JP6222875B1 - Epidural space identification device - Google Patents

Abstract

When an epidural anesthesia is performed, it is confirmed that the injection needle has reached the epidural space by visually observing a change in an expansion portion provided in a plunger inserted into a barrel connected to the injection needle. Provided is an epidural space identifying device for identifying a change of an inflated portion that is easy to confirm. A barrel 2 having a distal end portion connected to the side of an injection needle 5 for epidural anesthesia, a plunger 3 inserted into and retracted from the proximal end side into the barrel 2, and a plunger 3 An expansion portion 4d that is provided at the distal end of the needle 3 and that expands toward the proximal end side in the plunger 3 when the plunger 3 is pushed in while the air discharge is restricted on the injection needle 5 side and the internal pressure becomes a positive pressure state. The plunger is provided with a window 9 for visually recognizing the displacement of the expansion member base end 4e when the internal pressure changes. [Selection] Figure 3

Description

  The present invention relates to a technical field of an identification device for identifying that a needle tip has reached an epidural space when performing epidural anesthesia performed when performing various analgesic procedures in surgery, obstetrics, etc. It is.

  Epidural anesthesia is a local anesthesia used for various analgesic procedures in surgery, obstetrics, etc., but when performing anesthesia, the needle tip of the injection needle is punctured into the epidural space (space) of the spinal column Is required to be identified. As an identification method, since the epidural space is located beyond the hard yellow ligament, when the toffee needle is punctured into the spinal column, the resistance disappears from the state where the needle tip hits the yellow ligament and received resistance. Thus, the “resistance disappearance method” for distinguishing the needle tip from reaching the epidural space is generally used, and this technique requires an advanced and skilled technique for anesthesiologists.

  Therefore, the one disclosed in Patent Document 1 is known as an identification device for identifying that the needle tip has reached the epidural space. In this case, the injection needle was punctured with the plunger inserted to the required amount position in the barrel connected to the needle tip of the epidural anesthesia syringe, and the needle tip reached the yellow ligament and felt puncture resistance. When the puncture is interrupted at one stage and the plunger is pushed into the barrel, the expansion portion expands due to the positive pressure inside the plunger. After that, when the puncture is resumed and the needle tip reaches the epidural space in a negative pressure state, the inflated part is recessed and returns to the original state. Can be confirmed.

Japanese Patent No. 5467668

  However, the thing of the said patent document 1 is surrounded by the two cylinders, a barrel and a plunger, since the expansion part is provided in the inside of the cylinder of a plunger, and the visibility of an expansion part is bad, and an expansion part There is a problem that it is sometimes difficult to confirm the change of the above, and there is a problem to be solved by the present invention.

The present invention has been created in order to solve the above-mentioned problems in view of the above circumstances, and the invention of claim 1 has a cylindrical shape and a distal end portion of an injection needle for epidural anesthesia. A barrel that is connected to the side, a plunger that is inserted into the barrel from the proximal end side, and a plunger that is provided at the distal end of the plunger. And an inflating member having an inflating part that inflates to the proximal end side in the plunger in a positive pressure state, and for identifying that the needle tip of the injection needle has reached the epidural space In the epidural space identification device, the plunger is provided with a window for visually recognizing the displacement of the base end of the expansion member when the internal pressure changes, and the plunger It has a cylindrical part on the tip side, and the plunger The cylindrical portion is hollow and has a proximal end open, and the expansion member has a proximal end that is flush with the proximal end surface of the cylindrical portion provided in the plunger in the non-expanded state, while the proximal end in the expanded state. Is an epidural space identifying device that is displaced so as to protrude from the proximal end surface of the cylindrical portion provided in the plunger toward the window side .
The invention according to claim 2, wherein the expansion member is provided with a protruding portion of the solid as a base end portion, projecting portion is in sliding contact so as to be movable in the inner peripheral surface of the cylindrical portion with the plunger The epidural space identification device according to claim 1.
The invention according to claim 3 is the epidural space identification device according to claim 2 , wherein the protrusion is colored.
According to a fourth aspect of the present invention, the barrel is provided with a holding portion, and the plunger includes a locking portion that locks the holding portion at a predetermined position when the plunger is inserted into the barrel. The epidural space identification device according to any one of claims 1 to 3.
The invention according to claim 5 is the epidural space identification device according to claim 4, wherein a plurality of the holding portions or the locking portions are provided at different positions in the axial direction.

According to the first aspect of the present invention, the displacement of the base end portion of the inflating member accompanying the change of the inflating portion can be visually recognized from the window portion. It becomes. In addition , it is easy to identify whether the needle tip has reached the epidural space because it is possible to confirm the change of the inflated portion by checking whether the base end of the inflating member is flush with the base end surface of the cylindrical portion of the plunger. It becomes.
According to the invention of claim 2 , the shape of the protruding portion protrudes without changing during expansion, so that the visibility is good and it is easy to identify whether the needle tip has reached the epidural space.
According to the invention of claim 3 , since the solid protruding portion is colored and protrudes, the color of the base end portion of the expansion member does not become light at the time of expansion, and the displacement of the base end portion is more easily visible. .
According to the invention of claim 4 , since the position of the plunger can be held at a predetermined position, the operability is improved.
According to the invention of claim 5 , when the plunger is pushed in, it can be punctured while holding the plunger at each position, so that the operability is improved.

It is a front view of the epidural space identification device of (A) an initial position, (B) an inflated state at a pushing position, and (C) an inflated state at a pushing position. (A) Initial position, (B) During transition from the initial position to the pushed position, (C) is a side view of the epidural space identification device in an expanded state at the pressed position. (A) It is front sectional drawing of the epidural space identification apparatus of an expansion state in a pushing position, (B) a non-expansion state in a pushing position. (A) AA sectional view of FIG. 1 (B), (B) BB sectional view of FIG. 1 (B), (C) CC sectional view of FIG. 1 (C), (D) FIG. It is DD sectional drawing of (B).

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. In the drawings, reference numeral 1 denotes a syringe for epidural space identification. The syringe 1 includes a cylindrical barrel 2, a plunger 3 that is inserted into and retracted into the barrel 2, and an expansion member provided on the plunger 3. (Diaphragm, gasket) 4.

  The barrel 2 is made of a transparent or translucent material whose inside can be visually recognized, and includes a cylindrical tube portion 2a into which the plunger 3 is inserted into the inner periphery. The base end 2b of the tube portion 2a is open and flanged. Part 2c is formed. On the other hand, the distal end portion of the cylindrical portion 2a is bottomed to form a bottom portion 2d, and a proximal end portion 6a of a tube 6 connected to the injection needle 5 for epidural space puncture is attached to and detached from the bottom portion 2d. A luer taper portion 2e that is freely fixed is formed. The cylindrical wall on the proximal end side of the tubular portion 2a is provided with a first holding hole 2f on the proximal end side and a second holding hole 2g on the distal end side as holding portions provided at different positions in the axial direction. As described later, the plunger 3 can be held at a predetermined position. And the guide groove 2i which connects between the 1st, 2nd holding holes 2f and 2g is formed in the internal peripheral surface 2h of the cylinder part 2a.

  The plunger 3 is loosely or slidably fitted in the cylindrical portion 2a of the barrel 2 (in this embodiment, it is loosely fitted). A body portion 3a and a flange portion 3c are formed. And a base end portion 3b. The main body 3a is provided with a cylindrical plunger tube portion 8 on the distal end side and a plunger base portion 10 having a cross-shaped cross section on the proximal end side, and the space between the plunger tube portion 8 and the plunger base portion 10 is the circumferential direction. A plurality of (three in the present embodiment) columnar bodies 9a are connected so as to have one gap S1, and the first gap S1 is a window portion 9 having no cylindrical wall or the like.

  The plunger cylinder portion 8 has an opening at the distal end portion 8a and a proximal end portion 8b, and a locking groove 8c is formed on the outer peripheral surface of the distal end portion 8a. Further, the three columnar bodies 9 a that connect the base end face 8 d of the plunger cylinder portion 8 and the tip end portion 10 a of the plunger base portion 10 are provided at equal intervals on the outer peripheral portion of the window portion 9.

  The plunger base portion 10 includes a tip portion 10a that is slightly smaller in diameter than the inner diameter of the cylindrical portion 2a of the barrel 2 and is formed in a disc shape, and a shaft portion 10b having a cross-shaped cross section. Since the distal end portion 10a is slightly smaller in diameter than the inner diameter of the cylindrical portion 2a of the barrel 2, a second gap S2 is generated between the inner end of the cylindrical portion 2a when inserted into the barrel 2, and the window portion 9 The first gap S1 and the second gap S2 communicate with each other so that air flows in and out. In the shaft portion 10b, as a locking portion for locking to the holding portion (the first holding hole 2f, the second holding hole 2g) of the barrel 2, a protruding protrusion whose protruding end protrudes in an arc shape toward the outer diameter direction 10c is formed. The locking projection 10c is formed by cutting out a part of the shaft portion 10b. The locking projection 10c is flexible so as to bend in the inner diameter direction. The holding hole 2f and the second holding hole 2g are fitted and locked. When the plunger 3 is inserted into the barrel 2, the locking projection 10c of the plunger 3 is fitted and locked in the first holding hole 2f, and then the locking projection 10c is bent in the inner diameter direction when the plunger 3 is pushed. Then, it moves to the tip side along the guide groove 2i and is fitted and locked in the second holding hole 2g. By doing so, the position at which the locking projection 10c is locked to the first holding hole 2f of the barrel 2 is the initial position, and the position at which the locking protrusion 10c is locked to the second holding hole 2g is the pushing position. Since operations such as puncture can be performed while being held in position, operability is improved.

  The expansion member 4 is formed of a rubber-like elastic material such as silicone rubber or natural rubber. The outer peripheral portion 4a of the expansion member 4 is in a state where it is externally fitted to the outer periphery of the distal end portion 8a of the plunger cylinder portion 8. The inner peripheral surface 2h is lightly press-fitted to prevent air leakage, and in a state where the plunger 3 is not pushed and pulled, the posture is maintained so as to be slidably slidable so as not to move. Moreover, the latching protrusion 4b inserted in the latching groove 8c of the plunger 3 is formed in the internal peripheral surface of the outer peripheral part 4a.

  The distal end portion 4c continuing from the outer peripheral portion 4a of the expansion member 4 is thick with the outer peripheral portion 4a and is in contact with the distal end portion 8a of the plunger cylinder portion 8. Then, following the inner end of the distal end portion 4c, an inflatable portion (diaphragm) which comes into contact with the inner peripheral surface 8e of the plunger cylinder portion 8 and is in a thin cylindrical shape having a height up to substantially the same position as the outer peripheral portion 4a. Part) 4d is provided. A solid cylindrical protrusion 4e is formed as a base end portion of the expansion member 4 on the base end side of the expansion portion 4d. The projecting portion 4e is slidably contacted with the inner peripheral surface 8e of the plunger cylinder portion 8 so that the base end 4f is in contact with the base end surface 8d of the plunger cylinder portion 8 when the expansion portion 4d is not expanded. It is set to be flush. As a result, the expansion portion 4d expands to the base end side when the plunger 3 shifts from the initial position to the pushing position in the positive pressure state, and the protrusion 4e protrudes from the base end surface 8d of the plunger cylinder portion 8 and is displaced during expansion. It has become.

  In addition, visibility can be improved by making the expansion | swelling member 4 into appropriate coloring. In the inflated state, the thin inflatable portion 4d expands toward the proximal end and the radial thickness becomes thin, so the color becomes thin. However, since the solid protrusion 4e does not become thin, the inflatable portion 4d itself The effect of improving the visibility by coloring is greater than when protruding.

  When performing epidural anesthesia, it is possible to identify whether the needle tip of the injection needle 5 has reached the epidural space as follows. First, the plunger 3 is inserted into the barrel 2, and the locking projection 10c is fitted and locked in the first holding hole 2f of the barrel 2 to hold the plunger 3 in the initial position. Then, with the injection needle 5 and the syringe 1 connected in communication via the tube 6, the injection needle 5 is punctured into the spinal column, and when the needle tip reaches the yellow ligament and feels puncture resistance, the injection needle 5 Is temporarily interrupted (state shown in FIG. 1A). In this state, the needle tip of the injection needle 5 is in a sealed state. In this state, the plunger 3 is further pushed to the distal end side, and the locking projection 10c fitted and locked in the first holding hole 2f is moved to the distal side along the guide groove 2i to be fitted and locked in the second holding hole 2g. Then, the plunger 3 is set to the pushing position. Then, the inflated portion 4d is inflated to the proximal end side (the state shown in FIGS. 1B and 3A). At this time, the base end 4f of the protruding portion 4e provided on the base end side of the inflating portion 4d protrudes from the base end surface 8d of the plunger cylinder portion 8 and is positioned in the first gap S1 of the window portion 9, so that the window The protrusion of the protrusion 4e can be easily visually recognized from the position of the part 9. And after confirming this protrusion, the puncture of the injection needle 5 is restarted. When the needle tip reaches the epidural space in a negative pressure state and air is injected into the epidural space, the inflating part 4d becomes the original non-expanded state (FIG. 1 (C), FIG. 3 ( B)), since the base end 4f of the projecting portion 4e that has been projected is flush with the base end surface 8d of the plunger tube portion 8, the projection of the projecting portion 4e disappears from the position of the window 9 and is flush. By confirming that it has become, it can be determined that the needle tip has reached the epidural space. Thereafter, epidural anesthesia can be performed by removing the syringe 1 from the tube 6 or the like.

  In the present embodiment configured as described, when performing epidural anesthesia, the syringe 1 and the injection needle 5 are connected with the plunger 3 held in the initial position, and then the injection needle 5 is punctured into the spinal column. To do. When the needle tip reaches the yellow ligament, the puncture is interrupted once, and when the plunger 3 is pushed to the pushing position, the expanding portion 4d expands to the base end side, and the protruding portion 4e which is the base end portion of the expanding member is the base end It will be displaced to the position of the side window 9. Thereafter, the puncture of the injection needle 5 is resumed, and when the needle tip reaches the epidural space, air that has become positive pressure due to the expansion of the expansion portion 4d flows out into the negative epidural space. As a result, the expanded portion 4d is brought into the original non-expanded state, and the protruding portion 4e is displaced to the original position on the distal end side. In such an operation, it is easy to confirm the change of the expanding portion 4d by visually recognizing the displacement of the protruding portion 4e that is the base end portion of the expanding member from the window portion 9, that is, whether or not the needle tip has reached the epidural space. It has become.

  Further, since the base end 4f of the protrusion 4e is flush with the base end face 8d of the plunger cylinder 8 when not inflated, the base end 4f of the protrusion 4e is flush with the base end face 8d of the plunger cylinder 8. It is only necessary to check whether the needle tip is in the shape, and it is possible to more easily identify whether the needle tip has reached the epidural space. Since the solid protrusion 4e, not the expansion part 4d, protrudes from the base end face 8d of the plunger cylinder part 8 toward the window part 9, the protrusion 4e protrudes without changing its shape when the expansion part 4d is expanded. Therefore, it is possible to more easily identify whether the needle tip has reached the epidural space. In addition, when the inflatable member 4 is colored, the inflatable portion 4d becomes thinner and lighter in color when inflated, but the protrusion 4e does not become lighter in color, and thus the visibility is greatly improved by coloring. Therefore, it is easier to visually recognize the displacement of the base end portion.

  Further, the barrel 2 is provided with a first holding hole 2f and a second holding hole 2g as holding parts, and the plunger 3 is a locking projection that is fitted and locked into the first and second holding holes 2f and 2g. Since the plunger 3 can be held in the barrel 2 at the initial position and the pushed-in position, the puncture can be performed while the plunger 3 is securely held at the predetermined position, and the operability is good.

  It goes without saying that the present invention is not limited to the configuration of the above embodiment. For example, the plunger base 10 may not be a cross-shaped cross section but may be a cylinder. Further, the barrel 2 is provided with a first holding hole 2f and a second holding hole 2g as holding parts, and the plunger 3 is provided with a locking projection 10c as a locking part. A holding projection that protrudes in the inner diameter direction from the peripheral surface 2h without a gap may be provided as a holding portion, and a locking hole in which the holding projection is fitted into the plunger 3 may be provided as a locking portion. Further, the shape of the locking portion and the holding portion is not limited to that in which the protruding end of the convex portion is fitted and locked in the hole. For example, an annular concave groove is formed on the inner peripheral surface 2h of the cylindrical portion 2a of the barrel 2. Then, this may be used as a holding portion, and the plunger 3 may be provided with an annular ridge that fits in the groove, and the plunger inserted into the barrel 2 has various shapes that can be held at a predetermined position. be able to.

  Further, the expansion member 4 is provided with the protrusion 4e on the base end side of the expansion portion 4d. However, without providing the protrusion 4e separately, the base end of the expansion portion 4d in the expanded state is the cylindrical portion of the plunger 3. It is good also as what protruded from the base end surface 8d of 8, and was able to visually recognize this protrusion from the window part 9. The configuration for visually recognizing the displacement of the base end portion of the expansion member from the window portion 9 is not limited to the confirmation of the displacement of the base end 4f. For example, the outer peripheral surface of the protruding portion 4e is colored differently from other portions. In addition, the coloration cannot be visually recognized from the window portion 9 when it is not inflated, but can be made visible from the window portion 9 when it is inflated.

  Furthermore, when the window portion 9 is provided, the plunger cylinder portion 8 and the plunger base portion 10 are connected by a columnar body 9a. However, the window portion 9 may be formed by cutting out a part of a cylinder wall, for example. Good. That is, if there is no cylindrical wall between the cylindrical portion 2a of the barrel 2 and the protruding portion 4e protruding in the expanded state and the first gap S1 is formed and the window portion 9 is provided, the cylindrical wall of the plunger 3 during expansion Since the protruding portion 4e of the expansion member 4 is not surrounded, it is easy to see whether the protruding portion 4e is protruding, and it is easy to check whether the needle tip of the injection needle 5 has reached the epidural space. It will be able to do.

  INDUSTRIAL APPLICABILITY The present invention can be used for an epidural space identification device that identifies whether the needle tip has reached the epidural space when performing epidural anesthesia.

1 Syringe 2 Barrel 2f First holding hole (holding part)
2g Second holding hole (holding part)
3 Plunger 4 Expansion member 4d Expansion part 4e Protrusion part (base end part)
4f (base end)
5 Injection needle 8 Plunger tube portion 8d Base end surface 8e Inner peripheral surface 9 Window portion 10 Plunger base portion 10c Locking convex portion (locking portion)

Claims (5)

A barrel that has a cylindrical shape, the tip of which is connected to the side of the injection needle for epidural anesthesia,
A plunger which is inserted into the barrel from the proximal end side so as to freely move in and out,
An inflatable member provided at the distal end of the plunger and having an inflating portion that expands toward the base end side in the plunger, when the plunger is pushed in while air discharge is restricted on the injection needle side, An epidural space identification device for identifying that the tip of an injection needle has reached the epidural space, comprising:
The plunger has a window for visually recognizing the displacement of the expansion member base end when the internal pressure changes ,
The plunger includes a cylindrical portion on the distal end side of the window portion,
The cylindrical portion provided in the plunger is hollow and the base end is open,
In the non-expanded state, the expansion member is flush with the base end surface of the cylindrical portion provided in the plunger, while in the expanded state, the base end is located on the window side from the base end surface of the cylindrical portion provided in the plunger. An epidural space identifying device, wherein the epidural space is displaced so as to protrude into the surface. The said expansion member is provided with the solid protrusion part as a base end part, This protrusion part is slidably contacted to the internal peripheral surface of the cylinder part with which the said plunger was provided. 1 epidural腔識another apparatus according. The epidural space identification device according to claim 2 , wherein the protrusion is colored. It said barrel holding portion is provided, said plunger claim 1, characterized in that it comprises a locking portion for locking the holder in place upon insertion into the barrel of 3 The epidural space identification device according to any one of the above. The epidural space identification device according to claim 4 , wherein a plurality of the holding portions or the locking portions are provided at different positions in the axial direction.

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