JP4956758B2 - Puncture pain relief device - Google Patents

Description

The present invention relates to a puncture pain relieving device for reducing pain when a puncture needle is hit on a body for artificial dialysis or the like.

  Needless to say, it is necessary to be prepared for considerable pain when an injection is given for vaccination. In general, the frequency of injections is at most several times a year, and many people endure pain in anticipation of an effect. However, if renal dialysis is indispensable due to kidney disease, etc., it is necessary to continue to pierce the arm with two puncture needles several times a week. descend. However, with regard to artificial dialysis, as in general infusions, the pain is most severe at the moment when the puncture needle is stabbed, and the pain is gradually alleviated if the patient is resting after the puncture.

  The puncture needle used for artificial dialysis needs to secure a flow rate of about 0.2 liters per minute, its diameter is as large as about 1.2 mm, and the pain when pricking it is a serious problem that cannot be ignored. . Therefore, various improvement methods have been studied, and a technique for locally numbing the skin with drugs has been established. Specifically, an adhesive sheet impregnated with lidocaine, which is a local anesthetic, is affixed to the skin, and the surrounding nerves are temporarily paralyzed, and then the puncture needle is inserted. In this case, in order to fully exhibit the effect of anesthesia, it is necessary to attach a sheet about 30 minutes before puncturing.

  In addition to anesthesia using such drugs, the use of frozen anesthesia that locally cools the skin has also been studied. Frozen anesthesia is effective by cooling the body tissue to 20 degrees Celsius or less, but ethyl chloride used as a coolant is troublesome to store and handle, and is painful when rapidly cooling the skin Therefore, actual use is not progressing at all. As for the cooling means that uses a Peltier element, techniques such as the following patent documents have been developed. Patent Document 1 is intended to relieve pain when an injection needle such as artificial dialysis is stabbed for a long time, and a probe incorporating a Peltier element is brought into contact with the site where the injection needle is pierced, during artificial dialysis, Repeated heating and cooling can stimulate terminal nerves to promote blood circulation and relieve pain. Patent Document 2 is a cooling device for reducing pain at the time of puncturing an injection needle, which uses a Peltier element for cooling, and further irradiates light having a vasodilating action. .

JP 2000-342617 A JP 2004-337296 A

  A method for locally numbing the skin using the anesthetic as described above has established handling procedures and is currently used in many artificial dialysis facilities. However, the use of drugs may cause allergic reactions depending on the constitution, and not everyone can use it with peace of mind. In addition, since the adhesive sheet is continuously pasted at almost the same position, there is a problem that the skin gets drowned after many years of use. Furthermore, in order to obtain the effect of anesthesia, it is necessary to continue the application for 30 minutes or more, and if the application is forgotten, there are many problems such as delaying the start time of dialysis.

  In addition, as for the method of cooling the skin as in the above-mentioned patent document, when the skin is excessively cooled, intense discomfort occurs, and repeated use may cause frostbite on the skin. During artificial dialysis, it is necessary to alleviate the pain caused by puncture at the moment when the needle is stabbed. Therefore, keeping the probe in contact with the arm during artificial dialysis places an extra burden on the body and may increase the feeling of later fatigue.

  In addition, during dialysis, it is necessary to take thorough hygiene measures to prevent infectious diseases, and medical instruments are also disinfected each time they are used. In order to carry out this disinfection reliably, in addition to soft measures such as thorough technical guidance for medical staff, hardware measures such as preventing dirt from adhering to medical devices are also important.

The present invention has been developed on the basis of such circumstances, and an object thereof is to provide a puncture pain relieving device for reducing pain when a puncture needle is hit on the body for artificial dialysis or the like.

The invention according to claim 1 for solving the above problems includes a Peltier element, a holding box that accommodates the Peltier element, a pressing body that contacts the heat absorption surface of the Peltier element, and a heat dissipation surface of the Peltier element. A cooling fan, an arm protruding from the holding box, a temperature sensor for measuring the temperature of the pressing body, display means for notifying information obtained by the temperature sensor, and a control unit for managing the overall operation The pressing body protrudes in a spherical shape from the holding box, and the temperature of the pressing body can be maintained from 3 degrees Celsius to 7 degrees Celsius by the Peltier element, the temperature sensor, and the control unit. that the range is possible notification by the display means, for supplying air to the fan, an intake opening at the tip or side of the arm, and on the rear side of the pressing body is provided with an exhaust port, wherein Side of the lifting box is puncturing pain relieving device, characterized in that the planar without holes or the like.

  The present invention is a puncture pain relieving device that cools the skin at a low temperature generated by a Peltier element and relieves pain at the time of puncture. The appearance is composed of a box-shaped holding box and an arm extending outwardly. ing. A Peltier element is a plate-like semiconductor, and has the function of transferring heat from one surface to the other surface by applying a direct current. The temperature of one surface rises, and the temperature of the other surface increases. descend. Hereinafter, the surface on which the temperature rises is referred to as a heat dissipation surface, and the surface on which the temperature decreases is referred to as a heat absorption surface. In order to lower the temperature of the heat absorbing surface, the heat radiating surface on the opposite side is cooled to promote heat transfer. The holding box has a simple box shape that accommodates the Peltier element, and a fan that releases hot air from the heat radiating surface to the outside is incorporated therein.

  The arm is a bar-like portion protruding from the holding box and functions as a handle of the device according to the present invention. Therefore, it is necessary to secure a length and a cross-section that can be easily grasped by a palm. The specific cross-sectional shape is arbitrary, and can be selected as appropriate, such as a circle, an ellipse, or a square. In addition, the connecting part between the holding box and the arm is flexible, but considering workability, it is best to attach the arm to the side of the holding box. By providing such an arm, the apparatus can be handled with the same feeling as a writing instrument.

  The temperature sensor is used to measure the temperature of the pressing body, and can check whether or not the temperature is appropriate before the pressing body is brought into contact with the skin. If the temperature of the pressing body is higher than the specified temperature, the nerve cannot be paralyzed, and conversely, if it is too low, frostbite may be caused. In addition, a display means is provided to notify medical staff and the like that the temperature is appropriate.

  The display means is for visually informing that the temperature of the pressing body is within an appropriate range, and a liquid crystal panel or the like may be used in addition to a simple lamp. As a specific example of the display means, an LED is used to display green when it is at an appropriate temperature, red when it is not appropriate, or a character such as “available” using a liquid crystal panel. You can freely.

  In order to manage the operation of each electronic device such as a Peltier element, fan, temperature sensor, and display means, a control unit is also required. The control unit can be incorporated in a holding box or an arm as long as an integrated circuit is possible, but may be provided separately by extending wiring from the arm. In an actual apparatus, a power supply unit that converts AC current into DC is also required.

  The pressing body is a plate that transmits the low temperature generated by the Peltier element to the outside of the holding box, one surface of which is in contact with the heat absorbing surface of the Peltier element, and the other surface protruding spherically from the holding box. Yes. By this protrusion, the contact pressure and contact area with the skin of the person to be treated increase, and the efficiency of heat conduction inevitably increases. Although the outer shape of the pressing body is spherical as described above, it does not necessarily have to be a geometric spherical surface, and may simply project into a convex lens shape. The pressing body is preferably made of a material having excellent heat transfer coefficient and durability against chemicals such as disinfection, and aluminum alloy or the like is used.

Further, in order to supply air to the fan, an intake port is provided at the tip or side of the arm, and an exhaust port is provided on the back side of the pressing body. In order to increase the cooling capacity of the Peltier element, it is necessary to efficiently take away the heat generated on the heat dissipation surface, and as described above, a fan is equipped, but at this time, inhaling bodily fluids etc. together with air is prevented. There is a need.

  Therefore, in the present invention, an intake port for taking in cooling air is provided at the tip or side surface of the arm. For this reason, the intake port is inevitably located far away from the pressing body, so that inhalation of bodily fluids and the like can be prevented, and the hygiene aspect is excellent. In addition, since it is not necessary to provide an air inlet in the holding box, the side surface of the holding box has a flat shape with no holes, and the disinfection work is extremely easy. In addition, the exhaust port which discharge | releases the air from a fan outside is located in the other side of a press body, and the problem in terms of hygiene does not occur.

The invention according to claim 2 specifies the configuration of the apparatus, and the surface of the pressing body is provided with a skin temperature sensor for measuring the surface temperature of the skin, and this temperature can be notified by the display means. It is characterized by being. In order to numb the skin according to the present invention, it is necessary to cool the surface temperature of the skin from 22 degrees to 28 degrees. Therefore, if the surface temperature of the skin can be measured by the apparatus and notified to medical staff or the like, convenience is improved. The skin temperature sensor according to the present invention is for measuring the temperature in contact with the skin, and is installed on the surface of the pressing body. In addition, in order to ensure the measurement accuracy of a skin temperature sensor, it is necessary to suppress heat transfer with a boundary surface with the pressing body as a heat insulating structure. The display means can display not only the temperature of the pressing body obtained by the temperature sensor but also the temperature measured by the skin temperature sensor.

When the pressing body is brought into contact with the skin by incorporating a Peltier element, a fan, a temperature sensor and the like into the holding box and projecting the pressing body into a spherical shape from the holding box as in the first aspect of the invention. The adhesiveness of the skin increases and the skin can be cooled quickly. In addition, since the arm is provided in the holding box, it can be handled with the same feeling as a writing instrument, and is excellent in operability and convenience.

By cooling the skin with the device according to the invention, the puncture needle can be hit with almost no pain and the quality of life of people who undergo multiple dialysis per week is improved. Moreover, unlike the method using a pressure-sensitive adhesive sheet impregnated with lidocaine or the like, there is no possibility of causing an allergic reaction, and it can be safely used for anyone, and can be used for about 30 seconds. It is possible to complete the preparations prior to. In addition, the present invention has a higher temperature setting than frozen anesthesia, and does not cause discomfort to the person to be treated, does not destroy surrounding tissues, and does not adversely affect the body even when used every time.

In addition, by providing an air inlet for cooling the Peltier element at the tip or side of the arm, the distance between the air inlet and the skin of the person to be treated is increased, and body fluid and the like are not sucked into the inside. In addition, it is not necessary to provide an air inlet in the holding box, and the side surface of the holding box is flat, so that the disinfection can be easily performed, and an excellent effect in preventing infection is exhibited.

By providing a skin temperature sensor that directly measures the surface temperature of the skin as in the invention described in claim 2, it is possible to reliably grasp whether or not the skin temperature is suitable for puncture.

It is a perspective view which shows the external appearance of the puncture pain relieving apparatus by this invention, (A) was seen from upper direction, (B) was seen from the downward direction. The detailed shape of the puncture pain relief apparatus by this invention is shown, (A) is a side view, (B) is a longitudinal cross-sectional view. It is a perspective view which shows the example of a use condition of the puncture pain relieving apparatus by this invention. It is a perspective view which shows the puncture pain relief apparatus of the shape different from FIG. 1, (A) is what was seen from upper direction, (B) was seen from the downward direction. It is a block diagram which shows the structure of the electronic device integrated in a puncture pain alleviation apparatus. The flow regarding a puncture pain alleviation device is shown, (A) is a flow of operation, and (B) is a flow at the time of use. It is a graph which shows the clinical test result implemented in the process of this invention. FIG. 9 is a chart showing the correlation between the skin surface temperature and pain based on the results of FIG. 7, the horizontal axis is the skin surface temperature, the vertical axis is the pain, and the numerical value in the frame is the number of persons concerned. is there.

  FIG. 1 shows the external appearance of a puncture pain alleviating device 11 according to the present invention. FIG. 1 (A) is viewed from above, and FIG. 1 (B) is viewed from below. The apparatus includes a holding box 12 in which a Peltier element 15 and the like are incorporated, and an arm 13 protruding from the side surface, and an electric wire 23 for receiving electric power extends from the tip of the arm 13. A cooling Peltier element 15 is incorporated inside the holding box 12, but in order to efficiently dissipate the heat generated here, a fan 17 is provided on the upper part thereof, as shown in FIG. As described above, hot air is discharged to the outside from the exhaust port 19 on the upper surface of the holding box 12. Further, as shown in FIG. 1B, the lower surface of the holding box 12 has a pressing body 14 protruding in a spherical shape, and has a function of cooling the skin. The pressing body 14 is made of an aluminum alloy having excellent thermal conductivity, and is in contact with the heat absorbing surface of the Peltier element 15. When the Peltier element 15 is energized, it is quickly cooled.

  The arm 13 functions as a handle, but a switch 20 and a display means 21 are incorporated on the side peripheral surface thereof. The switch 20 is used when the Peltier element 15 is energized. At the same time, the fan 17 is also rotated to dissipate heat. The display means 21 uses an LED, and lights up red when the switch 20 is turned on. When the pressing body 14 is cooled to a specified temperature, it is lit in green to notify the outside that it can be used. The temperature sensor 16 is incorporated so as to come into contact with the pressing body 14 and constantly monitors the temperature of the pressing body 14.

  The tip of the arm 13 is an air inlet 24, and air that cools the heat dissipation surface of the Peltier element 15 is taken in from here, passes through the arm 13 and is sent into the holding box 12, and then the fan 17 to the outside. Therefore, the holding box 12 does not need a hole for inhalation, there is no fear that a body fluid or the like is sucked into the inside, and the side surface of the holding box 12 is not uneven, so that the disinfection work is easy. In addition, this apparatus needs to maintain the temperature of the pressing body 14 appropriately using the temperature sensor 16, and a control unit 22 using a microcomputer is incorporated in the arm 13.

  When actually using this apparatus, first, the switch 20 is turned on to cool the pressing body 14. When the temperature of the pressing body 14 reaches 3 degrees which is the lower limit of the specified value, the display means 21 is lit in green to notify that it can be used. At the same time, the energization to the Peltier element 15 is stopped in order to prevent further temperature decrease, but energization is resumed when the temperature rises. When the pressing body 14 is pressed against the skin of the person to be treated in this state, the cooling of the skin proceeds without giving excessive stimulation, and when the pressing is continued for about 30 seconds, the cooling penetrates to the subcutaneous tissue, The nerve can be paralyzed without causing discomfort.

  FIG. 2 shows a detailed shape of the puncture pain alleviating device 11 according to the present invention, FIG. 2 (A) is a side view, and FIG. 2 (B) is a longitudinal section. As shown in FIG. 2 (A), the pressing body 14 protrudes in a spherical shape from the lower surface of the holding box 12, and when pressed against the skin, the contact pressure increases and the contact area also increases. Can be cooled. The switch 20 and the display means 21 are arranged in the vicinity of the base of the arm 13 in consideration of operability and visibility, and an electric wire 23 extends from the tip of the arm 13 to the outside. A power supply unit 25 for rectification is provided.

  As shown in FIG. 2B, a Peltier element 15 or the like is incorporated in the holding box 12. The Peltier element 15 has a plate shape, and when energized, the temperature of the lower heat absorbing surface is lowered and the temperature of the upper heat radiating surface is increased. The heat-absorbing surface is in surface contact with the pressing body 14, and in order to reduce the temperature of the pressing body 14 efficiently, a radiator 18 having fins is in surface contact with the opposing heat-dissipating surface and is generated here. Hot air is discharged to the outside by the fan 17. The air passing through the radiator 18 is taken in from the air inlet 24 at the tip of the arm 13 and discharged to the outside from the air outlet 19 on the upper surface of the holding box 12.

  On the back side of the switch 20 and the display means 21, a control unit 22 for managing the entire operation is incorporated. The control unit 22 is supplied with electric power by the electric wire 23, and manages the operations of the Peltier element 15 and the fan 17 based on information from the temperature sensor 16 after the switch 20 is turned on. The temperature sensor 16 is embedded in the pressing body 14 so that the temperature of the pressing body 14 can be accurately grasped.

  FIG. 3 shows an example of the usage state of the puncture pain alleviating device 11 according to the present invention. Immediately before hitting the puncture needle on the arm of the patient for artificial dialysis or the like, the medical staff grasps the puncture pain alleviating device 11 and brings the pressing body 14 into contact with the skin of the patient. Since the arm 13 is provided in the present invention, it can be handled in the same manner as a writing instrument, and when the arm 13 is gripped, the switch 20 is arranged near the tip of the finger, so that the operability is excellent. The visibility of the display means 21 is also good. Since the intake port 24 is located far from the arm of the person to be treated, it does not inhale body fluid and the like and is excellent in hygiene. Further, the person to be treated does not receive hot air from the fan 17.

  4 shows a puncture pain alleviating device 11 having a shape different from that in FIG. 1, FIG. 4 (A) is seen from above, and FIG. 4 (B) is seen from below. As the display means 21 for notifying the state of the apparatus, a simple LED as shown in FIG. 1 can be used. However, by using a liquid crystal panel as shown in FIG. The characteristics are further improved. For example, when the pressing body 14 is cooled, the remaining time until the medical staff reaches the specified temperature can be predicted by displaying the temperature in real time, and the efficiency of work is improved by effectively using the time.

  Further, as shown in FIG. 4B, a skin temperature sensor 26 is incorporated on the surface of the pressing body 14, and the surface temperature of the skin is measured in real time. By notifying the temperature on the display means 21, it can be easily determined whether or not the skin is properly cooled. The skin temperature sensor 26 sandwiches a heat insulating material at the boundary with the pressing body 14 in order to increase measurement accuracy. The switch 20 is provided for time measurement in addition to being used for turning the power on and off. When the time measurement switch 20 is pressed, the measured temperature by the skin temperature sensor 26 is displayed alternately in addition to the elapsed time similar to that of the stopwatch, and the skin can be cooled in an optimum state.

  In addition, the air inlet 24 for cooling the Peltier element 15 is not necessarily provided at the tip of the arm 13 as shown in FIG. 1, and may be provided on the side surface of the intermediate portion of the arm 13 as shown in FIG. Even in this case, it is sufficiently away from the pressing body 14, and no problem arises in terms of hygiene. The inside of the holding box 12 has the same structure as that shown in FIG. 2, and a fan 17 is disposed above the Peltier element 15, and a temperature sensor 16 and a pressing body 14 are disposed below.

  FIG. 5 shows the configuration of the electronic device incorporated in the puncture pain alleviating apparatus 11. The Peltier element 15 and the display means 21 are all connected to the control unit 22, and a series of operations proceeds based on a program incorporated in the control unit 22. Therefore, when the switch 20 is operated, energization of the Peltier element 15 and the fan 17 is started. At this time, the temperature of the pressing body 14 is constantly measured by the temperature sensor 16, and when the specified temperature is reached, energization to the Peltier element 15 is terminated. The timer is used to measure an elapsed time when the pressing body 14 is brought into contact with the skin, and time measurement is started when a medical staff or the like operates the switch 20. At this time, the skin surface temperature by the skin temperature sensor 26 can be displayed simultaneously with the display of the elapsed time.

  FIG. 6 shows a flow relating to the puncture pain alleviating apparatus 11, FIG. 6 (A) is a flow of operation, and FIG. 6 (B) is a flow during use. When the pressing body 14 is cooled, a function for managing the temperature within an appropriate range is indispensable. As shown in FIG. 6A, the energization to the Peltier element 15 is controlled based on the information of the temperature sensor 16. is doing. In the present invention, control is performed so that the measured value of the temperature sensor 16 is in the range of 3 degrees to 7 degrees based on the test data thus far.

  In use, the switch 20 is first turned on as shown in FIG. When the temperature of the pressing body 14 falls within an appropriate range, the display means 21 notifies the medical staff of that fact. Thereafter, the pressing body 14 is brought into contact with the skin of the person to be treated, and at the same time, the time is measured with a timer. The timer can be built in the puncture pain alleviating apparatus 11, but a general-purpose stopwatch may be used. When 20 seconds to 60 seconds elapse after pressing is started, the surface temperature of the skin is cooled from 22 degrees to 28 degrees, and the surrounding nerves are paralyzed. The reason why the pressing time varies from 20 seconds to 60 seconds is that there is a difference in the cooling rate due to the difference in the heat capacity of the pressing body 14 and the body temperature of the person to be treated.

  FIG. 7 shows the results of a clinical trial conducted in the course of the present invention. This test was conducted at an artificial dialysis facility in Ishikawa Prefecture from March to May 2009. The skin surface temperature (measured with a laser irradiation thermometer immediately after cooling the skin surface temperature), pressing body 14 Temperature (measured immediately before the skin is cooled by the temperature sensor 16 incorporated in the puncture pain relieving device 11), cooling time (time when the pressing body is brought into contact with the skin), pain (10 stages based on subjectivity) Evaluation) is recorded. The puncture needle is hit at two positions on the arterial side or the vein side, and the pain is defined as 10 when no relief measures are taken, and the numerical value is smaller as the pain is weaker. As shown in this chart, it is found that the pain is alleviated by cooling the skin surface to approximately 25 degrees Celsius. The time required for cooling is about 1 minute at the longest.

  FIG. 8 shows the correlation between the skin surface temperature and pain based on the results of FIG. 7. The horizontal axis is the skin surface temperature, the vertical axis is the pain, and the numerical value in the frame is the corresponding person. Number of people (total number of people). Thus, it can be seen that the pain of most people is greatly alleviated by setting the skin surface temperature to 22 degrees to 28 degrees. On the other hand, when the surface temperature is 30 ° C. or higher, as shown in the upper right of the chart, it can be seen that the pain is hardly alleviated.

11 Puncture Pain Relief Device 12 Holding Box 13 Arm 14 Pressing Body 15 Peltier Element 16 Temperature Sensor 17 Fan 18 Radiator 19 Exhaust Port 20 Switch 21 Display Unit 22 Control Unit 23 Electric Wire 24 Inlet Port 25 Power Supply Unit 26 Skin Temperature Sensor

Claims (2)

A Peltier element (15);
A holding box (12) for housing the Peltier element (15);
A pressing body (14) in contact with the endothermic surface of the Peltier element (15);
A fan (17) for cooling the heat dissipation surface of the Peltier element (15);
An arm (13) protruding from the holding box (12);
A temperature sensor (16) for measuring the temperature of the pressing body (14);
Display means (21) for notifying information obtained by the temperature sensor (16);
A control unit (22) for managing the entire operation;
With
The pressing body (14) protrudes spherically from the holding box (12), and the temperature of the pressing body (14) by the Peltier element (15), the temperature sensor (16), and the control unit (22). Can be maintained from 3 degrees Celsius to 7 degrees Celsius, and can be informed by the display means (21) that it is within this temperature range ,
In order to supply air to the fan (17), the tip (13) of the arm (13) is provided with an intake port (24), and the back side of the pressing body (14) is provided with an exhaust port (19). A puncture pain alleviating device characterized in that the side surface of the box (12) is flat without holes . The surface of the pressing body (14) is provided with a skin temperature sensor (26) for measuring the surface temperature of the skin, and this temperature can be notified by the display means (21). The puncture pain alleviating device according to claim 1 .

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