch that takes place with 0.5 second interval.Thisly be easy to observed response prompting anesthetist or nurse anaesthetist, the oblique distal tip tip of needle tubing 20 is enough near waiting to execute narcotic target nerve.So the hypodermic syringe by promoting to communicate with the near-end 22 of rustless steel needle tubing 20 injects anesthetis in the mode of routine.
Embodiment by the modulated current level that can replace with this embodiment also can carry out this accurate operation.
Although utilized a preferred embodiment to describe the present invention, obviously, under the prerequisite that does not deviate from the invention scope that is defined by the claims, can also carry out multiple improvement.For example, thus stimulator can have and is used to change current level or pulse width changes the shifter that passes to patient's corresponding charge level on one's body.In addition, can otherwise show the generation of pulse, comprise with the buzzer that can listen replacing above-mentioned LED or using jointly with above-mentioned LED.
Claims (16)
1. self-contained type's electronic position-fixing device comprises:
A conduction needle tubing, described needle tubing has a near-end, a far-end and a hollow tube chamber that runs through near-end and far-end;
A non-conductive pipe, described non-conductive pipe has a near-end, a far-end and a path that runs through the opening of near-end and far-end, described non-conductive pipe box is contained on the described needle tubing, makes the described far-end of the described far-end of described non-conductive pipe and described needle tubing close; And
A conductive layer, described conductive layer have a far-end that is positioned on the non-conductive pipe, and thus, described needle tubing and described conductive layer have been determined first and two conductors that separated each other coaxially by described non-conductive pipe respectively;
One is fixed on the lever of handling described device on the described needle tubing for the people, and described lever comprises a shell; And
An electricity irritation generator circuit, described electricity irritation generator circuit is arranged in described shell, and with described first conductor and the described second conductor electric connection, described electricity irritation generator can be supplied with predetermined electric charge to described conductor, therefore, when described pin is in the tissue of patient, described electric charge is enough to cause a predetermined current by tissue of patient between the described far-end of the described far-end of described conductive layer and described needle tubing, and described electric current is enough to bring out patient's tic reaction.
2. device as claimed in claim 1, wherein, distance is about 1.0mm between the described far-end of described conduction needle tubing and the described far-end of described conductive layer.
3. device as claimed in claim 1, wherein, described conduction needle tubing stretches out a bit of from described lever, and comprises a joint that the described tube chamber of drug delivery device and described conduction needle tubing is coupled together.
4. device as claimed in claim 3, wherein, described joint also comprises a flexible pipe.
5. device as claimed in claim 1, wherein, described stimulus generator circuit comprises the on/off switch that can be pressed into by operator's finger.
6. device as claimed in claim 1, wherein, described circuit can the repetition form produce described predetermined charge pulse with predetermined.
7. device as claimed in claim 6, wherein, described predetermined form comprises the charge pulse that is made of different electric currents.
8. device as claimed in claim 7, wherein, described charge pulse is controlled to comprise predetermined constant current by described circuit.
9. device as claimed in claim 8, wherein, described predetermined constant current is between about 0.1 milliampere to about 0.8 milliampere.
10. device as claimed in claim 6, wherein, described predetermined form comprises the pulse that the persistent period is different.
11. device as claimed in claim 10, wherein, the described persistent period of described pulse is between about 100 microseconds and 1,000 microsecond.
12. device as claimed in claim 6, wherein, described predetermined charge pulse form comprises the predetermined time interval between the described pulse.
13. device as claimed in claim 12, wherein, described predetermined time interval is between about 0.25 second and about 2.0 seconds.
14. device as claimed in claim 6, wherein, described circuit also has the indication that characterizes described charge pulse.
15. device as claimed in claim 14, wherein, described indication also comprises the sound that the operator that can be used described device hears.
16. device as claimed in claim 14, wherein, described indication also comprises the luminous indication that the operator that can be used described device see.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 97118553 CN1177467A (en) | 1996-08-05 | 1997-08-05 | Double-pole charge pulser convenient for positioning nerre for use in periphery nerve blocking operation |
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US695,151 | 1996-08-05 | ||
| CN 97118553 CN1177467A (en) | 1996-08-05 | 1997-08-05 | Double-pole charge pulser convenient for positioning nerre for use in periphery nerve blocking operation |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN1177467A true CN1177467A (en) | 1998-04-01 |
Family
ID=5174838
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 97118553 Pending CN1177467A (en) | 1996-08-05 | 1997-08-05 | Double-pole charge pulser convenient for positioning nerre for use in periphery nerve blocking operation |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN1177467A (en) |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103070667A (en) * | 2007-11-08 | 2013-05-01 | 泰拉克利昂公司 | Non-invasive device and method for locating a structure such as a nerve |
| CN108136188A (en) * | 2015-10-09 | 2018-06-08 | 心脏起搏器股份公司 | Connector block component |
| CN108367116A (en) * | 2015-10-16 | 2018-08-03 | 里程碑科技有限公司 | Hypodermic method and apparatus are carried out using electrical nerve stimulation |
-
1997
- 1997-08-05 CN CN 97118553 patent/CN1177467A/en active Pending
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103070667A (en) * | 2007-11-08 | 2013-05-01 | 泰拉克利昂公司 | Non-invasive device and method for locating a structure such as a nerve |
| CN103070667B (en) * | 2007-11-08 | 2016-03-16 | 泰拉克利昂公司 | For locating non-invasive device as the structure of nerve and method |
| CN108136188A (en) * | 2015-10-09 | 2018-06-08 | 心脏起搏器股份公司 | Connector block component |
| CN108367116A (en) * | 2015-10-16 | 2018-08-03 | 里程碑科技有限公司 | Hypodermic method and apparatus are carried out using electrical nerve stimulation |
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