GB2366735A

GB2366735A - Bite block

Info

Publication number: GB2366735A
Application number: GB0115754A
Authority: GB
Inventors: Bryan Robert Smith; Giovanni Ambroselli
Original assignee: Individual
Current assignee: Individual
Priority date: 2000-06-27
Filing date: 2001-06-27
Publication date: 2002-03-20
Also published as: GB0115754D0; GB0015538D0

Abstract

A rigid block possessing an elongate rod of malleable material extending from it to prevent it bing swallowed, whose end possesses endotracheal tube or mask attaching means <I>i.e.</I> a clip. Alternatively the block has a hook shaped retaining portion for engaging the patients cheek. The block, which may be tapered to fit between teeth on one side of the mouth, possesses tooth engagement surfaces on opposite sides which may be channels and possess surfaces made from resilient elastomer, a single piece of which may form the whole block. The blocks' diameter may vary in the transverse or orthogonal directions so jaw separation may be altered by twisting the block. The block may possess a hollow core formed by a passage extending into it from the widest end and may possess a pressure sensor moulded into it which may be a pneumatic pressure gauge or a piezo-electric transducer.

Description

<Desc/Clms Page number 1> Surgical Device The present invention relates to a surgical device for holding apart the jaws of an anaesthetised patient.

when a patient is being anaesthetised for an operation, it is common practice either to insert a laryngeal mask into the patient's hypopharynx or to intubate using an endotracheal tube. Gases are then passed to the patient through one of these devices to maintain a state of anaesthesia.

A common problem, however, is that during anaesthesia, if the patient becomes "light" (i.e semi-conscious), a condition that normally occurs during induction or reversal, the patient will often bite into and therefore occlude the lumen of the laryngeal mask or endotracheal tube, thereby inhibiting the flow of gas to the patient. Also, significant damage may occur to the patient's teeth or gums (in the case of an edentulate patient) or to the lumen, as the latter is bitten upon by the patient.

Hitherto, to prevent an anaesthetised patient biting upon the lumen of a laryngeal mask or endotracheal tube, it has been known to insert a rolled gauze between the patient's teeth. The gauze is normally taped to the lumen, which is in turn taped to the patient's face.

However, besides this method of securing the gauze in place being inconvenient and time consuming to carry out, the considerable bulk of the rolled gauze has been found to inhibit the insertion or removal of a laryngeal mask or endotracheal tube into a patient's buccal ;cavity. It has therefore been typical to insert or remove the gauze with the mask or tube in place. This situation is clearly not ideal, as it is at the time of insertion or removal of the mask or tube that a patient is most likely to bite upon the lumen of the mask or tube.

Furthermore, patients have been known to respond to an allergy caused by the tape used to attach the lumen, resulting in reddening and soreness of the face.

We have now devised an arrangement which overcomes the above limitations.

In accordance with the present invention, there is provided a surgical device comprising a rigid block for fitting between opposed teeth or gum portions of a patient's maxilla and mandible.

It will be appreciated that, in use, such a device will allow the patient's jaws to be held apart whilst a laryngeal mask or an endotracheal tube is inserted into or removed from his buccal cavity: further instruments may also be inserted, relatively unobstructed, into the patient's buccal cavity with the mask or tube in place.

Preferably the device comprises a retaining portion which, in use, extends out of the mouth of the patient, to prevent the block from being swallowed.

The retaining portion may comprise an elongate rod, the distal end of which is provided with means for attaching to the lumen of a laryngeal mask or an endotracheal tube. Thus, the elongate rod will not only prevent the block from being swallowed, but will also support the lumen of the laryngeal mask or the endotracheal tube.

Preferably the elongate rod is formed from a malleable material to allow the lumen to be re-positioned outside of the patient's buccal cavity. For example, the lumen may be moved between caudad, cephalad or lateral positions as required.

The device is preferably arranged such that the position of the attaching means along the rod and/or along the lumen may be readily varied.

Preferably the attaching means comprise a resilient clip.

Alternatively, the retaining portion may comprise a portion which hooks around the patient's cheek adjacent his mouth.

Preferably opposite faces of the block are provided with formations, preferably respective channels, within which said opposed teeth or gum portions locate.

Preferably the diameter of the block differs in at least two transverse directions, such that by twisting the block through an angle, the extent to which the patient's jaws are held apart may be varied or the block may be adapted to fit different sized mouths.

Most preferably the diameter of the block differs in two orthogonal directions, such that two degrees of separation of the patient's jaws may be obtained, or the device may be adapted to fit two different sized mouths, by twisting the block through 90 degrees.

Preferably the block is tapered to fit between opposed molar teeth or gum portions on one side of the patient's buccal cavity.

Preferably at least the surface of the block is formed from a resilient elastomeric material to cushion the patient's teeth or gums. Most preferably the block comprises a single piece of a resilient elastomeric material, preferably having a hollow core.

Where the block is tapered to fit between opposed molar teeth or gum portions on one side of the patient's buccal cavity, the hollow core is preferably formed by an open passage which extends partially into the block from its wider end.

Preferably the block incorporates a transducer for

providing a measure of the pressure exerted on the block by the patient's jaw.

For example, the transducer may comprise an electronic transducer, such as a piezo-electric transducer, moulded or otherwise incorporated into the block, or a pneumatic pressure gauge responsive to any decrease in the volume of an air cavity formed within the block.

Embodiments of the present invention will now be described by way of examples only and with reference to the accompanying drawings, in which: Figure 1 is a perspective view of a surgical device in accordance with the present invention; Figure 2 is a perspective view showing the device of Figure 1 in use; Figure 3 is a perspective view of a preferred embodiment of bite-block in accordance with the present invention; Figures 4, 5 and 6 are further views of the bite-block of Figure 3, from the direction s A, B and C of Figure 3 respectively; Figure 7,8 and 9 are respectively first and second perspective views and an end view of a further surgical device in accordance with the present invention; and Figures 10 and 11 are sections through the device of Figures 7 to 9 along the lines A-A and B-B respectively. Referring to Figure 1 of the drawings, a device is shown for holding apart the jaws of an anaesthetised patient, the device comprising a rigid elastomeric block 2, and a resilient C-shaped clip 4 connected via a malleable rod 6, which extends from one end of the block 2.

In use, the device is fitted to a patient as shown in

Figure 2, with the block 2 secured between the maxilla and mandibular molar teeth of the patient, on one side of his buccal cavity, such that the malleable rod 6 extends forwards from the patient's mouth. A laryngeal mask or endotracheal tube _#s then introduced into the patient's mouth, the clip 4 attached to the lumen 8 of the mask or tube and the rod 6 formed into an appropriated shape to position the lumen 8 such that it projects substantially from the centre of the patient's mouth. The block 2 is oriented such that the patient Is maxilla and mandibular molar teeth locate within respective channels 10,12 formed in opposite faces of the block and is further formed with a cavity 14 which connects, via a channel 16 extending through the malleable rod 6, to a pneumatic pressure gauge (not shown) . This pressure gauge allows the amount of pressure exerted by the patient upon the block to be measured.

Whilst a pneumatic pressure sensing arrangement is shown in Figures 1 and 2, it would remain in accordance with the present invention for the block to house an electronic pressure transducer, such as a piezo-electric device, which connects to electronic processing and display means via a wire routed through the channel 16.

Also, whilst Figures 1 and 2 show a wedge-shaped block 2, the channelled upper and lower faces of which are tapered to conform to the angle between a patient's open jaws, the side-faces of the block might also be tapered and formed with respective channels 18,20 as shown in Figures 3 to 6, thus allowing the block to be twisted through 90 degrees, to vary the extent to which the patient's jaws are held apart or to adapt the block to fit different sized mouths.

It would further remain in accordance with the present

invention for the clip 4 to be slidably mounted to the malleable rod 6 such that the position of the clip along the rod may be readily varied.

Figures 7 to 11 show a device into which a hollow, resilient block having substantially the same exterior dimensions as that of Figures 3 to 6 has been incorporated. A hooked portion 22 of the device extends from one corner of the block, which, in use, extends forwards from a patient's mouth and then backwards along the outside of his cheek, to prevent the block from being swallowed.

The surgical devices thus described provide effective means for holding apart the jaws of anaesthetised patients.

Claims

claims. 1) A surgical device comprising a rigid block for fitting between opposed teeth or gum portions of a patient's maxilla and mandible. 2) A surgical device as claimed in Claim 1, comprising a retaining portion which, in use, extends out of the mouth of the patient, to prevent the block from being swallowed. 3) A surgical device as claimed in Claim 2, wherein the retaining portion comprises an elongate rod, the distal end of which is provided with means for attaching to the lumen of a laryngeal mask or an endotracheal tube. 4) A surgical device as claimed in Claim 3, wherein the elongate rod is formed from a malleable material to allow the lumen to be re-positioned outside of the patient's buccal cavity.

5) A surgical device as claimed in Claim 3 or Claim 4, arranged such that the position of the attaching means along the rod and/or along the lumen may be readily varied. 6) A surgical device as claimed in any of Claims 3 to 5, wherein the attaching means comprise a resilient clip. 7) A surgical device as claimed in Claim 2, wherein the retaining portion comprises a portion which hooks around the patient's cheek adjacent his mouth.

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8) A surgical device as claimed in any preceding claim, wherein opposite faces of the block are provided with formations, within which said opposed teeth or gum portions locate. 9) A surgical device as claimed in Claim 8, wherein said formations comprise respective channels. 10) A surgical device as claimed in any preceding claim, wherein the diameter of the block differs in at least two transverse directions, such that by twisting the block through an angle, the extent to which the patient's jaws are held apart may be varied or the block may be adapted to fit different sized mouths. 11) A surgical device as claimed in Claim 10, wherein the diameter of the block differs in two orthogonal directions, such that two degrees of separation of the patient's jaws may be obtained, or the device may be adapted to fit two different sized mouths, by twisting the block through 90 degrees. 12) A surgical device as claimed in any preceding claim, wherein the block is tapered to fit between opposed molar teeth or gum portions on one side of the patient's buccal cavity.

13) A surgical device as claimed in any preceding claim, wherein at least the surface of the block is formed from a resilient elastomeric material to cushion the patient's teeth or gums. 14) A surgical device as claimed in Claim 13, wherein the

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block comprises a single piece of a resilient elastomeric material. 15) A surgical device as claimed in Claim 14, wherein the block has a hollow core. 16) A surgical device as claimed in Claim 15 appended to Claim 12, wherein the hollow core is formed by an open passage which extends partially into the block from its wider end. 17) A surgical device as claimed in any preceding claims, wherein the block incorporates a transducer for providing a measure of the pressure exerted on the block by the patient's jaw. 18) A surgical device as claimed in Claim 17, wherein the transducer comprises an electronic transducer moulded or otherwise incorporated into the block 19) A surgical device as claimed in Claim 18, wherein the electronic transducer comprises a piezo-electric transducer. 20) A surgical device as claimed in Claim 17, wherein the transducer comprises a pneumatic pressure gauge responsive to any decrease in the volume of an air cavity formed within the block. 21) A surgical device substantially as herein described with reference to the accompanying drawings.