DE102010023287A1 - Lens tube electrode for use with endotracheal lens tube, has electrode carrier, which is made from flexible material, where electrode carrier is formed as hose suspended or applied and positioned on endotracheal lens tube - Google Patents

Abstract

The lens tube electrode (4) has an electrode carrier, which is made from flexible material. The electrode carrier is formed as a hose suspended or applied and positioned on an endotracheal lens tube (1), where the hose is made from flexible material. An electrically conductive structure is formed as a layer or coating of the hose. The electrically conductive structure is made from electrically conductive silicon material.

Description

The invention relates to a tube electrode, which is intended for attachment to an endotracheal tube and having an electrode carrier made of flexible material, which electrode carrier carries at least one electrically conductive structure, which is electrically connected to a peripherally insulated electrical line.

In thyroid, laryngeal or cervical spinal surgery, there is a risk of damage to the vocal cords and thus paralysis of the vocal cords on one or both sides, causing voice disorders. If both sides are paralyzed, the patient suffers from respiratory distress. This risk is also increased by the fact that the nerve in question is very small and therefore hardly distinguishable from the environment. However, overstretching of the vocal cords and, in particular, severance of the nerve in question may result in an eventually permanent loss of the patient's voice.

Therefore, various methods have been developed in which electrodes are attached to the endotracheal tube required during the operation, with which a continuous monitoring of the vocal cord function can be carried out. Mechanical, magnetic, caloric or electrical stimulation of the nervus Rekuurenz or the vagus nerve causes muscle contraction in the intact nerve. With the help of an EMG measurement on the vocal cord muscles, a possibly damaging impairment of the nerve recurrence during the operation can be indicated early.

From the US Pat. No. 7,583,991 B2 one is ready to know such a tube electrode, which is intended for attachment to an endotracheal tube. The previously known tube electrode has a plate-shaped or foil-shaped electrode carrier of flexible material. This electrode carrier carries on its one side at least one electrically conductive structure, which is connected to a, leading to a display and circumferentially insulated electrical line, which is connected to the serving as a display meter. By cutting off a part of the plate-shaped or foil-shaped electrode carrier, the tube electrode can be cut to the required size in order subsequently to fix the tube electrode to the outer circumference of the endotracheal tube by means of an adhesive layer; This adhesive layer is provided on the side facing away from the electrically conductive structure flat side of the electrode carrier. However, the tube electrode previously known from US Pat. No. 7,583,991 B2 entails a further risk of injury to the patient due to the sharp-edged and in particular sharp-edged electrode carrier.

There is therefore in particular the task of creating a tube electrode of the type mentioned above, which can be fixed in a simple manner positionally accurate, secure and firm on the outer circumference of an endotracheal tube without this would be associated with a further risk of injury to the patient.

The achievement of this object is in the Tubuselektrode in the input type mentioned in particular that the electrode support is designed as a pushed onto the Endotrachealtubus and positionable hose made of elastic material which has at least in a partial area, the at least one electrically conductive structure, the electrically conductive structure is formed as a layer or coating of the tube and that the hose for pushing onto the endotracheal tube expandable and / or designed to be fixed on the endotracheal tube contractible.

The tube electrode according to the invention has an electrode carrier, which is designed as a tube of elastic material which can be pushed onto the endotracheal tube and can be positioned. The tubular electrode carrier of the tube electrode according to the invention has, at least in a partial region, the at least one electrically conductive structure which is necessary for the transmission and detection of the electrical impulses exerted on this region. In this case, the electrically conductive structure can be designed as a layer or coating of the tubular electrode carrier. In order to push the tubular electrode carrier onto the endotracheal tube and to be able to fix it in a positionally accurate and secure manner, the tubular electrode carrier can be widened for pushing onto the endotracheal tube and / or contractible for fixing on the endotracheal tube. In this case, the tube electrode according to the invention securely and firmly adheres to the tube surface itself of such Endotrachealtubus having a spiral or helical outer surface without an adhesive layer would be required. Since the tube electrode according to the invention also requires no sharp-edged plate or foil, an additional risk of injury is avoided in this respect.

In order to increase the differentiability of the measurement, it may be advantageous if the tube electrode has at least two electrically insulated structures which are electrically insulated from one another and which are each electrically connected to a line which is insulated on the circumference.

Good contact between the body surface of the patient on the one hand and the tube electrode according to the invention on the other hand is favored if the at least one, electrically conductive structure extends at least over a partial area and preferably over the entire longitudinal extent of the tubular electrode carrier.

A preferred development according to the invention, which can substantially facilitate the application of the tube electrode according to the invention to the endotracheal tube, provides that the at least one electrically conductive structure is made of an electrically conductive silicone material and / or that two adjacent structures are not electrically electrically connected by means of a silicone layer conductive silicone material are electrically separated from each other.

The handling of the tube electrode according to the invention is further facilitated if the electrode carrier in an annular rolled state on the endotracheal tube can be pushed and unwound in the desired sliding position in a tubular elongated state on the endotracheal tube or unrolled.

In this case, a preferred development according to the invention of its own worthy of protection before that the electrode carrier in a tubular-shaped Arplikator rolled up state on the endotracheal tube and pushed from there in the desired sliding position in a tubular elongated state on the endotracheal tube unwinding or unrolled. The applicator ensures a sufficient clear diameter of the tube electrode in order to be able to push it on the endotracheal tube in a simple manner.

It is expedient that the clear inner diameter of the sleeve-shaped applicator is greater than the outer diameter of the endotracheal tube.

Another embodiment according to the invention provides that the electrode carrier can be pushed onto the endotracheal tube and compressed or contracted there in the desired sliding position by means of chemical or physical and in particular by thermal action on the electrode carrier material in such a way that the electrode carrier lays around the endotracheal tube , In this embodiment, the electrode carrier may practically be formed like a heat-shrinkable tube which tightly surrounds the endotracheal tube with a corresponding thermal action on the tube material, that the tube electrode is positioned there precisely and securely and fixed.

Further features of the invention will become apparent from the following description of an embodiment of the invention in conjunction with the claims and the drawings. The individual features may be implemented individually or in combination in an embodiment according to the invention.

It shows:

1 an endotracheal tube, which surrounds a sleeve-shaped applicator, on which an annularly wound tubular tube electrode is provided, which is intended to be pushed or applied to the outer circumference of the endotracheal tube,

2 the endotracheal tube 1 with the tube electrode applied to it,

3 the applicator off 1 with the tube electrode still in its annular wound state on the applicator,

4 in its developed state tubular tube electrode from the 1 to 3 , and

5 the Tubuselektrode shown in its unwound tubular state of the 1 to 4 in a front view.

In the 1 and 2 is an endotracheal tube 1 presented during endotracheal surgery to ventilate the patient. The endotracheal tube made of flexible material 1 is tubular and has a balloon on its outer periphery 2 on, with the help of a tubular gas supply 3 can be inflated so that the endotracheal tube 1 is set in the desired location in the throat of the patient.

In thyroid, laryngeal or cervical spinal surgery, there is a risk of damage to the vocal cords and thus paralysis of the vocal cords on one or both sides, causing voice disorders. If both sides are paralyzed, the patient suffers from respiratory distress. This risk is also increased by the fact that the nerve in question is very small and therefore hardly distinguishable from the environment. However, overstretching of the vocal cords and, in particular, severance of the nerve in question may result in an eventually permanent loss of the patient's voice.

In order to be able to measure the impulses transmitted to the Vocalis muscle by means of a voltage measurement and to be able to indicate at an early stage any possibly damaging impairment of the vocal cord function during the operation, there is a tube electrode 4 provided for attachment to the outer circumference of the endotracheal tube 1 is determined. The in the 1 to 5 shown tube electrode 4 has a flexible electrode carrier 5 acting as one on the endotracheal tube 1 can be pushed or applied and there positionable hose made of elastic material.

The tubular electrode carrier 5 has at least one electrically conductive structure and preferably at least two, over the tube circumference of the electrode carrier 5 in particular uniformly distributed electrically conductive structures 6 . 7 on, which may be formed as a layer or as a coating of the hose and each with an electrical line 8th . 9 in signal connection. These lines 8th . 9 which are electrically connected to an EMG device serving as a display, carry in the hose 5 wegführenden portion of their longitudinal extent an insulation.

From the 1 and 3 it becomes clear that the hose 5 expandable and in a longitudinally annularly rolled condition on the endotracheal tube 1 can be pushed or applied to be unwound there in the desired sliding position or position of use in a tubular state.

The tube electrode shown here 4 thus has an electrode carrier 5 acting as one on the endotracheal tube 1 can be pushed or applied and there positionable hose elastic material is formed. The tubular electrode carrier 5 the tube electrode 4 has at least in a partial area, the electrically conductive structures 6 . 7 which is necessary for transmission and detection of the electrical impulses applied to this area of the patient. To the tubular electrode carrier 5 on the endotracheal tube 1 postpone and to be able to determine exact position and safe, is the tubular electrode carrier 5 expandable accordingly. The Tubuselektrode adheres 4 safely and firmly on the tube surface itself of such Endotrachealtubus 1 , which has a - not shown here - spiral or helical wire insert, without an adhesive layer would be required.

As the tube electrode 4 no sharp-edged plate or foil needed, also an additional risk of injury to the patient is avoided.

In this case, the handling of Tubuselektrode shown here 4 relieved by the fact that the tubular electrode carrier 5 in an in 3 shown in more detail on a sleeve-shaped applicator 10 annularly rolled up state on the endotracheal tube 1 slidable and from there in the desired sliding position in a tubular elongated state on the endotracheal tube 1 unwindable or unrollable before the applicator 10 again from the electrode carrier 5 can be removed. In this case, the clear inner diameter of the sleeve-shaped applicator 10 larger than the outer diameter of the endotracheal tube 1 in the area in question.

The tube electrode shown here 4 , which can be formed single or multi-pole, is placed on an endotracheal tube 1 or another product using the applicator 10 applied. In the process, the tube electrode becomes 4 arranged in the region of the vocal folds. The electrically conductive structures 6 . 7 , which the electrode contact surface of Tubuselektrode 4 form lying on the right and left vocal fold. To the electrically conductive structures 6 . 7 are the electrical wires 8th . 9 electrically connected, which lead to an EMG device or to another display, on which the electrophysiological signals can be signaled. The amplifier used in the EMG device should have a sufficient gain of, for example, 100 to 500 times. As usual, the neutral electrode of the EMG device is placed on the forehead of the patient. Depending on the electrode design, a one to several channel measurement can be performed.

With the help of the applicator, the Tubuselektrode 4 in a simple way on the endotracheal tube 1 be applied. This is the applicator 10 pushed over the tube. Is the applicator 10 the tube electrode can be at the right position 4 by simply rolling on the outer surface of the endotracheal tube 1 be attached, wherein the Tubuselektrode 4 due to the intrinsic elasticity of the material used safely and firmly on the endotracheal tube 1 invests. The tube electrode 4 now sits tight on the tube 1 so the applicator 10 can be removed again. In this, in 2 state shown in detail with the Tubuselektrode 4 provided endotracheal tube 1 ready to use.

The tube electrode shown here 4 is characterized by its good adhesion to the outer surface of the endotracheal tube 1 without the need for an additional adhesive layer. Since the Tubuselektorde 4 due to the lack of a sharp-edged foil, there is no risk of injury, is the Tubuselektrode 4 atraumatic trained. With the help of applicator 10 can the tube selectorde 4 simply at the tube 1 be fixed.

In this case, a preferred embodiment provides that the two adjacent structures 6 . 7 made of an electrically conductive silicone material and at their longitudinal edges in each case by means of a silicone layer 11 . 12 are electrically separated from each other from an electrically non-conductive silicone material.

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• US 7583991 B2 [0004]

Claims (8)

Tube electrode ( 4 ), which can be attached to an endotracheal tube ( 1 ) and an electrode carrier ( 5 ) of flexible material, which electrode carrier ( 5 ) at least one electrically conductive structure ( 6 ) 7 ), which is provided with a peripherally insulated electrical line ( 8th ) 9 ) is electrically connected, characterized in that the electrode carrier ( 5 ) as one on the endotracheal tube ( 1 ) can be pushed or applied and positioned hose of elastic material, the least in a partial region, the at least one electrically conductive structure ( 6 ) 7 ) has the at least one electrically conductive structure ( 6 ) 7 ) is formed as a layer or coating of the tube, and that the tube for pushing or application to the endotracheal tube ( 1 ) expandable and / or for attachment to the endotracheal tube ( 1 ) is formed contractible. Tube electrode according to claim 1, characterized in that the tube electrode ( 4 ) according to claim 1, characterized in that the tube electrode ( 4 ) at least two electrically isolated from each other, electrically conductive structures ( 6 ) 7 ), each with a circumferentially insulated line ( 8th ) 9 ) are electrically connected. Tube electrode according to claim 1 or 2, characterized in that the at least one, electrically conductive structure ( 6 ) 7 ) at least over a portion and preferably over the entire longitudinal extent of the tubular electrode carrier ( 5 ). Tube electrode according to one of claims 1 to 3, characterized in that the at least one electrically conductive structure, ( 6 ) 7 ) made of an electrically conductive silicone material and / or that two adjacent structures ( 6 ) 7 ) preferably on both sides by means of a silicone layer ( 11 ) 12 ) are electrically separated from each other from an electrically non-conductive silicone material. Tube electrode according to one of claims 1 to 4, characterized in that the electrode carrier ( 5 ) in an annular rolled state on the endotracheal tube ( 1 ) and in the desired sliding position in a tubular elongated state on the endotracheal tube ( 1 ) can be unwound or unrolled. Tube electrode according to one of claims 1 to 5, characterized in that the electrode carrier ( 5 ) in one on a sleeve-shaped applicator ( 10 ) annularly wound up state on the endotracheal tube ( 1 ) and from there in the desired sliding position in a tubular elongated state on the endotracheal tube ( 1 ) can be unwound or unrolled. Tube electrode according to one of claims 1 to 6, characterized in that the inside diameter of the sleeve-shaped applicator ( 10 ) greater than the outer diameter of the endotracheal tube ( 1 ). Tube electrode according to one of claims 1 to 7, characterized in that the electrode carrier ( 5 ) on the endotracheal tube ( 1 ) and in the desired sliding position by means of chemical or physical and in particular by means of thermal action on the electrode carrier material is compressible or contractible such that the electrode carrier ( 5 ) around the endotracheal tube ( 1 ) lies.

Images