WO2015141562A1 - Fluid delivery pump - Google Patents

Fluid delivery pump Download PDF

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Publication number
WO2015141562A1
WO2015141562A1 PCT/JP2015/057382 JP2015057382W WO2015141562A1 WO 2015141562 A1 WO2015141562 A1 WO 2015141562A1 JP 2015057382 W JP2015057382 W JP 2015057382W WO 2015141562 A1 WO2015141562 A1 WO 2015141562A1
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WO
WIPO (PCT)
Prior art keywords
upper limit
concentration
value
target
drug
Prior art date
Application number
PCT/JP2015/057382
Other languages
French (fr)
Japanese (ja)
Inventor
裕子 大澤
長谷川　英司
Original Assignee
テルモ株式会社
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Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2015141562A1 publication Critical patent/WO2015141562A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/172—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic
    • A61M5/1723—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic using feedback of body parameters, e.g. blood-sugar, pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/142—Pressure infusion, e.g. using pumps
    • A61M5/145—Pressure infusion, e.g. using pumps using pressurised reservoirs, e.g. pressurised by means of pistons
    • A61M5/1452—Pressure infusion, e.g. using pumps using pressurised reservoirs, e.g. pressurised by means of pistons pressurised by means of pistons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/142—Pressure infusion, e.g. using pumps
    • A61M2005/14208—Pressure infusion, e.g. using pumps with a programmable infusion control system, characterised by the infusion program
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/142—Pressure infusion, e.g. using pumps
    • A61M2005/14288—Infusion or injection simulation
    • A61M2005/14292—Computer-based infusion planning or simulation of spatio-temporal infusate distribution
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/142—Pressure infusion, e.g. using pumps
    • A61M2005/14288—Infusion or injection simulation
    • A61M2005/14296—Pharmacokinetic models

Definitions

  • the present invention relates to a liquid delivery pump used in the medical field for delivering a medicine into a patient's body.
  • a drug such as intravenous anesthetic
  • a medical setting such as an intensive care unit
  • the amount of fluid delivered is adjusted appropriately for a long period of time depending on the technique to be applied and the patient's symptoms. It is necessary to carry out liquid feeding.
  • infusion pumps and syringe pumps as devices for accurately delivering a medicine over a long period of time with a set amount of liquid to be delivered. Setting of the amount of liquid delivery is performed by a medical worker using an infusion pump or a syringe pump.
  • the upper limit of the amount of liquid delivered is different. Therefore, when delivering a drug, it is necessary to appropriately adjust the liquid delivery amount so as not to exceed the upper limit set for each type of drug, depending on whether or not the efficacy of the drug is expressed. There is. Conventionally, the adjustment of the liquid feeding amount has been manually performed by medical personnel. For this reason, there is a problem in that the adjustment of the liquid feeding amount depending on whether or not the efficacy of the drug is expressed is not always performed at an appropriate timing.
  • TCI pump Target Controlled Infusion
  • TCI pump Target Controlled Infusion
  • a target blood concentration is set instead of the delivery volume.
  • the TCI pump automatically adjusts the amount of liquid delivered so that the blood concentration of the delivered medicine reaches the target concentration and is maintained.
  • the blood concentration of the medicine is calculated based on the simulation from the amount of medicine delivered.
  • the TCI pump when used, there is a possibility that the liquid will be fed with a liquid feeding amount that exceeds the upper limit value of the liquid feeding amount determined according to the type of the medicine. For example, when the target blood concentration was set higher than the allowable blood concentration at the start of drug delivery, the upper limit was exceeded in order to quickly reach the target blood concentration. There is a possibility that the drug will be delivered in the amount delivered.
  • Some TCI pumps can set an upper limit value of the liquid delivery amount in order to prevent delivery of a medicine at a liquid delivery amount exceeding the upper limit value. However, it does not have a function to switch the upper limit value of the liquid feeding amount depending on whether or not the efficacy of the drug is expressed, and the liquid is not always delivered at an appropriate liquid feeding amount. There is also a problem that the upper limit value of the liquid feeding amount is set erroneously.
  • the present invention has been made to solve the above-described problems, and at the time of delivering a medicine, the medicine is delivered with an appropriate amount of medicine that does not exceed a predetermined upper limit defined for each kind of medicine.
  • An object is to provide a liquid feed pump capable of liquid.
  • the liquid delivery pump for achieving the above object is a liquid delivery pump for delivering the medicine while simulating the concentration of the delivered medicine in the living body, and the liquid delivery pump for delivering the medicine
  • An observation unit that observes fluctuations in vitals, a calculation unit that calculates the concentration of the medicine in the living body based on the amount of the delivered medicine, and a value observed by the observation part becomes a predetermined target value
  • a vital determination unit that determines whether or not it has reached, an upper limit introduction flow rate of the drug, an upper limit maintenance flow rate of the drug, and a target concentration of blood concentration or effect site concentration of the drug calculated by the calculation unit;
  • a storage unit for storing the target value; a receiving unit for receiving input of the target concentration and the target value; and an upper limit value of the liquid delivery amount of the medicine according to a determination result of the vital determination unit.
  • Up to the upper limit introduction flow rate Is an upper limit value switching unit that switches to the upper limit maintenance flow rate, and an adjustment unit that adjusts the amount of the drug delivered in a range that does not exceed the upper limit value so that the blood concentration or the effect site concentration maintains the target concentration And having.
  • the present invention it is possible to observe changes in vitals of a living body to which a medicine is fed. Then, it can be determined whether or not the observed vital value has reached a predetermined target value. Furthermore, it is possible to switch the upper limit value of the drug delivery amount according to the determination result of whether or not the observed vital value has reached a predetermined target value. Therefore, according to the present invention, at the time of drug delivery, an appropriate liquid delivery amount that does not exceed a predetermined upper limit value determined depending on whether or not the efficacy of the drug is expressed for each type of drug. It is possible to deliver a medicine.
  • the upper limit value switching unit can be configured to switch to the maintenance flow rate.
  • the upper limit value switching unit can be configured to switch to the upper limit introduction flow rate.
  • the liquid feeding can be configured to stop the liquid feeding when the observed vital value reaches a predetermined limit value.
  • the target concentration is determined depending on whether the observed vital value has reached a predetermined target value and whether the calculated concentration of the medicine in the living body has reached the predetermined target concentration.
  • the reception unit when storing the upper limit introduction flow rate and the upper limit maintenance flow rate, can be configured to limit the acceptance of the upper limit maintenance flow rate exceeding the upper limit introduction flow rate. With this configuration, since the upper limit maintenance flow rate exceeding the upper limit introduction flow rate can be prevented from being stored erroneously, safety is improved.
  • the accepting unit can be configured to accept the input of the target value during liquid feeding. With this configuration, since the target value can be changed according to the situation, safety and convenience are further improved.
  • the accepting unit can be configured to accept the input of the target concentration during liquid feeding. With this configuration, since the target concentration can be changed according to the situation, safety and convenience are further improved.
  • the upper limit value switching unit can be configured to switch the upper limit value of the liquid feeding amount when the observed vital value is included within a predetermined allowable range based on the target value.
  • it can be configured to have a notification unit that notifies that the upper limit value of the amount of liquid to be delivered is switched.
  • the observed vital is a bispectral index.
  • it can be suitably used for feeding anesthetics such as intravenous anesthetics.
  • FIG. It is a figure which shows the change of the change of the bispectral index, and the blood concentration and effective site concentration of the delivered medicine, and when the liquid is delivered using the syringe pump according to the first embodiment of the present invention.
  • FIG. It is an external appearance front view for demonstrating the display part of the syringe pump which concerns on 1st Embodiment of this invention, Comprising: It is a figure in the middle of liquid feeding using a syringe pump.
  • FIG. It is a figure which shows the change of the change of the bispectral index, and the blood concentration and effective site concentration of the delivered medicine, and when the liquid is delivered using the syringe pump according to the second embodiment of the present invention.
  • FIG. It is a general
  • FIG. 1 It is a figure for demonstrating operation
  • FIG. It is a figure which shows the change of the change of the bispectral index, and the blood concentration and effective site concentration of the delivered medicine, and when the liquid is delivered using the syringe pump according to the third embodiment of the present invention.
  • FIG. It is a figure which shows the change of the change of the bispectral index, and the blood concentration and effective site concentration of the delivered medicine, and when the liquid is delivered using the syringe pump according to the fourth embodiment of the present invention.
  • FIG. It is an external appearance front view for demonstrating the display part of the syringe pump which concerns on 5th Embodiment of this invention, Comprising: It is a figure which shows the example of a display at the time of selecting the density
  • the syringe pump 1 according to the first embodiment of the present invention shown in FIG. 1 and FIG. 2 delivers a drug into a patient's body for a long time in an intensive care unit such as an ICU, CCU, or NICU. It is a liquid feed pump used for liquefying.
  • the syringe pump 1 can send various drugs including intravenous anesthetics into the patient's body.
  • intravenous anesthetics include propofol, mitazolam, and remifentanil.
  • an upper limit is set for each type of medicine in the amount of medicine delivered to the body of a patient.
  • the liquid feeding amount means a flow rate, and for example, ml / kg / second, ml / kg / hour, or the like is used as a unit.
  • the upper limit of the amount of liquid to be introduced (hereinafter referred to as the upper limit introduction flow rate) until the effect of the delivered drug is expressed, and the amount of the liquid that maintains the effect of the drug after the effect of the drug is expressed
  • the upper limit value (hereinafter, the upper limit maintenance flow rate) is different.
  • the upper limit maintenance flow rate is smaller than the upper limit introduction flow rate.
  • a document (hereinafter referred to as a drug package insert) that describes how to use the drug, precautions, and the like is attached to each drug.
  • the upper limit introduction flow rate and the upper limit maintenance flow rate are described in the medicine package insert.
  • the expression may be described in terms of an appropriate value for the liquid supply amount, not the expression for the upper limit value of the liquid supply amount, but it is substantially the same.
  • the drug delivery must be performed with an appropriate liquid delivery amount that does not exceed the upper limit introduction flow rate or the upper limit maintenance flow rate.
  • the syringe pump 1 switches the upper limit value of the liquid feeding amount to the upper limit introduction flow rate or the upper limit maintenance flow rate determined for each type of the drug according to whether or not the efficacy of the drug is manifested, so The drug is delivered in liquid volume.
  • the syringe pump 1 uses a bispectral index for determining whether or not the efficacy of the drug is expressed. .
  • the bispectral index is a value calculated based on the electroencephalogram.
  • the bispectral index has a value in the range of 0-100. It is known that there is a certain relationship between the value of the bispectral index and the expression state of the efficacy of the drug. For example, as the relationship between the value of the bispectral index and the state of the development of the anesthetic effect, the closer the bispectral index value is to 100, the more the patient is awake, and the lower the bispectral index value, the more the anesthesia is. It is known to be in effect. Furthermore, it is known that, for example, there is the following relationship, depending on the patient to whom the anesthetic is administered and the drug to be administered.
  • the bispectral index value when the bispectral index value is 70 to 80 or more, it is known that some patients may return to an awakened state during the procedure without continuing an unconscious state. . It is also known that when the value of the bispectral index is 50 to 60 or less, an unconscious state persists in most patients, and there is almost no awakening during the procedure. In addition, if the bispectral index value is below 20-30, the anesthesia is too effective, and there is no possibility of waking up during the procedure, but the patient may be at risk. It has been known.
  • the relationship between the value of the bispectral index and the expression state of the efficacy of the drug is not limited to the sedatives in the above-described examples, but is also observed in various anesthetics.
  • the syringe pump 1 determines whether or not the efficacy of the drug is manifested by whether or not the value of the bispectral index has reached a predetermined target value, and switches the upper limit value of the liquid delivery amount. I do.
  • the syringe pump 1 presses a syringe pusher 202 of a syringe 200 as a medicine storage container filled with a medicine in the T direction so that the medicine in the syringe body 201 is transferred to a tube 203.
  • the liquid is accurately delivered to the patient via the indwelling needle 204.
  • the syringe body 201 of the syringe 200 is set in the syringe pump 1 so as not to move by the clamp 5.
  • the syringe pump 1 has a main body cover 2.
  • the main body cover 2 is integrally formed of a molded resin material having chemical resistance. Thereby, the main body cover 2 has a splash-proof processing structure. Due to the splash-proof treatment structure, even if a drug or the like is applied, it can be prevented from entering the syringe pump 1.
  • the reason for having a splash-proof treatment structure is that the medicine in the syringe body 201 may spill, the drip solution disposed above may spill out, or disinfectant used in the vicinity may scatter and adhere.
  • the main body cover 2 has an upper portion 2A and a lower portion 2B.
  • a display unit 3 and an operation panel unit 4 are arranged in the upper part 2A.
  • a syringe setting unit 6 and a syringe pusher drive unit 7 for pushing the syringe pusher 202 are arranged.
  • the display unit 3 is an image display device capable of color display.
  • the display unit 3 can be configured by a color liquid crystal display device, for example.
  • the display unit 3 can display not only information notation in Japanese but also information in a plurality of foreign languages as necessary.
  • the display unit 3 is located at the upper left position of the upper portion 2 ⁇ / b> A of the main body cover 2 and above the syringe setting unit 6 and the syringe pusher driving unit 7.
  • the operation panel unit 4 is disposed on the right side of the display unit 3 in the upper part of the main body cover 2.
  • a power ON / OFF button 4A, an operation indicator 4F, and operation buttons are arranged on the operation panel unit 4.
  • FIG. 1 and FIG. 2 show an example in which four minimum required fast-forward switch buttons 4B, start switch buttons 4C, stop switch buttons 4D, and menu selection buttons 4E are arranged as operation buttons.
  • the syringe setting unit 6 and the syringe pusher driving unit 7 are arranged side by side along the X direction.
  • the syringe setting unit 6 can select and fix a plurality of different types of syringes 200, 300, and 400, which will be described later with reference to FIG.
  • the syringe setting unit 6 includes a storage unit 8 that stores the syringe body 201 and a clamp 5.
  • the accommodating portion 8 is a concave portion having a substantially semicircular cross section and is formed along the X direction.
  • a tube fixing portion 9 for detachably holding the tube 203 is formed on the wall portion at the end of the housing portion 8.
  • the clamp 5 When removing the syringe 200 from the syringe setting unit 6 by operating the clamp 5, the clamp 5 is pulled in the Y1 direction (frontward direction) against the force of a spring (not shown) and turned 90 degrees in the R1 direction.
  • the syringe body 201 can be detached from the housing portion 8 after being fixed by the clamp 5. Further, when the clamp 5 is operated and the syringe 200 is attached to the syringe setting unit 6, the clamp 5 is pulled in the Y1 direction against the force of the spring (not shown) and turned 90 degrees in the R2 direction. By returning to the Y2 direction, the syringe body 201 can be housed in the housing portion 8 and fixed by the clamp 5.
  • the right end portion 8E of the accommodating portion 8 of the syringe setting portion 6 is partially cut away so that the clamp 5 can fix the syringe with the accommodating amount of 2.5 mL, 5 mL, 10 mL, 20 mL, 30 mL, and 50 mL. It has become.
  • the syringe pusher 202 When the syringe body 201 is housed and fixed in the housing portion 8, the syringe pusher 202 is disposed in the syringe pusher drive portion 7.
  • the syringe pusher drive unit 7 has a slider 10. The slider 10 pushes the pusher flange 205 of the syringe pusher 202 little by little along the T direction relative to the syringe body 201 in accordance with a command from the control unit 100 shown in FIGS. 2 and 8.
  • the X direction, the Y direction, and the Z direction in FIGS. 1 and 2 are orthogonal to each other, and the Z direction is the vertical direction.
  • a BIS monitor 500 is connected to the syringe pump 1 via a cable 501.
  • the BIS monitor 500 observes an electroencephalogram via an electroencephalogram measurement probe (not shown) attached to the patient's head. Then, a bispectral index is calculated based on the observed electroencephalogram. The value of the bispectral index can be calculated by a known method. The calculated bispectral index value is input to the control unit 100 of the syringe pump 1 via the cable 501 as described later.
  • FIG. 3 shows a display content example of the display unit 3.
  • the display content example of the display unit 3 is an example and is not particularly limited.
  • FIG. 7 is a perspective view showing an example of the above-described multiple types of syringes.
  • 1 and 2 show an example in which the syringe 200 having the largest amount of medicine is fixed.
  • the syringe 200 having the largest amount of medicine is provided with a syringe main body 201 and a syringe pusher 202, and the syringe main body 201 has a main body flange 209, and the syringe pusher. 202 has a pusher flange 205.
  • the syringe main body 201 is formed with a medicine scale 210.
  • One end of a flexible tube 203 is detachably connected to the outlet 211 of the syringe body 201.
  • the syringe 300 having a medium amount of medicine has a syringe main body 301 and a syringe pusher 302, and the syringe main body 301 has a main body flange 309.
  • the child 302 has a pusher flange 305.
  • the syringe body 301 is formed with a medicine scale 310.
  • One end of a flexible tube 203 is detachably connected to the outlet 311 of the syringe body 301.
  • the syringe 400 with the smallest amount of medicine is provided with a syringe body 401 and a syringe pusher 402.
  • the syringe body 401 has a body flange 409, and the syringe pusher.
  • Reference numeral 402 has a pusher flange 405.
  • the syringe body 401 is formed with a drug scale 410.
  • One end of a flexible tube 203 is detachably connected to the outlet 411 of the syringe body 401.
  • the syringe 200 shown in FIG. 7A has, for example, a medicine capacity of 50 mL
  • the syringe 300 shown in FIG. 7B has, for example, a medicine capacity of 10 mL, 20 mL, and 30 mL
  • the syringe 400 shown in FIG. The syringes 300 and 400 can be housed and fixed in the housing portion 8 in the same manner as the syringe 200 shown in FIGS. 1 and 2.
  • the syringe pump 1 has a control unit (computer) 100 that performs overall operation determination and control.
  • the control unit 100 is, for example, a one-chip microcomputer, and includes a ROM (Read Only Memory) 101, a RAM (Random Access Memory) 102, a nonvolatile memory 103, and a clock 104.
  • the clock 104 can correct the current time by a predetermined operation, and can acquire the current time, measure the elapsed time of a predetermined liquid feeding operation, measure the reference time of liquid feeding speed control, and the like.
  • the control unit 100 shown in FIG. 8 is connected to a power ON / OFF button 4A and a switch 111.
  • the switch 111 supplies power to the control unit 100 from either the power converter unit 112 or the rechargeable battery 113 by switching between the power converter unit 112 and the rechargeable battery 113 such as a lithium ion battery.
  • the power converter unit 112 is connected to a commercial AC power source 115 via an outlet 114.
  • a pair of detection switches 120 and 121 are arranged in the accommodating portion 8.
  • the detection switches 120 and 121 detect whether or not the syringe body 201 of the syringe 200 is correctly arranged in the storage unit 8 and notify the control unit 100 of it.
  • the clamp sensor 122 notifies the control unit 100 whether or not the syringe body 201 is reliably clamped by the clamp 5 by detecting the position state of the clamp 5.
  • the feed screw 135 is rotated to move the slider 10 in the T direction.
  • the slider 10 presses the syringe pusher 202 in the T direction, and accurately delivers the medicine in the syringe main body 201 shown in FIG. 2 to the patient P through the tube 203 via the indwelling needle 204. .
  • the fast forward switch button 4B, the start switch button 4C, the stop switch button 4D, and the menu selection button 4E are electrically connected to the control unit 100.
  • the start switch button 4 ⁇ / b> C is pressed, a liquid feed start control signal is input to the control unit 100.
  • the stop switch button 4D is pressed, a liquid feed stop control signal is input to the control unit 100.
  • the display unit driver 130 is electrically connected to the control unit 100.
  • the display unit driver 130 drives the display unit 3 according to instructions from the control unit 100 to display various information on the display unit 3.
  • the speaker 131 is electrically connected to the control unit 100.
  • the speaker 131 notifies various alarm contents by voice according to a command from the control unit 100.
  • the control unit 100 has a function as a calculation unit that calculates the concentration of the medicine in the living body based on the amount of the medicine delivered into the living body from the start of the feeding.
  • the amount of the medicine delivered into the living body from the start of feeding is, for example, the inner diameter of the syringe body 201 of the syringe 200 and the movement amount of the slider 10 moved in the T direction by the feed screw 135 from the start of feeding. It can be calculated by multiplying.
  • the concentration of the drug in the living body is calculated by simulation.
  • the simulation is performed using a 3-compartment model based on pharmacokinetics, but is not limited to this.
  • the concentration is calculated by dividing the body into three parts (hereinafter, compartments).
  • One of the three compartments is a compartment that models blood.
  • the other two compartments are obtained by modeling a tissue rich in blood flow such as muscle and a tissue such as fat having rough blood flow in the living body.
  • the drug is administered in a compartment that models blood. Then, the drug moves at a predetermined transition speed between the compartment modeling the blood and the other two compartments.
  • the drug is excreted outside the body at a predetermined excretion rate through a compartment modeling blood.
  • the concentration of the delivered drug in each compartment including the blood concentration, based on the information on the patient to whom the drug is delivered and the relationship between the amount of delivered drug, the transfer rate, and the excretion rate. Can do.
  • the effect site concentration which is the concentration of the site to which the drug is applied, can also be calculated.
  • a neuromuscular junction can be considered as an effect site.
  • the liquid delivery amount is calculated based on the difference between the blood concentration or effect site concentration of the drug calculated in this way and the set target concentration. If the upper limit value is exceeded, the liquid delivery amount is the upper limit value.
  • the nonvolatile memory 103 stores the upper limit introduction flow rate and the upper limit maintenance flow rate for each type of medicine.
  • the non-volatile memory 103 stores a target value of the bispectral index. Further, the nonvolatile memory 103 stores a target density. The target concentration is stored in units of mcg / ml, for example.
  • the non-volatile memory 103 stores information on a patient to be fed and the type of medicine to be fed. The stored patient information includes, for example, sex, age, height, weight, and the like. Further, the non-volatile memory 103 stores an upper limit value of the liquid feeding amount switched by the control unit 100 as will be described later.
  • the control unit 100 is electrically connected to the BIS monitor 500 via the external device connection terminal 160.
  • the bispectral index value is input from the BIS monitor 500 to the control unit 100.
  • the control unit 100 further serves as a reception unit that receives input of information such as the upper limit introduction flow rate, the upper limit maintenance flow rate, the target value, the target concentration, the patient information, and the type of medicine to be delivered, which are stored in the nonvolatile memory 103. It has a function.
  • the control unit 100 stores the received information in the nonvolatile memory 103.
  • the control unit 100 accepts input even during drug delivery. Therefore, the target value and the target concentration stored in the nonvolatile memory 103 can be changed during the delivery of the medicine.
  • the control unit 100 checks the input upper limit introduction flow rate and the upper limit maintenance flow rate, and limits the acceptance of unauthorized input. Specifically, the control unit 100 checks the magnitude relationship between the upper limit introduction flow rate and the upper limit maintenance flow rate. When the upper limit maintenance flow rate exceeds the upper limit introduction flow rate, the input upper limit introduction flow rate and upper limit maintenance flow rate are not stored in the nonvolatile memory 103.
  • Input of information on the upper limit introduction flow rate and the upper limit maintenance flow rate to the control unit 100 can be performed by various methods.
  • the upper limit introduction flow rate and the upper limit maintenance flow rate can be input for each type of medicine.
  • a computer 141 such as a desktop computer and the control unit 100 are connected via a communication port 140. Then, by operating the computer 141, the upper limit introduction flow rate and the upper limit maintenance flow rate can be input to the control unit 100 via the communication port 140 for each type of medicine.
  • the computer 141 may be connected to the medicine database 150 as shown in FIG.
  • the upper limit introduction flow rate and the upper limit maintenance flow rate can be collectively stored as a drug library for each type of drug.
  • the upper limit introduction flow rate and the upper limit maintenance flow rate stored for each type of drug in the drug database 150 can be input to the control unit 100 via the communication port 140.
  • the drug library may record information on drugs other than the upper limit introduction flow rate and the upper limit maintenance flow rate. For example, drug manufacturers and contraindication information may be recorded for each type of drug. Such information can also be input to the control unit 100 through the communication port 140 together with the upper limit introduction flow rate and the upper limit maintenance flow rate.
  • the drug library can be generated collectively for each hospital or ward and stored in the drug database 150.
  • Information on the patient to be delivered, the type of medicine to be delivered, the target value of the bispectral index, and the target concentration are operated by operating the operation buttons of the operation panel unit 4 according to the display content of the display unit 3. Can be entered.
  • FIGS. 4A and 4B show examples of display contents of the display unit 3 when inputting information on a patient to be fed.
  • information such as the sex, age, height, and weight of the patient to be fed can be input.
  • FIG. 5 shows a display content example of the display unit 3 when inputting the type of medicine to be delivered.
  • 6A and 6B show examples of display contents of the display unit 3 when inputting the target value and target density of the bispectral index.
  • the target value of the bispectral index and the target concentration of blood concentration can be input.
  • the control unit 100 starts liquid feeding when the start switch button 4C is pressed and a liquid feeding start control signal is input. Further, when the stop switch button 4D is pressed and a liquid feed stop control signal is input, the control unit 100 stops liquid feeding.
  • the control unit 100 functions as a vital determination unit that determines whether or not the value of the bispectral index input from the BIS monitor 500 has reached the target value, and the upper limit value switching that switches the upper limit value of the liquid feeding amount A function as a unit and a function as an adjustment unit for adjusting a liquid feeding amount.
  • the non-volatile memory uses the upper limit introduction flow rate stored in the non-volatile memory 103 as the upper limit value of the drug supply amount in accordance with the type of the drug to be sent stored in the non-volatile memory 103. 103.
  • step S102 it is determined whether or not a liquid feed end condition is satisfied.
  • the liquid feeding end condition is satisfied, the liquid feeding is finished. At least when the stop switch button 4D is pressed and an input of a control signal for the end of liquid feeding is received, the liquid feeding end condition is satisfied.
  • step S103 the upper limit value stored in the non-volatile memory 103 is not exceeded, and the blood concentration of the drug after liquid feeding is maintained at the target concentration stored in the non-volatile memory 103.
  • the blood concentration of the drug after feeding can be calculated by simulation based on the amount of the medicine to be sent, the patient information stored in the nonvolatile memory 103, the kind of the medicine to be sent, and the like. it can.
  • the medicine is fed by the slider 10 pressing the syringe pusher 202 in the T direction (see FIGS. 1 and 2).
  • the slider 10 is moved by driving the motor driver 134 of the syringe pusher drive unit 7 (see FIG. 8).
  • step S104 it is determined whether or not the bispectral index value input from the BIS monitor 500 has reached the target value. If it is determined that the target value has not been reached, the process returns to step S102. If it is determined that the target value has been reached, the process proceeds to step S105.
  • step S105 the upper limit value of the liquid feeding amount is switched from the upper limit introduction flow rate to the upper limit maintenance flow rate.
  • Switching of the upper limit value is performed by rewriting the upper limit value stored in the nonvolatile memory 103. That is, the upper limit maintenance flow rate stored in the non-volatile memory 103 is stored in the non-volatile memory 103 as the upper limit value of the drug delivery amount in accordance with the type of the drug to be sent stored in the non-volatile memory 103. In this way, the upper limit value is switched.
  • the control unit 100 notifies that the upper limit value has been switched after the upper limit value has been switched.
  • Various methods can be considered for the notification. For example, it is possible to notify that the upper limit value has been switched by issuing a command to the speaker 131 to emit a buzzer sound. It is also possible to issue a command to the display unit driver 130 to display and notify the display unit 3 of text or video indicating that the upper limit has been switched.
  • step S106 it is determined whether or not the liquid feed end condition is satisfied, as in step S102.
  • the liquid feeding is finished.
  • step S ⁇ b> 107 the upper limit value stored in the non-volatile memory 103 is not exceeded, and the blood concentration of the drug after liquid feeding is maintained at the target concentration stored in the non-volatile memory 103.
  • the blood concentration of the drug after liquid feeding can be calculated by simulation in the same manner as in step S103.
  • the medicine is fed by pressing the syringe pusher 202 in the same manner as in step S103.
  • step S108 it is determined whether or not the bispectral index value input from the BIS monitor 500 has reached the target value stored in the nonvolatile memory 103. If it is determined that the target value has been reached, the process returns to step S106. If it is determined that the target value has not been reached, the process proceeds to step S109.
  • step S109 the upper limit value of the liquid feeding amount is switched from the upper limit maintenance flow rate to the upper limit introduction flow rate. That is, the upper limit introduction flow rate stored in the non-volatile memory 103 is stored in the non-volatile memory 103 as the upper limit value of the drug delivery amount in accordance with the type of the drug to be sent stored in the non-volatile memory 103. . After switching the upper limit value, control unit 100 notifies that the upper limit value has been switched, and returns to step S102.
  • FIG. 10 is a graph showing an example of changes in the concentration of the drug in the living body when the drug is fed using the syringe pump 1.
  • d0 represents blood concentration
  • d1 represents effect site concentration
  • D1 represents target concentration.
  • b0 shows the value of a bispectral index
  • B1 shows the target value of a bispectral index.
  • T0 indicates a liquid feeding start time
  • T1 indicates a time when the blood concentration reaches the target concentration D1
  • T2 indicates a time when the value of the bispectral index b0 reaches the target value B1.
  • the syringe pump 1 starts liquid feeding at the time T0 with the upper limit introduction flow rate as the upper limit value of the liquid feeding amount.
  • the blood concentration d0 reaches the target concentration D1 at time T1.
  • the blood concentration d0 is maintained at the target concentration.
  • the bispectral index value b0 reaches the target value B1.
  • the upper limit value of the liquid feeding amount is switched from the upper limit introduction flow rate to the upper limit maintenance flow rate.
  • FIGS. 11A to 11C are diagrams showing an example of transition of display contents of the display unit 3 while the medicine is being delivered.
  • FIG. 11A shows a display example of the display unit 3 immediately after the start of liquid feeding.
  • FIG. 11B shows a display example of the display unit 3 when the value of the bispectral index reaches the target value.
  • FIG. 11C shows a display example of the display unit 3 after the bispectral index value reaches the target value.
  • the display unit 3 displays the target value B1 and the target concentration D1 stored in the nonvolatile memory 103.
  • the current value of the bispectral index b0 is displayed.
  • the display unit 3 displays a prediction line for the blood concentration d0 of the drug and a prediction line for the effect site concentration d1 calculated based on the simulation while the drug is being delivered.
  • the axis T indicates time and the axis D indicates concentration.
  • a region d1 ′ filled with black represents a transition history of the effect site concentration d1 from the start of liquid feeding to the present time.
  • control unit 100 and the computer 141 are connected via the communication port 140.
  • the computer 141 is operated to input the drug library information stored in the drug database 150 to the control unit 100 via the communication port 140.
  • the upper limit introduction flow rate and the upper limit maintenance flow rate recorded in the medicine library are stored in the nonvolatile memory 103 for each kind of medicine.
  • the BIS monitor 500 is connected to the syringe pump 1 via the cable 501. Then, an electroencephalogram measurement probe (not shown) is attached to the patient's head.
  • the syringe 200 is set in the syringe pump 1.
  • the syringe pump 1 is set by the method described above using the clamp 5.
  • the indwelling needle 204 with which the tube 203 was connected is inserted in a patient.
  • various information is input using the display unit 3 and the operation panel unit 4.
  • sex, age, height, and weight are input as patient information.
  • the type of medicine to be fed is input.
  • the target value of the bispectral index and the target concentration of the blood concentration are input.
  • the start switch button 4C is pressed to start feeding the medicine into the patient's body. Switching of the upper limit value of the liquid feeding amount and adjustment of the liquid feeding amount are performed by the control unit 100 according to the flowchart shown in FIG. The liquid feeding is performed until the liquid feeding end condition described above is satisfied.
  • the target value of the bispectral index can be changed during feeding. That is, the target value can be changed when the drug effect is not manifested even though the value of the bispectral index has reached the target value.
  • the target value may be changed when the efficacy of the drug is observed before the bispectral index value reaches the target value.
  • the target value can be changed by operating the operation panel unit 4 in accordance with the display on the display unit 3.
  • the target concentration of blood concentration can be changed during liquid feeding.
  • the target concentration can be changed when the value of the bispectral index does not reach the target value even though the effect site concentration reaches the target concentration.
  • the target concentration may be changed when the value of the bispectral index reaches the target value before the effect site concentration reaches the target concentration.
  • the target density can be changed by operating the operation panel unit 4 in accordance with the display on the display unit 3.
  • the present embodiment it is possible to observe the vital fluctuation of the living body to which the medicine is fed. Then, it can be determined whether or not the observed vital value has reached a predetermined target value. Furthermore, it is possible to switch the upper limit value of the drug delivery amount according to the determination result of whether or not the observed vital value has reached a predetermined target value. Therefore, according to this embodiment, at the time of drug delivery, an appropriate liquid delivery amount that does not exceed a predetermined upper limit value determined depending on whether or not the efficacy of the drug is expressed for each type of drug. It is possible to feed the drug with.
  • the upper limit introduction flow rate when the observed vital value reaches the target value, the upper limit of the liquid delivery amount when the medicine is delivered The value can be switched from the upper limit introduction flow rate to the upper limit maintenance flow rate. Thereby, in the state where the effect of the medicine is expressed in a specific part of the living body, the medicine can be fed with a liquid feeding amount that does not exceed the upper limit value of the allowable liquid feeding amount.
  • the upper limit maintenance flow rate when the upper limit maintenance flow rate is set as the upper limit value, when the observed vital value no longer satisfies the target value, The upper limit value can be switched from the upper limit maintenance flow rate to the upper limit introduction flow rate. As a result, when the effect of the drug is changed to a state where it is not expressed, the target concentration of the blood concentration can be changed to quickly return to the state where the drug effect is expressed. it can.
  • the amount of liquid delivered when the medicine is delivered is adjusted so that the blood concentration is maintained at the target concentration.
  • the blood concentration is kept constant without exceeding a predetermined target concentration, so that safety is improved.
  • the reception of the upper limit maintenance flow rate exceeding the upper limit introduction flow rate is limited.
  • the present embodiment it is possible to accept the input of the target value of the bispectral index during liquid feeding. Thereby, since the target value can be changed according to the situation, safety and convenience are further improved.
  • the present embodiment it is possible to accept the input of the target concentration during the liquid feeding. Thereby, since the target density can be changed according to the situation, safety and convenience are further improved.
  • the bispectral index it is determined by the bispectral index whether or not the efficacy of the drug is expressed.
  • it can use suitably for liquid feeding of anesthetics, such as a vein anesthetic.
  • the control unit 100 switches the upper limit value depending on whether or not the bispectral index value has reached the target value.
  • the bispectral index value is set to a predetermined allowable value based on the target value.
  • the upper limit value may be switched according to whether or not it falls within the range.
  • the control unit 100 determines that the value of the bispectral index is (50.0-50.0 ⁇ 0.05) or more, (50 0.0 + 50.0 ⁇ 0.05), the upper limit value of the liquid feeding amount may be switched depending on whether it is included in the range.
  • the allowable range can be input to the control unit 100 by operating the operation button of the operation panel unit 4 in accordance with the display content of the display unit 3 in the same manner as the target value.
  • the input allowable range is stored in the nonvolatile memory 103.
  • FIG. 12 shows a display example of the display unit 3 when the allowable range is input together with the target value.
  • 50 is input as the target value of the bispectral index
  • ⁇ 5.00% is input as the allowable range.
  • the control unit 100 By configuring the control unit 100 as described above, the upper limit value of the liquid feeding amount can be switched when the value of the bispectral index is included in the allowable range based on the target value. Thereby, since the timing which switches the upper limit of liquid feeding amount can be set flexibly according to a condition, the convenience improves further.
  • the syringe pump according to the second embodiment is different from the operation of the control unit 100 of the syringe pump according to the first embodiment in the operation related to the switching of the upper limit value of the liquid feeding amount performed by the control unit and the adjustment of the liquid feeding amount. .
  • the control unit 100 of the syringe pump 1 according to the first embodiment adjusts the liquid feeding amount so that the blood concentration is maintained at the target concentration.
  • the control unit of the syringe pump according to the second embodiment is different from the control unit 100 in that the liquid supply amount is adjusted so that the effective site concentration is maintained at the target concentration.
  • FIG. 13 is a flowchart for explaining operations related to switching of the upper limit value of the liquid feeding amount and adjustment of the liquid feeding amount performed by the control unit of the syringe pump according to the second embodiment.
  • step S203 and step S207 in which liquid feeding is performed so as to maintain the effective site concentration at the target concentration.
  • the operation is the same as that of the control unit 100 of the pump 1.
  • step S201 for setting the upper limit introduction flow rate is the same as step S101.
  • Step S202 and Step S206 for determining whether or not the liquid feed end condition is satisfied are the same as Step S102 and Step S106.
  • Step S204 and Step S208 for determining whether or not the value of the bispectral index has reached the target value are the same as Step S104 and Step S108.
  • step S205 and step S209 for switching the upper limit value are the same as step S105 and step S109. Description of these steps will be omitted, and only the different steps S203 and S207 will be described below.
  • Step S203 and step S207 differ from the corresponding steps S103 and S107 of the control unit 100 in the first embodiment in the following points. That is, in step S103 and step S107, liquid feeding was performed so as to maintain the blood concentration at the target concentration. On the other hand, in step S203 and step S207, liquid feeding is performed so as to maintain the effective site concentration at the target concentration.
  • step S203 and step S207 the upper limit value stored in the nonvolatile memory 103 is not exceeded, and the effective site concentration of the drug after liquid feeding is the target concentration stored in the nonvolatile memory 103.
  • the liquid is fed at a liquid feed amount maintained at a constant value.
  • the effective site concentration of the drug after feeding can be calculated by simulation based on the amount of the medicine to be delivered, the patient information stored in the nonvolatile memory 103, the kind of medicine to be delivered, and the like. it can.
  • the liquid delivery of the medicine is performed by pressing the syringe pusher 202 as in step S103.
  • FIG. 14 is a graph showing an example of a change in the concentration of the drug in the living body when the drug is fed using the syringe pump according to the second embodiment.
  • d0 represents blood concentration
  • d1 represents effect site concentration
  • D1 represents target concentration.
  • b0 shows the value of a bispectral index
  • B1 shows the target value of a bispectral index.
  • T0 indicates a liquid feeding start time
  • T1 indicates a time when the blood concentration d0 reaches the target concentration D1
  • T2 indicates a time when the value of the bispectral index b0 reaches the target value B1.
  • the syringe pump according to the second embodiment starts feeding a drug at time T0 with the upper limit introduction flow rate as the upper limit value of the liquid feed amount.
  • the blood concentration d0 reaches the target concentration D1 at time T1.
  • the value of the bispectral index b0 reaches the target value B1 at time T2.
  • the upper limit value of the liquid feeding amount is switched from the upper limit introduction flow rate to the upper limit maintenance flow rate.
  • the effect site concentration d1 reaches the target concentration D1 in the vicinity of time T2.
  • the blood concentration d0 is not maintained at the target concentration between time T1 and time T2.
  • the liquid supply amount is adjusted so as to maintain the blood concentration at the target concentration.
  • the liquid supply amount is adjusted so as to maintain the effective site concentration d1 at the target concentration. It is.
  • the amount of liquid delivered between time T1 and time T2 is relatively greater in the second embodiment than in the first embodiment. Therefore, the time required for the value of the bispectral index to reach the target value can be relatively shortened as compared with the first embodiment.
  • the amount of liquid delivered when the drug is delivered is adjusted so as to maintain the effective site concentration at the target concentration.
  • the operation related to the adjustment of the liquid feeding amount performed by the control unit is different from the operation of the control unit 100 of the syringe pump 1 according to the first embodiment and its modification.
  • the control unit of the syringe pump according to the third embodiment performs the following operation in order to more optimally adjust the liquid feeding amount of the medicine. That is, the control unit of the syringe pump according to the third embodiment has a function as a vital determination unit that determines whether or not the value of the bispectral index has reached the target value. It has a function as a density determination unit that determines whether or not it has been reached.
  • the target concentration stored in the nonvolatile memory is changed. This is different from the control unit 100. Since the configuration of the main body cover 2, the display unit 3, and the operation panel unit 4 other than the control unit is the same as that of the first embodiment, the description thereof is omitted. Further, among the operations of the control unit of the syringe pump according to the third embodiment, operations such as driving of the motor driver 134 are the same as those in the first embodiment, and thus the description thereof is omitted.
  • the controller of the syringe pump according to the third embodiment will perform the following two operations in addition to the operation of the controller 100 of the syringe pump 1 according to the first embodiment and the modification thereof, if outlined.
  • the first operation is to set the target concentration stored in the nonvolatile memory to a predetermined amount when the effect site concentration has reached the target concentration even though the bispectral index value has not reached the target value. It is an operation to raise only. Thereby, as will be described later, it is possible to prevent the amount of the medicine to be fed more than necessary and promote the expression of the efficacy of the medicine.
  • the second operation is to set the target concentration stored in the nonvolatile memory to a predetermined amount when the effect site concentration does not reach the target concentration even though the value of the bispectral index has reached the target value. It is an operation to pull down only. Thereby, as will be described later, it is possible to prevent the medicine from being sent excessively.
  • FIG. 16 is a flowchart for explaining an operation related to adjustment of the liquid feeding amount performed by the control unit of the syringe pump according to the third embodiment.
  • the operation of the control unit of the syringe pump according to the third embodiment shown in FIG. 16 includes step S311 and step S313 for determining whether or not the effect site concentration has reached the target concentration, and step S310 for changing the target concentration. Except for step S312, the operation is the same as the operation of the control unit 100 of the syringe pump 1 according to the first embodiment. Specifically, step S301 for setting the upper limit introduction flow rate is the same as step S101. Further, Step S302 and Step S306 for determining whether or not the liquid feed end condition is satisfied are the same as Step S102 and Step S106.
  • Step S304 and Step S308 for determining whether or not the value of the bispectral index has reached the target value are the same as Step S104 and Step S108.
  • Steps S305 and S309 for switching the upper limit value are the same as steps S105 and S109. Description of these steps is omitted, and only the different steps S310 to S313 are described below.
  • step S311 for determining whether or not the effect site concentration has reached the target concentration the following processing is performed. First, based on the amount of the medicine delivered in step S303, the patient information stored in the nonvolatile memory 103, the kind of medicine to be delivered, and the like, the effect site concentration of the delivered medicine is simulated. Calculate. Next, it is determined whether or not the calculated effect site concentration has reached the target concentration stored in the nonvolatile memory 103. If it is determined that the target density has not been reached, the process returns to step S302. If it is determined that the target density has been reached, the process proceeds to step S310.
  • step S310 for changing the target density the following processing is performed. That is, processing for raising the target density stored in the nonvolatile memory 103 and changing it to a target density higher than the current density is performed.
  • the target density after change is calculated by adding the target density before change multiplied by the adjustment width to the target density before change. For example, when the target concentration before change is 3.00 mcg / ml and the adjustment range is 5.00%, (3.0 + 3.0 ⁇ 0.05) mcg / ml is set as the target concentration after change.
  • the method for calculating the target density after the change is not particularly limited as long as the target density after the change is higher than the target density before the change.
  • step S313 for determining whether or not the effect site concentration has reached the target concentration, the following processing is performed. First, based on the amount of the medicine delivered in step S307, the patient information stored in the nonvolatile memory 103, the kind of medicine to be delivered, and the like, the effect site concentration of the delivered medicine is simulated. Calculate. Next, it is determined whether or not the calculated effect site concentration has reached the target concentration stored in the nonvolatile memory 103. If it is determined that the target density has been reached, the process returns to step S306. If it is determined that the target density has not been reached, the process proceeds to step S312.
  • step S312 for changing the target density the following processing is performed. That is, a process is performed in which the target density stored in the nonvolatile memory 103 is lowered and changed to a target density lower than the current density.
  • the target density after change is calculated by subtracting the target density before change multiplied by the adjustment width from the target density before change. For example, when the target concentration before change is 3.00 mcg / ml and the adjustment range is 5.00%, (3.0-3.0 ⁇ 0.05) mcg / ml is set as the target concentration after change.
  • the method for calculating the target density after the change is not particularly limited as long as the target density after the change is lower than the target density before the change.
  • the adjustment width can be input to the control unit of the syringe pump according to the third embodiment by operating the operation button of the operation panel unit 4 according to the display content of the display unit 3.
  • the input adjustment width can be stored in the nonvolatile memory 103.
  • FIG. 15 shows a display content example of the display unit 3 when inputting the adjustment width.
  • FIG. 17 and FIG. 18 are graphs showing examples of changes in the bispectral index value and the concentration of the drug in the living body when the drug is fed using the syringe pump according to the third embodiment.
  • d0 indicates the blood concentration
  • d1 indicates the effect site concentration
  • D1 indicates the target concentration at the start of liquid feeding.
  • b0 shows the value of a bispectral index
  • B1 shows the target value of a bispectral index.
  • T0 shows a liquid feeding start time.
  • FIG. 17 shows an example in which steps S312 and S313 related to the reduction of the target density shown in FIG. 16 are executed.
  • FIG. 18 shows an example of the case where steps S310 and S311 related to the target density increase shown in FIG. 16 are executed.
  • the syringe pump according to the third embodiment starts feeding a drug at time T0 with the upper limit introduction flow rate as the upper limit value of the liquid feeding amount.
  • the blood concentration d0 reaches the target concentration D1 at time T1.
  • the value of the bispectral index b0 reaches the target value B1 at time T2.
  • the upper limit value of the liquid feeding amount is switched from the upper limit introduction flow rate to the upper limit maintenance flow rate.
  • the efficacy of the drug should be expressed at time T2. That is, if the target concentration D1 is correctly set as the concentration at which the efficacy of the drug is expressed, the effective site concentration d1 should reach the target concentration D1 at time T2. However, as shown in FIG. 17, there is a case where the effect site concentration d1 does not reach the target concentration D1 even though the value of the bispectral index b0 reaches the target value B1.
  • the target concentration D1 is set higher than the value that should be originally set as the concentration at which the efficacy of the drug is expressed. That would have been done.
  • the amount of medicine to be fed is adjusted so that the upper limit is not exceeded and the blood concentration d0 is maintained at the target concentration D1. Therefore, when the target concentration D1 is set to a high value, there is a possibility that the medicine is excessively fed, which is not preferable.
  • the control unit of the syringe pump according to the third embodiment lowers the target concentration D1 to the target concentration D1 ′ according to the flowchart shown in FIG. As a result, the amount of liquid to be delivered is adjusted so as not to exceed the upper limit value and the blood concentration d0 is maintained at the target concentration D1 ′. Since the target concentration D1 ′ is lower than the target concentration D1, it is possible to prevent the drug from being excessively fed in a state where the drug efficacy is expressed. Even after the target concentration D1 is lowered to the target concentration D1 ′ at time T2, the effective site concentration d1 continues to increase. Therefore, even after the target concentration D1 is lowered to the target concentration D1 ′, the state where the efficacy of the drug is expressed is maintained.
  • the syringe pump according to the third embodiment starts feeding a medicine at time T0 with the upper limit introduction flow rate as the upper limit value of the liquid feeding amount.
  • the blood concentration d0 reaches the target concentration D1 at time T1.
  • the effect site concentration d1 reaches the target concentration D1 at time T2.
  • the efficacy of the drug should be expressed at time T2. That is, if the target concentration D1 is correctly set as the concentration at which the efficacy of the drug is expressed, the value of the bispectral index b0 should reach the target value B1 at time T2. However, as shown in FIG. 18, there are cases where the value of the bispectral index b0 does not reach the target value B1 even though the effect site density d1 has reached the target density D1. In this case, since the effect of the drug is not expressed in spite of the effect site concentration d1 reaching the target concentration D1, the target concentration D1 is higher than the value that should be originally set as the concentration at which the effect of the drug is expressed. It was set low.
  • the amount of medicine to be fed is adjusted so that the upper limit is not exceeded and the blood concentration d0 is maintained at the target concentration D1. For this reason, when the target concentration D1 is set to be low, the amount of the medicine to be fed may be suppressed more than necessary, which is not preferable.
  • the control unit of the syringe pump according to the third embodiment raises the target concentration D1 to the target concentration D1 ′ according to the flowchart shown in FIG. As a result, the amount of liquid to be delivered is adjusted so as not to exceed the upper limit value and the blood concentration d0 is maintained at the target concentration D1 ′. Since the target concentration D1 ′ is higher than the target concentration D1, the amount of drug delivered increases in order to increase the blood concentration. Thereby, the expression of the efficacy of the drug is promoted.
  • the target concentration is adjusted according to whether or not the value of the bispectral index has reached a predetermined target value and whether or not the effect site concentration has reached the predetermined target concentration. Is done. Thereby, since the adjustment of the liquid feeding amount according to whether or not the efficacy of the drug is expressed is more optimal, the safety is further improved.
  • control part which concerns on this embodiment changed the target density
  • the target concentration may be changed when the liquid delivery amount is adjusted so that the effect site concentration is maintained at the target concentration.
  • the operation related to the adjustment of the liquid feeding amount performed by the control unit is different from the operation of the control unit 100 of the syringe pump according to the first embodiment and its modification.
  • the control unit of the syringe pump according to the fourth embodiment has a bispectral index value of a predetermined limit in order to more appropriately adjust the amount of liquid to be delivered. It differs from the control unit 100 in that the liquid feeding is stopped when the value is reached. Since the configuration of the main body cover 2, the display unit 3, and the operation panel unit 4 other than the control unit is the same as that of the first embodiment, the description thereof is omitted. Further, among the operations of the control unit of the syringe pump according to the fourth embodiment, operations such as driving of the motor driver 134 are the same as those in the first embodiment, and thus the description thereof is omitted.
  • the control unit accepts input of the limit value of the bispectral index in addition to the input of the target value of the bispectral index described in the first embodiment.
  • the limit value of the bispectral index can be input to the control unit according to the fourth embodiment by operating the operation button of the operation panel unit 4 according to the display content of the display unit 3.
  • FIG. 19 shows an example of display contents of the display unit 3 when inputting the limit value of the bispectral index.
  • the limit value of the bispectral index can be input by operating the operation button of the operation panel unit 4 in accordance with the display content example shown in FIG.
  • FIG. 20 is a flowchart for explaining the operation related to the adjustment of the liquid feeding amount performed by the control unit of the syringe pump according to the fourth embodiment.
  • step S410 in which it is determined whether or not the bispectral index value has reached the limit value.
  • the operation is the same as that of the first control unit 100.
  • step S401 for setting the upper limit introduction flow rate is the same as step S101.
  • Step S402 and Step S406 for determining whether or not the liquid feed end condition is satisfied are the same as Step S102 and Step S106.
  • Steps S404 and S408 for determining whether or not the bispectral index value has reached the target value are the same as steps S104 and S108.
  • step S405 and step S409 for switching the upper limit value are the same as step S105 and step S109. Description of these steps will be omitted, and only the different step S410 will be described below.
  • Step S410 for determining whether or not the value of the bispectral index has reached the limit value is aimed at the following. That is, when the value of the bispectral index has reached the limit value of the bispectral index stored in the nonvolatile memory 103, the purpose is to prevent the medicine from being fed.
  • step S410 the following processing is performed. That is, the value of the bispectral index is compared with the limit value of the bispectral index stored in the nonvolatile memory 103. When the bispectral index value has reached the limit value of the bispectral index stored in the nonvolatile memory 103, the process returns to step S406. If the bispectral index value has not reached the limit value of the bispectral index stored in the nonvolatile memory 103, the process proceeds to step S407.
  • FIG. 21 is a graph showing an example of changes in the concentration of the drug in the living body when the drug is fed using the syringe pump according to the fourth embodiment.
  • d0 represents the blood concentration
  • d1 represents the effect site concentration
  • D1 represents the target concentration at the start of liquid delivery.
  • b0 shows the value of a bispectral index
  • B1 shows the target value of a bispectral index.
  • T0 shows a liquid feeding start time.
  • the syringe pump according to the fourth embodiment starts feeding a medicine at time T0 with the upper limit introduction flow rate as the upper limit value of the liquid feeding amount.
  • the blood concentration d0 reaches the target concentration D1 at time T1.
  • the value of the bispectral index b0 reaches the target value B1 at time T2.
  • the upper limit value of the liquid feeding amount is switched from the upper limit introduction flow rate to the upper limit maintenance flow rate.
  • the efficacy of the drug should be expressed at time T2. That is, if the target concentration D1 is correctly set as the concentration at which the efficacy of the drug is expressed, the effective site concentration d1 should reach the target concentration D1 at time T2. However, as shown in FIG. 21, although the value of the bispectral index b0 has reached the target value B1, the effective site concentration d1 may not reach the target concentration D1. In this case, the effect site concentration d1 continues to increase after time T2 even though the efficacy of the drug is expressed at time T2. As a result, the efficacy of the drug may be expressed more than necessary, which is not preferable.
  • the control unit of the syringe pump according to the fourth embodiment stops the liquid feeding when the value of the bispectral index b0 reaches the limit value BL according to the flowchart shown in FIG. In the example shown in FIG. 21, the liquid feeding of the medicine is stopped at time T3. As a result, after the time T3, the increase in the effective site concentration d1 becomes slow, and it can be prevented that the efficacy of the drug is unnecessarily expressed.
  • the value of the bispectral index b0 starts to increase.
  • the value of the bispectral index b0 returns to the limit value BL at time T4. Therefore, since the liquid delivery of the medicine is resumed at time T4, the expression of the efficacy of the medicine is not weakened more than necessary.
  • the liquid feeding is stopped when the value of the bispectral index reaches a predetermined limit value.
  • control unit adjusts the liquid supply amount so that the blood concentration is maintained at the target concentration, and the liquid supply is performed when the value of the bispectral index reaches a limit value. Although it stopped, it is not limited to this. For example, in the case where the liquid supply amount is adjusted so that the effect site concentration is maintained at the target concentration, the liquid supply may be stopped when the value of the bispectral index reaches a limit value.
  • the medicine can be delivered while adjusting the liquid delivery amount more appropriately according to the technique to be applied, the kind of the medicine, or the like.
  • the operation related to the adjustment of the liquid feeding amount performed by the control unit is different from the operation of the control unit 100 of the syringe pump according to the first embodiment and the modification thereof in the following points. That is, in the control unit 100 of the syringe pump according to the first embodiment and the modification thereof, the target concentration to be maintained at the target concentration is predetermined.
  • the control part of the syringe pump according to the fifth embodiment relates to the first embodiment and its modification, in that the concentration of the target to be maintained at the target concentration can be specified in order to improve safety and convenience. Different from the control unit 100 of the syringe pump.
  • the control unit of the syringe pump according to the fifth embodiment adjusts the liquid feeding amount so that the concentration designated as the target to be maintained at the target concentration is maintained at the target concentration.
  • the control unit of the syringe pump according to the fifth embodiment sends the simulated effective site concentration so as to be maintained at the target concentration. Adjust the liquid volume.
  • the control unit of the syringe pump according to the fifth embodiment controls the amount of liquid delivered so that the simulated blood concentration is maintained at the target concentration. adjust.
  • the target concentration to be maintained at the target concentration can be designated to the control unit according to the fifth embodiment by various methods.
  • the target density to be maintained at the target density can be designated to the control unit according to the fifth embodiment. it can.
  • safety and convenience are further improved because it is easy to appropriately set the target concentration to be maintained at the target concentration according to the technique to be applied and the type of medicine.
  • the determination as to whether or not the efficacy of the delivered drug is manifested is made using the bispectral index value.
  • another observation may be used. For example, if a certain relationship is observed between the observed values such as blood pressure, body temperature, pulse, eye movement, etc. and the state of manifestation of the efficacy of the drug being delivered, the efficacy of the drug can be determined using the observed values. It may be determined whether or not it is expressed.
  • the configurations described in the first to fifth embodiments and the modifications thereof can be combined as appropriate.
  • the configuration of the control unit according to the target concentration change described as the third embodiment and the configuration of the control unit according to the stop of liquid feeding described as the fourth embodiment You may comprise the syringe pump which concerns on this invention.
  • the present invention is not limited thereto.
  • the present invention can be widely applied to medical liquid feeding pumps such as an infusion pump capable of adjusting the liquid feeding amount of a medicine.

Abstract

[Problem] To provide a fluid delivery pump which, when fluid-delivering a drug, makes it possible to deliver the drug in an appropriate fluid-delivery amount which does not exceed a prescribed upper-limit value stipulated for each type of drug. [Solution] A fluid delivery pump for delivering a drug while simulating the concentration of the delivered drug inside an organism, the fluid delivery pump being one which stores the upper-limit intake flow of a drug and the upper-limit maintenance flow of the drug, and according to whether the observed value in the vitals of the organism to which the drug is delivered reaches a target value or not, switches the upper-limit value for the fluid delivery amount of the drug to the upper-limit intake flow or the upper-limit maintenance flow.

Description

送液ポンプFeed pump
　本発明は、薬剤を患者の体内に送液するために医療分野で用いられる送液ポンプに関する。 The present invention relates to a liquid delivery pump used in the medical field for delivering a medicine into a patient's body.
　集中治療室等の医療現場において、静脈麻酔薬等の薬剤を患者の体内に送液する場合、適用する手技や患者の症状等に応じて、送液量を適切に調節しながら長時間に亘って送液を行う必要がある。設定された送液量で長時間に亘って正確に薬剤を送液する装置として、輸液ポンプやシリンジポンプがある。送液量の設定は、輸液ポンプやシリンジポンプを使用する医療従事者によって行われる。一般的に、薬剤を患者の体内に送液する際の送液量には、薬剤の種類に応じて定められた上限値がある。そして、薬剤の効能が発現されるまでの生体内への導入において許容される送液量の上限値と、生体の特定の部位において薬剤の効能が発現された後に効能を維持するために許容される送液量の上限値は異なる。従って、薬剤を送液する際には、薬剤の効能が発現されているか否かに応じて、薬剤の種類ごとに定められている上限値を超えないように送液量を適切に調節する必要がある。従来、この送液量の調節は、医療従事者によって手動で行われてきた。そのため、薬剤の効能が発現されているか否かに応じた送液量の調節が、必ずしも適切なタイミングで行われないという問題があった。 When a drug such as intravenous anesthetic is delivered into the patient's body in a medical setting such as an intensive care unit, the amount of fluid delivered is adjusted appropriately for a long period of time depending on the technique to be applied and the patient's symptoms. It is necessary to carry out liquid feeding. There are infusion pumps and syringe pumps as devices for accurately delivering a medicine over a long period of time with a set amount of liquid to be delivered. Setting of the amount of liquid delivery is performed by a medical worker using an infusion pump or a syringe pump. In general, there is an upper limit value determined in accordance with the type of medicine in the amount of liquid delivered when the medicine is delivered into the patient's body. In addition, the upper limit of the amount of liquid that is allowed for introduction into the living body until the efficacy of the drug is expressed, and it is allowed to maintain the efficacy after the efficacy of the drug is manifested in a specific part of the living body. The upper limit of the amount of liquid delivered is different. Therefore, when delivering a drug, it is necessary to appropriately adjust the liquid delivery amount so as not to exceed the upper limit set for each type of drug, depending on whether or not the efficacy of the drug is expressed. There is. Conventionally, the adjustment of the liquid feeding amount has been manually performed by medical personnel. For this reason, there is a problem in that the adjustment of the liquid feeding amount depending on whether or not the efficacy of the drug is expressed is not always performed at an appropriate timing.
　このような問題に対して、近年、送液された薬剤の血中濃度に応じて送液量の調節を自動で行うＴＣＩ（Ｔａｒｇｅｔ　Ｃｏｎｔｒｏｌｌｅｄ　Ｉｎｆｕｓｉｏｎ）と呼ばれる機能を備えたポンプ（以下、ＴＣＩポンプ）が開発されている（例えば、特許文献１参照）。ＴＣＩポンプを使用した薬剤の送液では、送液量の代わりに、目標とする血中濃度を設定する。ＴＣＩポンプは、送液された薬剤の血中濃度が目標濃度に到達して維持されるように送液量を自動で調節する。薬剤の血中濃度は、薬剤の送液量からシミュレーションに基づいて計算される。ＴＣＩポンプを使用することで、手動による送液量の調節を行うことなく、薬剤の血中濃度が目標濃度に維持されるように薬剤を長時間に亘って送液することができる。 In response to such problems, in recent years, a pump having a function called TCI (Target Controlled Infusion) that automatically adjusts the amount of liquid delivered according to the blood concentration of the delivered medicine (hereinafter referred to as TCI pump). Has been developed (see, for example, Patent Document 1). In drug delivery using a TCI pump, a target blood concentration is set instead of the delivery volume. The TCI pump automatically adjusts the amount of liquid delivered so that the blood concentration of the delivered medicine reaches the target concentration and is maintained. The blood concentration of the medicine is calculated based on the simulation from the amount of medicine delivered. By using the TCI pump, the medicine can be delivered over a long period of time so that the blood concentration of the medicine is maintained at the target concentration without manually adjusting the amount of liquid to be delivered.
特表２００８－５４６４３５号Special table 2008-546435
　しかしながら、ＴＣＩポンプを使用した場合、薬剤の種類に応じて定められている送液量の上限値を超えた送液量で送液されてしまう可能性がある。例えば、薬剤の送液開始時において、目標血中濃度が許容される血中濃度よりも高く設定された場合、血中濃度を目標血中濃度に速やかに到達させるために、上限値を超えた送液量で薬剤が送液される可能性がある。ＴＣＩポンプによっては、上限値を超えた送液量での薬剤の送液を防止するために、送液量の上限値を設定可能なものもある。しかし、薬剤の効能が発現されているか否かに応じて送液量の上限値を切り替えて送液する機能は有しておらず、適切な送液量で送液されるとは限らない。また、送液量の上限値が誤って設定されるという問題もあった。 However, when the TCI pump is used, there is a possibility that the liquid will be fed with a liquid feeding amount that exceeds the upper limit value of the liquid feeding amount determined according to the type of the medicine. For example, when the target blood concentration was set higher than the allowable blood concentration at the start of drug delivery, the upper limit was exceeded in order to quickly reach the target blood concentration. There is a possibility that the drug will be delivered in the amount delivered. Some TCI pumps can set an upper limit value of the liquid delivery amount in order to prevent delivery of a medicine at a liquid delivery amount exceeding the upper limit value. However, it does not have a function to switch the upper limit value of the liquid feeding amount depending on whether or not the efficacy of the drug is expressed, and the liquid is not always delivered at an appropriate liquid feeding amount. There is also a problem that the upper limit value of the liquid feeding amount is set erroneously.
　そこで、本発明は上記課題を解決するためになされたものであり、薬剤の送液時において、薬剤の種類ごとに定められている所定の上限値を超えない適切な送液量で薬剤を送液することが可能な送液ポンプの提供を目的とする。 Therefore, the present invention has been made to solve the above-described problems, and at the time of delivering a medicine, the medicine is delivered with an appropriate amount of medicine that does not exceed a predetermined upper limit defined for each kind of medicine. An object is to provide a liquid feed pump capable of liquid.
　上記目的を達成するための送液ポンプは、送液した薬剤の生体内における濃度をシミュレートしながら、前記薬剤を送液する送液ポンプであって、前記薬剤が送液された前記生体のバイタルの変動を観測する観測部と、送液された前記薬剤の量に基づいて、前記薬剤の生体内における濃度を演算する演算部と、前記観測部によって観測された値が所定の目標値に達しているか否かを判定するバイタル判定部と、前記薬剤の上限導入流量と、前記薬剤の上限維持流量と、前記演算部により演算された前記薬剤の血中濃度または効果部位濃度の目標濃度と、前記目標値と、を記憶する記憶部と、前記目標濃度と前記目標値の入力を受け付ける受付部と、前記バイタル判定部の判定結果に応じて、前記薬剤の送液量の上限値を前記上限導入流量または前記上限維持流量に切り替える上限値切り替え部と、前記血中濃度または前記効果部位濃度が前記目標濃度を維持するように前記上限値を超えない範囲で前記薬剤の送液量を調整する調整部と、を有する。 The liquid delivery pump for achieving the above object is a liquid delivery pump for delivering the medicine while simulating the concentration of the delivered medicine in the living body, and the liquid delivery pump for delivering the medicine An observation unit that observes fluctuations in vitals, a calculation unit that calculates the concentration of the medicine in the living body based on the amount of the delivered medicine, and a value observed by the observation part becomes a predetermined target value A vital determination unit that determines whether or not it has reached, an upper limit introduction flow rate of the drug, an upper limit maintenance flow rate of the drug, and a target concentration of blood concentration or effect site concentration of the drug calculated by the calculation unit; A storage unit for storing the target value; a receiving unit for receiving input of the target concentration and the target value; and an upper limit value of the liquid delivery amount of the medicine according to a determination result of the vital determination unit. Up to the upper limit introduction flow rate Is an upper limit value switching unit that switches to the upper limit maintenance flow rate, and an adjustment unit that adjusts the amount of the drug delivered in a range that does not exceed the upper limit value so that the blood concentration or the effect site concentration maintains the target concentration And having.
　本発明によれば、薬剤が送液された生体のバイタルの変動を観測することができる。そして、観測されたバイタルの値が所定の目標値に達しているか否かを判定することができる。さらに、観測されたバイタルの値が所定の目標値に達しているか否かの判定結果に応じて、薬剤の送液量の上限値を切り替えることができる。よって、本発明によれば、薬剤の送液時において、薬剤の種類ごとに薬剤の効能が発現されているか否かに応じて定められている所定の上限値を超えない適切な送液量で薬剤を送液することが可能である。 According to the present invention, it is possible to observe changes in vitals of a living body to which a medicine is fed. Then, it can be determined whether or not the observed vital value has reached a predetermined target value. Furthermore, it is possible to switch the upper limit value of the drug delivery amount according to the determination result of whether or not the observed vital value has reached a predetermined target value. Therefore, according to the present invention, at the time of drug delivery, an appropriate liquid delivery amount that does not exceed a predetermined upper limit value determined depending on whether or not the efficacy of the drug is expressed for each type of drug. It is possible to deliver a medicine.
　また、上限値として上限導入流量が設定されている場合に、観測されたバイタルの値が目標値に達したときに、薬剤を送液する際の送液量の上限値を上限導入流量から上限維持流量に切り替えるように上限値切り替え部を構成できる。当該構成により、生体の特定の部位において薬剤の効能が発現されている状態において、許容される送液量の上限値を超えない送液量で薬剤を送液することができる。 In addition, when the upper limit introduction flow rate is set as the upper limit value, when the observed vital value reaches the target value, the upper limit value of the liquid delivery amount when the drug is delivered is increased from the upper limit introduction flow rate. The upper limit value switching unit can be configured to switch to the maintenance flow rate. With this configuration, in a state where the efficacy of the drug is expressed in a specific part of the living body, the drug can be fed with a liquid feed amount that does not exceed the upper limit of the allowable liquid feed amount.
　また、上限値として上限維持流量が設定されている場合に、観測されたバイタルの値が目標値に達していないときに、薬剤を送液する際の送液量の上限値を上限維持流量から上限導入流量に切り替えるように上限値切り替え部を構成できる。当該構成により、薬剤の効能が発現された状態から発現されていない状態に変化したときに、薬剤の血中濃度あるいは効果部位濃度の目標濃度を変更することで、薬剤の効能が発現された状態へと速やかに戻すことができる。 In addition, when the upper limit maintenance flow rate is set as the upper limit value, when the observed vital value does not reach the target value, the upper limit value of the liquid delivery amount when the drug is delivered is determined from the upper limit maintenance flow rate. The upper limit value switching unit can be configured to switch to the upper limit introduction flow rate. The state in which the efficacy of the drug is expressed by changing the blood concentration of the drug or the target concentration of the effect site concentration when the drug efficacy is changed from the expressed state to the non-expressed state by the configuration. Can be quickly returned to.
　また、観測されたバイタルの値が所定の限界値に達したときに送液を停止するように構成できる。当該構成により、必要以上に薬剤の効能が発現されるのを防止できるため安全性がさらに向上する。 Also, it can be configured to stop the liquid feeding when the observed vital value reaches a predetermined limit value. With this configuration, it is possible to prevent the drug efficacy from being manifested more than necessary, thereby further improving safety.
　また、観測されたバイタルの値が所定の目標値に達しているか否か、及び、演算された薬剤の生体内における濃度が所定の目標濃度に達しているか否かの判定結果に応じて目標濃度を変更可能に管理するように構成できる。当該構成により、薬剤の効能が発現されているか否かに応じた送液量の調整がより最適になされるため安全性がさらに向上する。 Further, the target concentration is determined depending on whether the observed vital value has reached a predetermined target value and whether the calculated concentration of the medicine in the living body has reached the predetermined target concentration. Can be configured to be manageable. With this configuration, the amount of liquid to be fed is more optimally adjusted depending on whether or not the efficacy of the drug is expressed, and thus the safety is further improved.
　また、上限導入流量及び上限維持流量を記憶する際に、上限導入流量を超える上限維持流量の入力の受け付けを制限するように受付部を構成できる。当該構成により、上限導入流量を超える上限維持流量が誤って記憶されるのを防ぐことができるため安全性が向上する。 In addition, when storing the upper limit introduction flow rate and the upper limit maintenance flow rate, the reception unit can be configured to limit the acceptance of the upper limit maintenance flow rate exceeding the upper limit introduction flow rate. With this configuration, since the upper limit maintenance flow rate exceeding the upper limit introduction flow rate can be prevented from being stored erroneously, safety is improved.
　また、目標値の入力を送液中に受け付けるように受付部を構成できる。当該構成により、状況に応じて目標値を変更できるため安全性及び利便性がさらに向上する。 Also, the accepting unit can be configured to accept the input of the target value during liquid feeding. With this configuration, since the target value can be changed according to the situation, safety and convenience are further improved.
　また、目標濃度の入力を送液中に受け付けるように受付部を構成できる。当該構成により、状況に応じて目標濃度を変更できるため安全性及び利便性がさらに向上する。 Also, the accepting unit can be configured to accept the input of the target concentration during liquid feeding. With this configuration, since the target concentration can be changed according to the situation, safety and convenience are further improved.
　また、目標値を基準とした所定の許容範囲の範囲内に観測されたバイタルの値が含まれる場合に、送液量の上限値を切り替えるように上限値切り替え部を構成できる。当該構成により、送液量の上限値を切り替えるタイミングを状況に応じて柔軟に設定できるため利便性がさらに向上する。 Also, the upper limit value switching unit can be configured to switch the upper limit value of the liquid feeding amount when the observed vital value is included within a predetermined allowable range based on the target value. With this configuration, the timing for switching the upper limit value of the liquid feeding amount can be set flexibly according to the situation, so that convenience is further improved.
　また、薬剤の送液量の上限値が切り替わったことを知らせる報知部を有するように構成できる。当該構成により、薬剤の送液量の上限値が切り替わったことを適時に把握できるため安全性がさらに向上する。 Also, it can be configured to have a notification unit that notifies that the upper limit value of the amount of liquid to be delivered is switched. With this configuration, since it is possible to grasp in a timely manner that the upper limit value of the liquid delivery amount of the medicine has been switched, safety is further improved.
　また、観測されるバイタルがバイスペクトラルインデックスであるように構成できる。当該構成により、静脈麻酔薬等の麻酔薬の送液に好適に使用することができる。 Also, it can be configured so that the observed vital is a bispectral index. With this configuration, it can be suitably used for feeding anesthetics such as intravenous anesthetics.
本発明の第１実施形態に係るシリンジポンプを説明するための概観斜視図である。It is an outline perspective view for explaining a syringe pump concerning a 1st embodiment of the present invention. 本発明の第１実施形態に係るシリンジポンプを説明するための概観正面図である。It is a general | schematic front view for demonstrating the syringe pump which concerns on 1st Embodiment of this invention. 本発明の第１実施形態に係るシリンジポンプの表示部を説明するための概観正面図である。It is a general | schematic front view for demonstrating the display part of the syringe pump which concerns on 1st Embodiment of this invention. 本発明の第１実施形態に係るシリンジポンプの表示部を説明するための概観正面図であって、薬剤が送液される患者の情報を入力する際の表示例を示す図である。It is a general | schematic front view for demonstrating the display part of the syringe pump which concerns on 1st Embodiment of this invention, Comprising: It is a figure which shows the example of a display at the time of inputting the information of the patient into whom a chemical | medical agent is pumped. 本発明の第１実施形態に係るシリンジポンプの表示部を説明するための概観正面図であって、送液する薬剤の種類を入力する際の表示例を示す図である。It is a general | schematic front view for demonstrating the display part of the syringe pump which concerns on 1st Embodiment of this invention, Comprising: It is a figure which shows the example of a display at the time of inputting the kind of chemical | medical agent to liquid-feed. 本発明の第１実施形態に係るシリンジポンプの表示部を説明するための概観正面図であって、バイスペクトラルインデックスの目標値及び血中濃度の目標濃度を入力する際の表示例を示す図である。It is a general | schematic front view for demonstrating the display part of the syringe pump which concerns on 1st Embodiment of this invention, Comprising: It is a figure which shows the example of a display at the time of inputting the target value of a bispectral index, and the target density | concentration of blood concentration. is there. 本発明の第１実施形態に係るシリンジポンプに適用するシリンジを説明するための概観斜視図である。It is a general-view perspective view for demonstrating the syringe applied to the syringe pump which concerns on 1st Embodiment of this invention. 本発明の第１実施形態に係るシリンジポンプの電気的な構成を説明するための概略図である。It is the schematic for demonstrating the electrical structure of the syringe pump which concerns on 1st Embodiment of this invention. 本発明の第１実施形態に係るシリンジポンプの制御部の動作を説明するための図であって、送液量の上限値の切り替え及び送液量の調整に関する動作を説明するためのフローチャートである。It is a figure for demonstrating operation | movement of the control part of the syringe pump which concerns on 1st Embodiment of this invention, Comprising: It is a flowchart for demonstrating the operation | movement regarding switching of the upper limit of liquid feeding amount, and adjustment of liquid feeding amount. . バイスペクトラルインデックスの変化、並びに、送液された薬剤の血中濃度及び効果部位濃度の変化を示す図であって、本発明の第１実施形態に係るシリンジポンプを使用して送液した場合の図である。It is a figure which shows the change of the change of the bispectral index, and the blood concentration and effective site concentration of the delivered medicine, and when the liquid is delivered using the syringe pump according to the first embodiment of the present invention. FIG. 本発明の第１実施形態に係るシリンジポンプの表示部を説明するための外観正面図であって、シリンジポンプを使用して送液をしている際中の図である。It is an external appearance front view for demonstrating the display part of the syringe pump which concerns on 1st Embodiment of this invention, Comprising: It is a figure in the middle of liquid feeding using a syringe pump. 本発明の第１実施形態の変形例に係るシリンジポンプの表示部の表示例を説明するための外観正面図であって、バイスペクトラルインデックスの目標値と、その許容範囲を入力する際の表示例を示す図である。It is an external appearance front view for demonstrating the example of a display of the display part of the syringe pump which concerns on the modification of 1st Embodiment of this invention, Comprising: The example of a display at the time of inputting the target value of bispectral index, and its tolerance | permissible_range FIG. 本発明の第２実施形態に係るシリンジポンプの制御部の動作を説明するための図であって、送液量の上限値の切り替え及び送液量の調整に関する動作を説明するためのフローチャートである。It is a figure for demonstrating operation | movement of the control part of the syringe pump which concerns on 2nd Embodiment of this invention, Comprising: It is a flowchart for demonstrating the operation | movement regarding switching of the upper limit of liquid feeding amount, and adjustment of liquid feeding amount. . バイスペクトラルインデックスの変化、並びに、送液された薬剤の血中濃度及び効果部位濃度の変化を示す図であって、本発明の第２実施形態に係るシリンジポンプを使用して送液した場合の図である。It is a figure which shows the change of the change of the bispectral index, and the blood concentration and effective site concentration of the delivered medicine, and when the liquid is delivered using the syringe pump according to the second embodiment of the present invention. FIG. 本発明の第３実施形態に係るシリンジポンプの表示部を説明するための概観正面図であって、目標濃度の調整幅を入力する際の表示例を示す図である。It is a general | schematic front view for demonstrating the display part of the syringe pump which concerns on 3rd Embodiment of this invention, Comprising: It is a figure which shows the example of a display at the time of inputting the adjustment width | variety of target density | concentration. 本発明の第３実施形態に係るシリンジポンプの制御部の動作を説明するための図であって、送液量の上限値の切り替え及び送液量の調整に関する動作を説明するためのフローチャートである。It is a figure for demonstrating operation | movement of the control part of the syringe pump which concerns on 3rd Embodiment of this invention, Comprising: It is a flowchart for demonstrating the operation | movement regarding switching of the upper limit of liquid feeding amount and adjustment of liquid feeding amount. . バイスペクトラルインデックスの変化、並びに、送液された薬剤の血中濃度及び効果部位濃度の変化を示す図であって、本発明の第３実施形態に係るシリンジポンプを使用して送液した場合の図である。It is a figure which shows the change of the change of the bispectral index, and the blood concentration and effective site concentration of the delivered medicine, and when the liquid is delivered using the syringe pump according to the third embodiment of the present invention. FIG. バイスペクトラルインデックスの変化、並びに、送液された薬剤の血中濃度及び効果部位濃度の変化を示す図であって、本発明の第３実施形態に係るシリンジポンプを使用して送液した場合の図である。It is a figure which shows the change of the change of the bispectral index, and the blood concentration and effective site concentration of the delivered medicine, and when the liquid is delivered using the syringe pump according to the third embodiment of the present invention. FIG. 本発明の第４実施形態に係るシリンジポンプの表示部を説明するための概観正面図であって、バイスペクトラルインデックスの限界値を入力する際の表示例を示す図である。It is a general | schematic front view for demonstrating the display part of the syringe pump which concerns on 4th Embodiment of this invention, Comprising: It is a figure which shows the example of a display at the time of inputting the limit value of a bispectral index. 本発明の第４実施形態に係るシリンジポンプの制御部の動作を説明するための図であって、送液量の上限値の切り替え及び送液量の調整に関する動作を説明するためのフローチャートである。It is a figure for demonstrating operation | movement of the control part of the syringe pump which concerns on 4th Embodiment of this invention, Comprising: It is a flowchart for demonstrating the operation | movement regarding switching of the upper limit of liquid feeding amount, and adjustment of liquid feeding amount. . バイスペクトラルインデックスの変化、並びに、送液された薬剤の血中濃度及び効果部位濃度の変化を示す図であって、本発明の第４実施形態に係るシリンジポンプを使用して送液した場合の図である。It is a figure which shows the change of the change of the bispectral index, and the blood concentration and effective site concentration of the delivered medicine, and when the liquid is delivered using the syringe pump according to the fourth embodiment of the present invention. FIG. 本発明の第５実施形態に係るシリンジポンプの表示部を説明するための外観正面図であって、目標濃度に維持する対象の濃度を選択する際の表示例を示す図である。It is an external appearance front view for demonstrating the display part of the syringe pump which concerns on 5th Embodiment of this invention, Comprising: It is a figure which shows the example of a display at the time of selecting the density | concentration of the object maintained at target density | concentration.
　＜第１実施形態＞
　以下、図面を参照して、本発明の第１実施形態を説明する。なお、図面の寸法比率は、説明の都合上誇張されており、実際の比率とは異なる場合がある。 <First Embodiment>
Hereinafter, a first embodiment of the present invention will be described with reference to the drawings. In addition, the dimension ratio of drawing is exaggerated on account of description, and may differ from an actual ratio.
　図１及び図２に示す本発明の第１実施形態に係るシリンジポンプ１は、例えば、ＩＣＵ、ＣＣＵ、及び、ＮＩＣＵ等の集中治療室等において、長時間に亘って患者の体内に薬剤を送液するために使用される送液ポンプである。 The syringe pump 1 according to the first embodiment of the present invention shown in FIG. 1 and FIG. 2 delivers a drug into a patient's body for a long time in an intensive care unit such as an ICU, CCU, or NICU. It is a liquid feed pump used for liquefying.
　シリンジポンプ１は、静脈麻酔薬等を含む種々の薬剤を患者の体内に送液することができる。適用可能な静脈麻酔薬の例として、プロポフォール、ミタゾラム、及び、レミフェンタニル等がある。 The syringe pump 1 can send various drugs including intravenous anesthetics into the patient's body. Examples of applicable intravenous anesthetics include propofol, mitazolam, and remifentanil.
　一般的に、薬剤を患者の体内に送液する際の送液量には、薬剤の種類ごとに上限値が定められている。送液量とは流速を意味し、単位には、例えば、ｍｌ／ｋｇ／秒や、ｍｌ／ｋｇ／時などが用いられる。そして、送液された薬剤の効能が発現されるまでの導入における送液量の上限値（以下、上限導入流量）と、薬剤の効能が発現された後において薬剤の効能を維持する送液量の上限値（以下、上限維持流量）は異なる。通常、上限維持流量は、上限導入流量よりも小さい。薬剤の効能が発現されているにも関わらず、上限維持流量を上回る送液量で薬剤を送液するのは危険だからである。薬剤には、薬剤の使用方法や注意事項等を記載した文書（以下、薬剤添付文書）が、薬剤ごとに添付されている。そして、上限導入流量及び上限維持流量は、薬剤添付文書に記載されている。薬剤によって、送液量の上限値という表現ではなく、送液量の適正値などの表現で記載されている場合があるが実質的に同じである。薬剤の送液は、薬剤の効能が発現しているか否かに応じて、上限導入流量又は上限維持流量を超えない適切な送液量で行われなければならない。 In general, an upper limit is set for each type of medicine in the amount of medicine delivered to the body of a patient. The liquid feeding amount means a flow rate, and for example, ml / kg / second, ml / kg / hour, or the like is used as a unit. And the upper limit of the amount of liquid to be introduced (hereinafter referred to as the upper limit introduction flow rate) until the effect of the delivered drug is expressed, and the amount of the liquid that maintains the effect of the drug after the effect of the drug is expressed The upper limit value (hereinafter, the upper limit maintenance flow rate) is different. Usually, the upper limit maintenance flow rate is smaller than the upper limit introduction flow rate. This is because it is dangerous to deliver a drug with a liquid feeding amount that exceeds the upper limit maintenance flow rate even though the efficacy of the drug is expressed. A document (hereinafter referred to as a drug package insert) that describes how to use the drug, precautions, and the like is attached to each drug. The upper limit introduction flow rate and the upper limit maintenance flow rate are described in the medicine package insert. Depending on the drug, the expression may be described in terms of an appropriate value for the liquid supply amount, not the expression for the upper limit value of the liquid supply amount, but it is substantially the same. Depending on whether or not the efficacy of the drug is manifested, the drug delivery must be performed with an appropriate liquid delivery amount that does not exceed the upper limit introduction flow rate or the upper limit maintenance flow rate.
　そこで、シリンジポンプ１は、薬剤の効能が発現しているか否かに応じて送液量の上限値を薬剤の種類ごとに定められている上限導入流量又は上限維持流量に切り替えて、適切な送液量で薬剤を送液する。 Therefore, the syringe pump 1 switches the upper limit value of the liquid feeding amount to the upper limit introduction flow rate or the upper limit maintenance flow rate determined for each type of the drug according to whether or not the efficacy of the drug is manifested, so The drug is delivered in liquid volume.
　薬剤の効能が発現しているか否かの判定方法は種々のものが考えられるが、シリンジポンプ１は、薬剤の効能が発現しているか否かの判定にバイスペクトラルインデックス（Ｂｉｓｐｅｃｔｒａｌ　ｉｎｄｅｘ）を使用する。 There are various methods for determining whether or not the efficacy of the drug is expressed. The syringe pump 1 uses a bispectral index for determining whether or not the efficacy of the drug is expressed. .
　バイスペクトラルインデックスは脳波に基づいて算出される値である。バイスペクトラルインデックスは、０～１００の範囲の値を有する。バイスペクトラルインデックスの値と薬剤の効能の発現状態との間には一定の関係があることが知られている。例えば、バイスペクトラルインデックスの値と麻酔薬の効能の発現状態との間の関係として、バイスペクトラルインデックスの値が１００に近いほど患者は覚醒した状態にあり、バイスペクトラルインデックスの値が低いほど麻酔が効いている状態にあることが知られている。さらに、麻酔薬が投与される患者や投与される薬剤によって異なるが、例えば、次のような関係があることも知られている。すなわち、バイスペクトラルインデックスの値が７０～８０以上の場合、患者によっては意識のない状態が持続せずに、手技の最中に覚醒した状態に戻ってしまう可能性があることが知られている。また、バイスペクトラルインデックスの値が５０～６０以下の場合、ほとんどの患者において意識のない状態が持続し、手技の最中に覚醒することはほとんどないことが知られている。さらに、バイスペクトラルインデックスの値が２０～３０を下回ると、麻酔が効き過ぎた状態にあり、手技の最中に覚醒する可能性はなくなるが患者を危険な状態に晒してしまう可能性があることが知られている。バイスペクトラルインデックスの値と薬剤の効能の発現状態との間の関係は、上述した例の鎮静薬に限らず、様々な麻酔薬にもみられる。 The bispectral index is a value calculated based on the electroencephalogram. The bispectral index has a value in the range of 0-100. It is known that there is a certain relationship between the value of the bispectral index and the expression state of the efficacy of the drug. For example, as the relationship between the value of the bispectral index and the state of the development of the anesthetic effect, the closer the bispectral index value is to 100, the more the patient is awake, and the lower the bispectral index value, the more the anesthesia is. It is known to be in effect. Furthermore, it is known that, for example, there is the following relationship, depending on the patient to whom the anesthetic is administered and the drug to be administered. That is, when the bispectral index value is 70 to 80 or more, it is known that some patients may return to an awakened state during the procedure without continuing an unconscious state. . It is also known that when the value of the bispectral index is 50 to 60 or less, an unconscious state persists in most patients, and there is almost no awakening during the procedure. In addition, if the bispectral index value is below 20-30, the anesthesia is too effective, and there is no possibility of waking up during the procedure, but the patient may be at risk. It has been known. The relationship between the value of the bispectral index and the expression state of the efficacy of the drug is not limited to the sedatives in the above-described examples, but is also observed in various anesthetics.
　上述したようにバイスペクトラルインデックスの値と薬剤の効能の発現状態との間には一定の関係があるから、バイスペクトラルインデックスの値に基づいて、薬剤の効能が発現しているか否かを判定できる。シリンジポンプ１は、後述するように、バイスペクトラルインデックスの値が所定の目標値に達しているか否かによって、薬剤の効能が発現しているか否かを判定して送液量の上限値の切り替えを行う。 As described above, since there is a certain relationship between the value of the bispectral index and the expression state of the efficacy of the drug, it can be determined whether or not the efficacy of the drug is expressed based on the value of the bispectral index. . As will be described later, the syringe pump 1 determines whether or not the efficacy of the drug is manifested by whether or not the value of the bispectral index has reached a predetermined target value, and switches the upper limit value of the liquid delivery amount. I do.
　以下に、シリンジポンプ１の装置構成を詳細に説明する。 Hereinafter, the device configuration of the syringe pump 1 will be described in detail.
　図１及び図２に示すように、シリンジポンプ１は、薬剤を充填した、薬剤収納容器としてのシリンジ２００のシリンジ押子２０２をＴ方向に押圧して、シリンジ本体２０１内の薬剤を、チューブ２０３と留置針２０４を介して、患者に対して正確に送液する。このとき、シリンジ２００のシリンジ本体２０１は、クランプ５によって動かないようにシリンジポンプ１にセットされている。 As shown in FIGS. 1 and 2, the syringe pump 1 presses a syringe pusher 202 of a syringe 200 as a medicine storage container filled with a medicine in the T direction so that the medicine in the syringe body 201 is transferred to a tube 203. The liquid is accurately delivered to the patient via the indwelling needle 204. At this time, the syringe body 201 of the syringe 200 is set in the syringe pump 1 so as not to move by the clamp 5.
　シリンジポンプ１は、本体カバー２を有する。 The syringe pump 1 has a main body cover 2.
　本体カバー２は、耐薬品性を有する成型樹脂材料により一体成型されている。これにより、本体カバー２は防沫処理構造を有する。防沫処理構造により、仮に薬剤等がかかってもシリンジポンプ１の内部に侵入するのを防ぐことができる。防沫処理構造を有するのは、シリンジ本体２０１内の薬剤がこぼれたり、上方に配置されている点滴液がこぼれ落ちたり、周辺で用いる消毒液等が飛散して付着することがあるためである。 The main body cover 2 is integrally formed of a molded resin material having chemical resistance. Thereby, the main body cover 2 has a splash-proof processing structure. Due to the splash-proof treatment structure, even if a drug or the like is applied, it can be prevented from entering the syringe pump 1. The reason for having a splash-proof treatment structure is that the medicine in the syringe body 201 may spill, the drip solution disposed above may spill out, or disinfectant used in the vicinity may scatter and adhere.
　図１及び図２に示すように、本体カバー２は、上部分２Ａ及び下部分２Ｂを有する。 As shown in FIGS. 1 and 2, the main body cover 2 has an upper portion 2A and a lower portion 2B.
　上部分２Ａには、表示部３と、操作パネル部４が配置されている。 In the upper part 2A, a display unit 3 and an operation panel unit 4 are arranged.
　下部分２Ｂには、シリンジ設定部６と、シリンジ押子２０２を押すためのシリンジ押子駆動部７が配置されている。 In the lower part 2B, a syringe setting unit 6 and a syringe pusher drive unit 7 for pushing the syringe pusher 202 are arranged.
　表示部３は、カラー表示することができる画像表示装置である。表示部３は、例えば、カラー液晶表示装置により構成することができる。表示部３は、日本語表記による情報表記だけでなく、必要に応じて複数の外国語による情報の表示を行うことができる。表示部３は、本体カバー２の上部分２Ａの左上位置であって、シリンジ設定部６とシリンジ押子駆動部７の上側に配置されている。 The display unit 3 is an image display device capable of color display. The display unit 3 can be configured by a color liquid crystal display device, for example. The display unit 3 can display not only information notation in Japanese but also information in a plurality of foreign languages as necessary. The display unit 3 is located at the upper left position of the upper portion 2 </ b> A of the main body cover 2 and above the syringe setting unit 6 and the syringe pusher driving unit 7.
　操作パネル部４は、本体カバー２の上部分において表示部３の右側に配置されている。操作パネル部４には、電源ＯＮ／ＯＦＦボタン４Ａ、動作インジケータ４Ｆ、及び、操作ボタンが配置されている。図１及び図２には、操作ボタンとして、必要最小限の、早送りスイッチボタン４Ｂ、開始スイッチボタン４Ｃ、停止スイッチボタン４Ｄ、メニュー選択ボタン４Ｅが４ケ配置されている例を示している。 The operation panel unit 4 is disposed on the right side of the display unit 3 in the upper part of the main body cover 2. On the operation panel unit 4, a power ON / OFF button 4A, an operation indicator 4F, and operation buttons are arranged. FIG. 1 and FIG. 2 show an example in which four minimum required fast-forward switch buttons 4B, start switch buttons 4C, stop switch buttons 4D, and menu selection buttons 4E are arranged as operation buttons.
　図１及び図２に示すように、シリンジ設定部６とシリンジ押子駆動部７は、Ｘ方向に沿って並べて配置されている。シリンジ設定部６は、図７を用いて後で説明する複数種類の大きさの異なるシリンジ２００，３００，４００を、選択して着脱可能にはめ込んで固定することができる。 1 and 2, the syringe setting unit 6 and the syringe pusher driving unit 7 are arranged side by side along the X direction. The syringe setting unit 6 can select and fix a plurality of different types of syringes 200, 300, and 400, which will be described later with reference to FIG.
　図１及び図２に示すように、シリンジ設定部６は、シリンジ本体２０１を収容する収容部８と、クランプ５を有している。収容部８は、シリンジ本体２０１を収容するために、ほぼ断面半円形形状の凹部であり、Ｘ方向に沿って形成されている。収容部８の端部の壁部分には、チューブ２０３を着脱可能に挟み込むためのチューブ固定部９が形成されている。 As shown in FIGS. 1 and 2, the syringe setting unit 6 includes a storage unit 8 that stores the syringe body 201 and a clamp 5. In order to accommodate the syringe main body 201, the accommodating portion 8 is a concave portion having a substantially semicircular cross section and is formed along the X direction. A tube fixing portion 9 for detachably holding the tube 203 is formed on the wall portion at the end of the housing portion 8.
　クランプ５を操作してシリンジ２００をシリンジ設定部６から取り外す際には、クランプ５を図示しないスプリングの力に抗してＹ１方向（手前方向）に引っ張って、しかもＲ１方向に９０度回すことで、シリンジ本体２０１はクランプ５による固定を解除して、収容部８から取り外すことができる。また、クランプ５を操作してシリンジ２００をシリンジ設定部６に取り付ける際には、クランプ５を図示しないスプリングの力に抗してＹ１方向に引っ張ってＲ２方向に９０度回して、スプリングの力によりＹ２方向に戻すことで、シリンジ本体２０１は収容部８に収容してクランプ５により固定することができる。クランプ５により、２．５ｍＬ，５ｍＬ，１０ｍＬ，２０ｍＬ，３０ｍＬ，５０ｍＬの収容量のシリンジを固定することができるように、シリンジ設定部６の収容部８の右端部８Ｅは一部が切欠部となっている。 When removing the syringe 200 from the syringe setting unit 6 by operating the clamp 5, the clamp 5 is pulled in the Y1 direction (frontward direction) against the force of a spring (not shown) and turned 90 degrees in the R1 direction. The syringe body 201 can be detached from the housing portion 8 after being fixed by the clamp 5. Further, when the clamp 5 is operated and the syringe 200 is attached to the syringe setting unit 6, the clamp 5 is pulled in the Y1 direction against the force of the spring (not shown) and turned 90 degrees in the R2 direction. By returning to the Y2 direction, the syringe body 201 can be housed in the housing portion 8 and fixed by the clamp 5. The right end portion 8E of the accommodating portion 8 of the syringe setting portion 6 is partially cut away so that the clamp 5 can fix the syringe with the accommodating amount of 2.5 mL, 5 mL, 10 mL, 20 mL, 30 mL, and 50 mL. It has become.
　シリンジ本体２０１が収容部８内に収容されて固定されると、シリンジ押子２０２がシリンジ押子駆動部７内に配置される。このシリンジ押子駆動部７は、スライダ１０を有している。このスライダ１０は、図２及び図８に示す制御部１００からの指令により、シリンジ押子２０２の押子フランジ２０５を、シリンジ本体２０１に対して相対的にＴ方向に沿って少しずつ押す。 When the syringe body 201 is housed and fixed in the housing portion 8, the syringe pusher 202 is disposed in the syringe pusher drive portion 7. The syringe pusher drive unit 7 has a slider 10. The slider 10 pushes the pusher flange 205 of the syringe pusher 202 little by little along the T direction relative to the syringe body 201 in accordance with a command from the control unit 100 shown in FIGS. 2 and 8.
　なお、図１及び図２におけるＸ方向、Ｙ方向、Ｚ方向は互いに直交しており、Ｚ方向は上下方向である。 Note that the X direction, the Y direction, and the Z direction in FIGS. 1 and 2 are orthogonal to each other, and the Z direction is the vertical direction.
　図２に示すように、シリンジポンプ１には、ケーブル５０１を介してＢＩＳモニタ（Ｂｉｓｐｅｃｔｒａｌ　ｉｎｄｅｘ　ｍｏｎｉｔｏｒ）５００が接続される。 As shown in FIG. 2, a BIS monitor 500 is connected to the syringe pump 1 via a cable 501.
　ＢＩＳモニタ５００は、患者の頭部に取り付けた脳波測定用のプローブ（不図示）を介して脳波を観測する。そして、観測された脳波に基づいてバイスペクトラルインデックスを算出する。バイスペクトラルインデックスの値は、公知の方法で算出することができる。算出されたバイスペクトラルインデックスの値は、後述するように、ケーブル５０１を介してシリンジポンプ１の制御部１００に入力される。 The BIS monitor 500 observes an electroencephalogram via an electroencephalogram measurement probe (not shown) attached to the patient's head. Then, a bispectral index is calculated based on the observed electroencephalogram. The value of the bispectral index can be calculated by a known method. The calculated bispectral index value is input to the control unit 100 of the syringe pump 1 via the cable 501 as described later.
　図３は、表示部３の表示内容例を示す。この表示部３の表示内容例は、一例であるので、特に限定されない。 FIG. 3 shows a display content example of the display unit 3. The display content example of the display unit 3 is an example and is not particularly limited.
　図７は、上述した複数種類の大きさのシリンジの例を示す斜視図である。 FIG. 7 is a perspective view showing an example of the above-described multiple types of syringes.
　図１及び図２では、最も薬剤の収容量が大きいシリンジ２００が固定されている例を示している。 1 and 2 show an example in which the syringe 200 having the largest amount of medicine is fixed.
　図７（Ａ）に示すように、最も薬剤の収容量が大きいシリンジ２００は、シリンジ本体２０１と、シリンジ押子２０２を有しており、シリンジ本体２０１は本体フランジ２０９を有し、シリンジ押子２０２は押子フランジ２０５を有している。シリンジ本体２０１には、薬剤の目盛２１０が形成されている。シリンジ本体２０１の出口部２１１には、フレキシブルなチューブ２０３の一端部が着脱可能に接続される。 As shown in FIG. 7A, the syringe 200 having the largest amount of medicine is provided with a syringe main body 201 and a syringe pusher 202, and the syringe main body 201 has a main body flange 209, and the syringe pusher. 202 has a pusher flange 205. The syringe main body 201 is formed with a medicine scale 210. One end of a flexible tube 203 is detachably connected to the outlet 211 of the syringe body 201.
　図７（Ｂ）に示すように、薬剤の収容量が中くらいのシリンジ３００は、シリンジ本体３０１と、シリンジ押子３０２を有しており、シリンジ本体３０１は本体フランジ３０９を有し、シリンジ押子３０２は押子フランジ３０５を有している。シリンジ本体３０１には、薬剤の目盛３１０が形成されている。シリンジ本体３０１の出口部３１１には、フレキシブルなチューブ２０３の一端部が着脱可能に接続される。 As shown in FIG. 7B, the syringe 300 having a medium amount of medicine has a syringe main body 301 and a syringe pusher 302, and the syringe main body 301 has a main body flange 309. The child 302 has a pusher flange 305. The syringe body 301 is formed with a medicine scale 310. One end of a flexible tube 203 is detachably connected to the outlet 311 of the syringe body 301.
　図７（Ｃ）に示すように、最も薬剤の収容量が小さいシリンジ４００は、シリンジ本体４０１と、シリンジ押子４０２を有しており、シリンジ本体４０１は本体フランジ４０９を有し、シリンジ押子４０２は押子フランジ４０５を有している。シリンジ本体４０１には、薬剤の目盛４１０が形成されている。シリンジ本体４０１の出口部４１１には、フレキシブルなチューブ２０３の一端部が着脱可能に接続される。 As shown in FIG. 7C, the syringe 400 with the smallest amount of medicine is provided with a syringe body 401 and a syringe pusher 402. The syringe body 401 has a body flange 409, and the syringe pusher. Reference numeral 402 has a pusher flange 405. The syringe body 401 is formed with a drug scale 410. One end of a flexible tube 203 is detachably connected to the outlet 411 of the syringe body 401.
　図７（Ａ）に示すシリンジ２００は、例えば薬剤の収容量が５０ｍＬであり、図７（Ｂ）に示すシリンジ３００は、例えば薬剤の収容量が１０ｍＬ、２０ｍＬ、３０ｍＬであり、図７（Ｃ）に示すシリンジ４００は、例えば薬剤の収容量が２．５ｍＬ、５ｍＬである。シリンジ３００，４００は、図１及び図２に示すシリンジ２００と同様にして、収容部８に収容して固定して用いることができる。 The syringe 200 shown in FIG. 7A has, for example, a medicine capacity of 50 mL, and the syringe 300 shown in FIG. 7B has, for example, a medicine capacity of 10 mL, 20 mL, and 30 mL, and FIG. For example, the syringe 400 shown in FIG. The syringes 300 and 400 can be housed and fixed in the housing portion 8 in the same manner as the syringe 200 shown in FIGS. 1 and 2.
　次に、図８を参照して、図１及び図２に示すシリンジポンプ１の電気的な構成例を詳細に説明する。 Next, an example of the electrical configuration of the syringe pump 1 shown in FIGS. 1 and 2 will be described in detail with reference to FIG.
　図８において、シリンジポンプ１は、全体的な動作の判断、制御を行う制御部（コンピュータ）１００を有している。この制御部１００は、例えばワンチップのマイクロコンピュータであり、ＲＯＭ（読み出し専用メモリ）１０１、ＲＡＭ（ランダムアクセスメモリ）１０２、不揮発性メモリ１０３、そしてクロック１０４を有する。 8, the syringe pump 1 has a control unit (computer) 100 that performs overall operation determination and control. The control unit 100 is, for example, a one-chip microcomputer, and includes a ROM (Read Only Memory) 101, a RAM (Random Access Memory) 102, a nonvolatile memory 103, and a clock 104.
　クロック１０４は、所定の操作により現在時刻の修正ができ、現在時刻の取得や、所定の送液作業の経過時間の計測、送液の速度制御の基準時間の計測等ができる。 The clock 104 can correct the current time by a predetermined operation, and can acquire the current time, measure the elapsed time of a predetermined liquid feeding operation, measure the reference time of liquid feeding speed control, and the like.
　図８に示す制御部１００は、電源ＯＮ／ＯＦＦボタン４Ａと、スイッチ１１１が接続されている。 The control unit 100 shown in FIG. 8 is connected to a power ON / OFF button 4A and a switch 111.
　スイッチ１１１は、電源コンバータ部１１２と例えばリチウムイオン電池のような充電池１１３を切り換えることで、電源コンバータ部１１２と充電池１１３のいずれかから制御部１００に電源供給する。 The switch 111 supplies power to the control unit 100 from either the power converter unit 112 or the rechargeable battery 113 by switching between the power converter unit 112 and the rechargeable battery 113 such as a lithium ion battery.
　電源コンバータ部１１２は、コンセント１１４を介して商用交流電源１１５に接続されている。 The power converter unit 112 is connected to a commercial AC power source 115 via an outlet 114.
　図８において、収容部８内には、一対の検出スイッチ１２０，１２１が配置されている。検出スイッチ１２０，１２１は、シリンジ２００のシリンジ本体２０１が、収容部８に正しく配置されているかどうかを検知して、制御部１００に通知する。 In FIG. 8, a pair of detection switches 120 and 121 are arranged in the accommodating portion 8. The detection switches 120 and 121 detect whether or not the syringe body 201 of the syringe 200 is correctly arranged in the storage unit 8 and notify the control unit 100 of it.
　クランプセンサ１２２は、クランプ５の位置状態を検知することで、シリンジ本体２０１がクランプ５により確実にクランプされているかどうかを、制御部１００に通知する。 The clamp sensor 122 notifies the control unit 100 whether or not the syringe body 201 is reliably clamped by the clamp 5 by detecting the position state of the clamp 5.
　シリンジ押子駆動部７のモータ１３３は、制御部１００の指令によりモータドライバ１３４により駆動されると、送りネジ１３５を回転させてスライダ１０をＴ方向に移動させる。これにより、スライダ１０は、シリンジ押子２０２をＴ方向に押圧して、図２に示すシリンジ本体２０１内の薬剤を、チューブ２０３を通じて患者Ｐに対して留置針２０４を介して正確に送液する。 When the motor 133 of the syringe pusher drive unit 7 is driven by the motor driver 134 in response to a command from the control unit 100, the feed screw 135 is rotated to move the slider 10 in the T direction. Thereby, the slider 10 presses the syringe pusher 202 in the T direction, and accurately delivers the medicine in the syringe main body 201 shown in FIG. 2 to the patient P through the tube 203 via the indwelling needle 204. .
　図８において、早送りスイッチボタン４Ｂ、開始スイッチボタン４Ｃ、停止スイッチボタン４Ｄ、メニュー選択ボタン４Ｅは、制御部１００に電気的に接続されている。開始スイッチボタン４Ｃが押下されると送液開始の制御信号が制御部１００に入力される。また、停止スイッチボタン４Ｄが押下されると送液停止の制御信号が制御部１００に入力される。 8, the fast forward switch button 4B, the start switch button 4C, the stop switch button 4D, and the menu selection button 4E are electrically connected to the control unit 100. When the start switch button 4 </ b> C is pressed, a liquid feed start control signal is input to the control unit 100. Further, when the stop switch button 4D is pressed, a liquid feed stop control signal is input to the control unit 100.
　図８において、表示部ドライバ１３０は、制御部１００に電気的に接続されている。表示部ドライバ１３０は、制御部１００の指令により表示部３を駆動して種々の情報を表示部３に表示する。 In FIG. 8, the display unit driver 130 is electrically connected to the control unit 100. The display unit driver 130 drives the display unit 3 according to instructions from the control unit 100 to display various information on the display unit 3.
　図８において、スピーカ１３１は、制御部１００に電気的に接続されている。スピーカ１３１は、制御部１００の指令により各種の警報内容を音声により告知する。 In FIG. 8, the speaker 131 is electrically connected to the control unit 100. The speaker 131 notifies various alarm contents by voice according to a command from the control unit 100.
　制御部１００は、送液開始からそれまでに生体内に送液された薬剤の量に基づいて、薬剤の生体内における濃度を演算する演算部としての機能を有する。 The control unit 100 has a function as a calculation unit that calculates the concentration of the medicine in the living body based on the amount of the medicine delivered into the living body from the start of the feeding.
　送液開始から生体内に送液された薬剤の量は、例えば、シリンジ２００のシリンジ本体２０１の内径と、送りネジ１３５によってＴ方向に移動されるスライダ１０の送液開始からの移動量とを掛け合わせることで計算できる。 The amount of the medicine delivered into the living body from the start of feeding is, for example, the inner diameter of the syringe body 201 of the syringe 200 and the movement amount of the slider 10 moved in the T direction by the feed screw 135 from the start of feeding. It can be calculated by multiplying.
　薬剤の生体内における濃度は、シミュレーションによって演算される。 The concentration of the drug in the living body is calculated by simulation.
　シミュレーションは、薬物動態学に基づいて３－コンパートメントモデルを用いて行われるが、これに限定されない。 The simulation is performed using a 3-compartment model based on pharmacokinetics, but is not limited to this.
　３－コンパートメントモデルを用いたシミュレーションは、体内を３つの部分（以下、コンパートメント）に分けて濃度の計算を行う。３つのコンパートメントのうちの１つは、血液をモデル化したコンパートメントである。他の２つのコンパートメントは、生体内における筋肉などの血流が豊富な組織と脂肪などの血流が粗な組織をそれぞれモデル化したものである。薬剤は、血液をモデル化したコンパートメントに投与される。そして、血液をモデル化したコンパートメントと、他の２つのコンパートメントとの間で、薬物が所定の移行速度で移動する。また、薬剤は、血液をモデル化したコンパートメントを介して所定の排泄速度で体外に排泄される。薬剤が送液される患者の情報と、送液された薬剤の量、移行速度、及び、排泄速度等の関係から、血中濃度を含む各コンパートメントにおける送液された薬剤の濃度を計算することができる。コンパートメントに、薬剤が適用される部位をモデル化したコンパートメントを含めることで、薬剤が適用される部位の濃度である効果部位濃度を演算することもできる。たとえば、効果部位として、鎮静薬(プロポフォールなど)の場合は脳、筋弛緩薬(ミタゾラムなど)の場合は神経筋接合部が考えられる。送液量は、このように計算された薬剤の血中濃度または効果部位濃度と設定された目標濃度との差分に基づいて計算され、上限値を超えた場合には、送液量は上限値に設定される。 In the simulation using the 3-compartment model, the concentration is calculated by dividing the body into three parts (hereinafter, compartments). One of the three compartments is a compartment that models blood. The other two compartments are obtained by modeling a tissue rich in blood flow such as muscle and a tissue such as fat having rough blood flow in the living body. The drug is administered in a compartment that models blood. Then, the drug moves at a predetermined transition speed between the compartment modeling the blood and the other two compartments. In addition, the drug is excreted outside the body at a predetermined excretion rate through a compartment modeling blood. Calculate the concentration of the delivered drug in each compartment, including the blood concentration, based on the information on the patient to whom the drug is delivered and the relationship between the amount of delivered drug, the transfer rate, and the excretion rate. Can do. By including in the compartment a compartment that models the site to which the drug is applied, the effect site concentration, which is the concentration of the site to which the drug is applied, can also be calculated. For example, as an effect site, in the case of a sedative (such as propofol), the brain, and in the case of a muscle relaxant (such as mitazolam), a neuromuscular junction can be considered. The liquid delivery amount is calculated based on the difference between the blood concentration or effect site concentration of the drug calculated in this way and the set target concentration. If the upper limit value is exceeded, the liquid delivery amount is the upper limit value. Set to
　不揮発性メモリ１０３は、上限導入流量及び上限維持流量を薬剤の種類ごとに記憶する。また、不揮発性メモリ１０３は、バイスペクトラルインデックスの目標値を記憶する。さらに、不揮発性メモリ１０３は、目標濃度を記憶する。目標濃度は、例えば、ｍｃｇ／ｍｌ単位で記憶する。また、不揮発性メモリ１０３は、送液される患者の情報、及び、送液する薬剤の種類を記憶する。記憶する患者の情報は、例えば、性別、年齢、身長、及び、体重などである。さらに、不揮発性メモリ１０３は、後述するように制御部１００によって切り替えられる送液量の上限値を記憶する。 The nonvolatile memory 103 stores the upper limit introduction flow rate and the upper limit maintenance flow rate for each type of medicine. The non-volatile memory 103 stores a target value of the bispectral index. Further, the nonvolatile memory 103 stores a target density. The target concentration is stored in units of mcg / ml, for example. The non-volatile memory 103 stores information on a patient to be fed and the type of medicine to be fed. The stored patient information includes, for example, sex, age, height, weight, and the like. Further, the non-volatile memory 103 stores an upper limit value of the liquid feeding amount switched by the control unit 100 as will be described later.
　制御部１００は、外部機器接続端子１６０を介して、ＢＩＳモニタ５００と電気的に接続される。制御部１００には、ＢＩＳモニタ５００からバイスペクトラルインデックスの値が入力される。 The control unit 100 is electrically connected to the BIS monitor 500 via the external device connection terminal 160. The bispectral index value is input from the BIS monitor 500 to the control unit 100.
　制御部１００は、さらに、不揮発性メモリ１０３に記憶する上限導入流量、上限維持流量、目標値、目標濃度、患者の情報、及び、送液する薬剤の種類といった情報の入力を受け付ける受付部としての機能を有する。 The control unit 100 further serves as a reception unit that receives input of information such as the upper limit introduction flow rate, the upper limit maintenance flow rate, the target value, the target concentration, the patient information, and the type of medicine to be delivered, which are stored in the nonvolatile memory 103. It has a function.
　制御部１００は、入力を受け付けた情報を、不揮発性メモリ１０３に記憶する。 The control unit 100 stores the received information in the nonvolatile memory 103.
　制御部１００は、薬剤の送液中においても入力を受け付ける。よって、不揮発性メモリ１０３に記憶された目標値及び目標濃度は、薬剤の送液中において変更されることが可能である。 The control unit 100 accepts input even during drug delivery. Therefore, the target value and the target concentration stored in the nonvolatile memory 103 can be changed during the delivery of the medicine.
　制御部１００は、入力された上限導入流量及び上限維持流量をチェックして、不正な入力の受け付けを制限する。具体的には、制御部１００は、上限導入流量と上限維持流量の大小関係をチェックする。そして、上限維持流量が上限導入流量を上回る場合には、入力された上限導入流量及び上限維持流量を不揮発性メモリ１０３に記憶しない。 The control unit 100 checks the input upper limit introduction flow rate and the upper limit maintenance flow rate, and limits the acceptance of unauthorized input. Specifically, the control unit 100 checks the magnitude relationship between the upper limit introduction flow rate and the upper limit maintenance flow rate. When the upper limit maintenance flow rate exceeds the upper limit introduction flow rate, the input upper limit introduction flow rate and upper limit maintenance flow rate are not stored in the nonvolatile memory 103.
　制御部１００への上限導入流量及び上限維持流量に関する情報の入力は、種々の方法で行うことができる。 Input of information on the upper limit introduction flow rate and the upper limit maintenance flow rate to the control unit 100 can be performed by various methods.
　例えば、制御部１００に接続された操作パネル部４の操作ボタンを操作することで、薬剤の種類ごとに上限導入流量及び上限維持流量を入力することができる。 For example, by operating the operation button of the operation panel unit 4 connected to the control unit 100, the upper limit introduction flow rate and the upper limit maintenance flow rate can be input for each type of medicine.
　また、通信ポート１４０を介して入力することもできる。例えば、図８に示すように、通信ポート１４０を介してデスクトップコンピュータのようなコンピュータ１４１と制御部１００を接続する。そして、コンピュータ１４１を操作することで、上限導入流量及び上限維持流量を、薬剤の種類ごとに通信ポート１４０を介して制御部１００に入力することができる。 It is also possible to input via the communication port 140. For example, as shown in FIG. 8, a computer 141 such as a desktop computer and the control unit 100 are connected via a communication port 140. Then, by operating the computer 141, the upper limit introduction flow rate and the upper limit maintenance flow rate can be input to the control unit 100 via the communication port 140 for each type of medicine.
　この場合、図８に示すように、コンピュータ１４１を薬剤データベース１５０に接続してもよい。薬剤データベース１５０には、上限導入流量及び上限維持流量を薬剤の種類ごとに薬剤ライブラリとしてまとめて保存しておくことができる。コンピュータ１４１を操作することで、薬剤データベース１５０に薬剤の種類ごとに保存された上限導入流量及び上限維持流量を、通信ポート１４０を介して制御部１００に入力することができる。薬剤ライブラリは、上限導入流量及び上限維持流量以外の薬剤に関する情報を記録していてもよい。例えば、薬剤メーカー、及び、禁忌情報などを薬剤の種類ごとに記録していてもよい。それらの情報も、上限導入流量及び上限維持流量とともに、通信ポート１４０を介して制御部１００に入力することができる。薬剤ライブラリは、病院全体や病棟ごとにまとめて生成して、薬剤データベース１５０に保存しておくことができる。 In this case, the computer 141 may be connected to the medicine database 150 as shown in FIG. In the drug database 150, the upper limit introduction flow rate and the upper limit maintenance flow rate can be collectively stored as a drug library for each type of drug. By operating the computer 141, the upper limit introduction flow rate and the upper limit maintenance flow rate stored for each type of drug in the drug database 150 can be input to the control unit 100 via the communication port 140. The drug library may record information on drugs other than the upper limit introduction flow rate and the upper limit maintenance flow rate. For example, drug manufacturers and contraindication information may be recorded for each type of drug. Such information can also be input to the control unit 100 through the communication port 140 together with the upper limit introduction flow rate and the upper limit maintenance flow rate. The drug library can be generated collectively for each hospital or ward and stored in the drug database 150.
　送液される患者の情報、送液する薬剤の種類、バイスペクトラルインデックスの目標値、及び、目標濃度は、表示部３の表示内容に従って操作パネル部４の操作ボタンを操作することで制御部１００に入力することができる。 Information on the patient to be delivered, the type of medicine to be delivered, the target value of the bispectral index, and the target concentration are operated by operating the operation buttons of the operation panel unit 4 according to the display content of the display unit 3. Can be entered.
　図４（Ａ）（Ｂ）は、送液される患者の情報を入力する際の表示部３の表示内容例を示す。図４に示した表示内容例に従って操作パネル部４の操作ボタンを操作することで、送液される患者の性別、年齢、身長、及び、体重といった情報を入力することができる。 FIGS. 4A and 4B show examples of display contents of the display unit 3 when inputting information on a patient to be fed. By operating the operation buttons of the operation panel unit 4 according to the display content example shown in FIG. 4, information such as the sex, age, height, and weight of the patient to be fed can be input.
　図５は、送液する薬剤の種類を入力する際の表示部３の表示内容例を示す。図５に示した表示内容例に従って操作パネル部４の操作ボタンを操作することで、送液する薬剤の種類を入力することができる。 FIG. 5 shows a display content example of the display unit 3 when inputting the type of medicine to be delivered. By operating the operation button of the operation panel unit 4 in accordance with the display content example shown in FIG. 5, the type of medicine to be fed can be input.
　図６（Ａ）（Ｂ）は、バイスペクトラルインデックスの目標値及び目標濃度を入力する際の表示部３の表示内容例を示す。図６に示した表示内容例に従って操作パネル部４の操作ボタンを操作することで、バイスペクトラルインデックスの目標値及び血中濃度の目標濃度を入力することができる。 6A and 6B show examples of display contents of the display unit 3 when inputting the target value and target density of the bispectral index. By operating the operation button of the operation panel unit 4 in accordance with the display content example shown in FIG. 6, the target value of the bispectral index and the target concentration of blood concentration can be input.
　制御部１００は、開始スイッチボタン４Ｃが押下されて送液開始の制御信号が入力されると送液を開始する。また、制御部１００は、停止スイッチボタン４Ｄが押下されて送液停止の制御信号が入力されると送液を停止する。 The control unit 100 starts liquid feeding when the start switch button 4C is pressed and a liquid feeding start control signal is input. Further, when the stop switch button 4D is pressed and a liquid feed stop control signal is input, the control unit 100 stops liquid feeding.
　制御部１００は、ＢＩＳモニタ５００から入力されるバイスペクトラルインデックスの値が目標値に達しているか否かの判定を行うバイタル判定部としての機能、送液量の上限値の切り替えを行う上限値切り替え部としての機能、及び、送液量の調整を行う調整部としての機能を有する。図９に示すフローチャートを参照して、以下にそれらの動作を詳細に説明する。 The control unit 100 functions as a vital determination unit that determines whether or not the value of the bispectral index input from the BIS monitor 500 has reached the target value, and the upper limit value switching that switches the upper limit value of the liquid feeding amount A function as a unit and a function as an adjustment unit for adjusting a liquid feeding amount. These operations will be described in detail below with reference to the flowchart shown in FIG.
　まず、ステップＳ１０１で、不揮発性メモリ１０３に記憶されている送液する薬剤の種類に応じて、不揮発性メモリ１０３に記憶されている上限導入流量を薬剤の送液量の上限値として不揮発性メモリ１０３に記憶する。 First, in step S101, the non-volatile memory uses the upper limit introduction flow rate stored in the non-volatile memory 103 as the upper limit value of the drug supply amount in accordance with the type of the drug to be sent stored in the non-volatile memory 103. 103.
　次に、ステップＳ１０２で、送液終了条件を満たすか否かを判定する。送液終了条件が満たされた場合には、送液を終了する。少なくとも、停止スイッチボタン４Ｄが押下されて送液終了の制御信号の入力を受け付けた場合には、送液終了条件が満たされる。 Next, in step S102, it is determined whether or not a liquid feed end condition is satisfied. When the liquid feeding end condition is satisfied, the liquid feeding is finished. At least when the stop switch button 4D is pressed and an input of a control signal for the end of liquid feeding is received, the liquid feeding end condition is satisfied.
　次に、ステップＳ１０３で、不揮発性メモリ１０３に記憶された上限値を超えず、かつ、送液後の薬剤の血中濃度が、不揮発性メモリ１０３に記憶されている目標濃度に維持される送液量で送液を行う。送液後の薬剤の血中濃度は、送液される薬剤の量と、不揮発性メモリ１０３に記憶されている患者の情報及び送液する薬剤の種類などに基づいて、シミュレーションにより演算することができる。薬剤の送液は、スライダ１０がシリンジ押子２０２をＴ方向に押圧することで行われる（図１及び図２参照）。スライダ１０は、シリンジ押子駆動部７のモータドライバ１３４を駆動することによって移動される（図８参照）。 Next, in step S103, the upper limit value stored in the non-volatile memory 103 is not exceeded, and the blood concentration of the drug after liquid feeding is maintained at the target concentration stored in the non-volatile memory 103. Deliver the liquid in a liquid volume. The blood concentration of the drug after feeding can be calculated by simulation based on the amount of the medicine to be sent, the patient information stored in the nonvolatile memory 103, the kind of the medicine to be sent, and the like. it can. The medicine is fed by the slider 10 pressing the syringe pusher 202 in the T direction (see FIGS. 1 and 2). The slider 10 is moved by driving the motor driver 134 of the syringe pusher drive unit 7 (see FIG. 8).
　次に、ステップＳ１０４で、ＢＩＳモニタ５００から入力されたバイスペクトラルインデックスの値が目標値に達しているか否かを判定する。目標値に達していないと判定された場合は、ステップＳ１０２に戻る。目標値に達していると判定された場合は、ステップＳ１０５に進む。 Next, in step S104, it is determined whether or not the bispectral index value input from the BIS monitor 500 has reached the target value. If it is determined that the target value has not been reached, the process returns to step S102. If it is determined that the target value has been reached, the process proceeds to step S105.
　ステップＳ１０５で、送液量の上限値を上限導入流量から上限維持流量に切り替える。上限値の切り替えは、不揮発性メモリ１０３に記憶されている上限値を書き換えることで行われる。すなわち、不揮発性メモリ１０３に記憶されている送液する薬剤の種類に応じて、不揮発性メモリ１０３に記憶されている上限維持流量を薬剤の送液量の上限値として不揮発性メモリ１０３に記憶することで上限値の切り替えを行う。 In step S105, the upper limit value of the liquid feeding amount is switched from the upper limit introduction flow rate to the upper limit maintenance flow rate. Switching of the upper limit value is performed by rewriting the upper limit value stored in the nonvolatile memory 103. That is, the upper limit maintenance flow rate stored in the non-volatile memory 103 is stored in the non-volatile memory 103 as the upper limit value of the drug delivery amount in accordance with the type of the drug to be sent stored in the non-volatile memory 103. In this way, the upper limit value is switched.
　制御部１００は、上限値の切り替え後、上限値が切り替えられたことを報知する。報知する方法は種々の方法が考えられる。例えば、スピーカ１３１に指令を出してブザー音を発することにより、上限値が切り替えられたことを報知することができる。また、表示部ドライバ１３０に指令を出して、上限値が切り替えられたことを示すテキストや映像などを表示部３に表示して報知することもできる。 The control unit 100 notifies that the upper limit value has been switched after the upper limit value has been switched. Various methods can be considered for the notification. For example, it is possible to notify that the upper limit value has been switched by issuing a command to the speaker 131 to emit a buzzer sound. It is also possible to issue a command to the display unit driver 130 to display and notify the display unit 3 of text or video indicating that the upper limit has been switched.
　次に、ステップＳ１０６で、ステップＳ１０２と同様に、送液終了条件を満たすか否かを判定する。送液終了条件が満たされた場合には、送液を終了する。 Next, in step S106, it is determined whether or not the liquid feed end condition is satisfied, as in step S102. When the liquid feeding end condition is satisfied, the liquid feeding is finished.
　次に、ステップＳ１０７で、不揮発性メモリ１０３に記憶された上限値を超えず、かつ、送液後の薬剤の血中濃度が、不揮発性メモリ１０３に記憶されている目標濃度に維持される送液量で送液を行う。送液後の薬剤の血中濃度は、ステップＳ１０３と同様にシミュレーションにより演算することができる。また、薬剤の送液は、ステップＳ１０３と同様にシリンジ押子２０２を押圧することで行われる。 Next, in step S <b> 107, the upper limit value stored in the non-volatile memory 103 is not exceeded, and the blood concentration of the drug after liquid feeding is maintained at the target concentration stored in the non-volatile memory 103. Deliver the liquid in a liquid volume. The blood concentration of the drug after liquid feeding can be calculated by simulation in the same manner as in step S103. Also, the medicine is fed by pressing the syringe pusher 202 in the same manner as in step S103.
　次に、ステップＳ１０８で、ＢＩＳモニタ５００から入力されるバイスペクトラルインデックスの値が、不揮発性メモリ１０３に記憶されている目標値に達しているか否かを判定する。目標値に達していると判定された場合は、ステップＳ１０６に戻る。目標値に達していないと判定された場合は、ステップＳ１０９に進む。 Next, in step S108, it is determined whether or not the bispectral index value input from the BIS monitor 500 has reached the target value stored in the nonvolatile memory 103. If it is determined that the target value has been reached, the process returns to step S106. If it is determined that the target value has not been reached, the process proceeds to step S109.
　ステップＳ１０９で、送液量の上限値を上限維持流量から上限導入流量に切り替える。すなわち、不揮発性メモリ１０３に記憶されている送液する薬剤の種類に応じて、不揮発性メモリ１０３に記憶されている上限導入流量を薬剤の送液量の上限値として不揮発性メモリ１０３に記憶する。制御部１００は、上限値の切り替え後、上限値が切り替えられたことを報知し、ステップＳ１０２に戻る。 In step S109, the upper limit value of the liquid feeding amount is switched from the upper limit maintenance flow rate to the upper limit introduction flow rate. That is, the upper limit introduction flow rate stored in the non-volatile memory 103 is stored in the non-volatile memory 103 as the upper limit value of the drug delivery amount in accordance with the type of the drug to be sent stored in the non-volatile memory 103. . After switching the upper limit value, control unit 100 notifies that the upper limit value has been switched, and returns to step S102.
　以降、上述したステップを繰り返し、送液終了条件が満たされるまで送液を行う。 Thereafter, the above-described steps are repeated, and liquid feeding is performed until the liquid feeding end condition is satisfied.
　図１０は、シリンジポンプ１を使用して薬剤を送液した際の生体内における薬剤の濃度の変化の例を示すグラフである。ｄ０は血中濃度を示し、ｄ１は効果部位濃度を示し、Ｄ１は目標濃度を示す。そして、ｂ０はバイスペクトルインデックスの値を示し、Ｂ１はバイスペクトラルインデックスの目標値を示す。また、Ｔ０は送液開始時刻を示し、Ｔ１は血中濃度が目標濃度Ｄ１に達した時刻を示し、Ｔ２はバイスペクトラルインデックスｂ０の値が目標値Ｂ１に達した時刻を示す。 FIG. 10 is a graph showing an example of changes in the concentration of the drug in the living body when the drug is fed using the syringe pump 1. d0 represents blood concentration, d1 represents effect site concentration, and D1 represents target concentration. And b0 shows the value of a bispectral index, B1 shows the target value of a bispectral index. Further, T0 indicates a liquid feeding start time, T1 indicates a time when the blood concentration reaches the target concentration D1, and T2 indicates a time when the value of the bispectral index b0 reaches the target value B1.
　シリンジポンプ１は、時刻Ｔ０において上限導入流量を送液量の上限値として薬剤の送液を開始する。送液開始後、時刻Ｔ１において、血中濃度ｄ０が目標濃度Ｄ１に達する。時刻Ｔ１以降、血中濃度ｄ０は目標濃度に維持される。さらに、送液を続けると、バイスペクトラルインデックスの値ｂ０が目標値Ｂ１に達する。このとき、送液量の上限値が、上限導入流量から上限維持流量に切り替えられる。 The syringe pump 1 starts liquid feeding at the time T0 with the upper limit introduction flow rate as the upper limit value of the liquid feeding amount. After the start of feeding, the blood concentration d0 reaches the target concentration D1 at time T1. After time T1, the blood concentration d0 is maintained at the target concentration. Further, when the liquid feeding is continued, the bispectral index value b0 reaches the target value B1. At this time, the upper limit value of the liquid feeding amount is switched from the upper limit introduction flow rate to the upper limit maintenance flow rate.
　図１１（Ａ）～（Ｃ）は、薬剤を送液している際中の表示部３の表示内容の遷移の例を示した図である。図１１（Ａ）は、送液開始直後の表示部３の表示例を示す。図１１（Ｂ）は、バイスペクトラルインデックスの値が目標値に達したときの表示部３の表示例を示す。図１１（Ｃ）は、バイスペクトラルインデックスの値が目標値に達した後の表示部３の表示例を示す。 FIGS. 11A to 11C are diagrams showing an example of transition of display contents of the display unit 3 while the medicine is being delivered. FIG. 11A shows a display example of the display unit 3 immediately after the start of liquid feeding. FIG. 11B shows a display example of the display unit 3 when the value of the bispectral index reaches the target value. FIG. 11C shows a display example of the display unit 3 after the bispectral index value reaches the target value.
　図１１に示すように、表示部３は、不揮発性メモリ１０３に記憶されている目標値Ｂ１、目標濃度Ｄ１を表示する。また、現在のバイスペクトラルインデックスｂ０の値を表示する。さらに、表示部３は、薬剤を送液している際中において、シミュレーションに基づいて計算される薬剤の血中濃度ｄ０の予測線及び効果部位濃度ｄ１の予測線を表示する。軸Ｔは時刻を示し、軸Ｄは濃度を示す。黒色で塗りつぶされた領域ｄ１´は、送液開始から現時点までの効果部位濃度ｄ１の遷移の履歴を表している。 As shown in FIG. 11, the display unit 3 displays the target value B1 and the target concentration D1 stored in the nonvolatile memory 103. In addition, the current value of the bispectral index b0 is displayed. Furthermore, the display unit 3 displays a prediction line for the blood concentration d0 of the drug and a prediction line for the effect site concentration d1 calculated based on the simulation while the drug is being delivered. The axis T indicates time and the axis D indicates concentration. A region d1 ′ filled with black represents a transition history of the effect site concentration d1 from the start of liquid feeding to the present time.
　次に、シリンジポンプ１の使用例を説明する。 Next, a usage example of the syringe pump 1 will be described.
　まず、図８に示すように、通信ポート１４０を介して、制御部１００とコンピュータ１４１を接続する。 First, as shown in FIG. 8, the control unit 100 and the computer 141 are connected via the communication port 140.
　次に、コンピュータ１４１を操作して、薬剤データベース１５０に保存されている薬剤ライブラリの情報を、通信ポート１４０を介して制御部１００に入力する。この操作によって、薬剤ライブラリに記録されている上限導入流量及び上限維持流量が、不揮発性メモリ１０３に薬剤の種類ごとに記憶される。 Next, the computer 141 is operated to input the drug library information stored in the drug database 150 to the control unit 100 via the communication port 140. By this operation, the upper limit introduction flow rate and the upper limit maintenance flow rate recorded in the medicine library are stored in the nonvolatile memory 103 for each kind of medicine.
　次に、図２に示すように、ケーブル５０１を介してＢＩＳモニタ５００をシリンジポンプ１に接続する。そして、脳波測定用のプローブ（不図示）を患者の頭部に取り付ける。 Next, as shown in FIG. 2, the BIS monitor 500 is connected to the syringe pump 1 via the cable 501. Then, an electroencephalogram measurement probe (not shown) is attached to the patient's head.
　次に、図１及び図２に示すように、シリンジ２００を、シリンジポンプ１にセットする。シリンジポンプ１のセットは、クランプ５を使用して上述した方法で行う。そして、患者にチューブ２０３が接続された留置針２０４を挿入する。 Next, as shown in FIGS. 1 and 2, the syringe 200 is set in the syringe pump 1. The syringe pump 1 is set by the method described above using the clamp 5. And the indwelling needle 204 with which the tube 203 was connected is inserted in a patient.
　次に、図４～図６に示すように、表示部３と操作パネル部４を使用して各種情報の入力を行う。まず、患者の情報として、性別、年齢、身長、及び、体重を入力する。次に、送液する薬剤の種類を入力する。そして、バイスペクトラルインデックスの目標値と、血中濃度の目標濃度を入力する。 Next, as shown in FIGS. 4 to 6, various information is input using the display unit 3 and the operation panel unit 4. First, sex, age, height, and weight are input as patient information. Next, the type of medicine to be fed is input. Then, the target value of the bispectral index and the target concentration of the blood concentration are input.
　次に、開始スイッチボタン４Ｃを押下して、患者の体内への薬剤の送液を開始する。送液量の上限値の切り替え及び送液量の調整は、図９に示したフローチャートに従って制御部１００によって行われる。送液は、上述した送液終了条件が満たされるまで行われる。 Next, the start switch button 4C is pressed to start feeding the medicine into the patient's body. Switching of the upper limit value of the liquid feeding amount and adjustment of the liquid feeding amount are performed by the control unit 100 according to the flowchart shown in FIG. The liquid feeding is performed until the liquid feeding end condition described above is satisfied.
　送液量の上限値が切り替わった際に、スピーカ１３１によって、上限値が切り替えられたことを知らせるブザー音が発せられる。 When the upper limit value of the liquid feeding amount is switched, a buzzer sound is generated by the speaker 131 informing that the upper limit value has been switched.
　また、バイスペクトラルインデックスの目標値を送液中に変更することができる。すなわち、バイスペクトラルインデックスの値が目標値に達しているにも関わらず、薬剤の効能の発現が認められない場合において、目標値を変更することができる。あるいは、バイスペクトラルインデックスの値が目標値に達する前に薬剤の効能の発現が認められる場合に、目標値を変更してもよい。目標値は、上述したように、表示部３の表示に従って操作パネル部４を操作することで変更することができる。 In addition, the target value of the bispectral index can be changed during feeding. That is, the target value can be changed when the drug effect is not manifested even though the value of the bispectral index has reached the target value. Alternatively, the target value may be changed when the efficacy of the drug is observed before the bispectral index value reaches the target value. As described above, the target value can be changed by operating the operation panel unit 4 in accordance with the display on the display unit 3.
　さらに、血中濃度の目標濃度を送液中に変更することもできる。すなわち、効果部位濃度が目標濃度に達しているにも関わらず、バイスペクトラルインデックスの値が目標値に達しない場合において、目標濃度を変更することができる。あるいは、効果部位濃度が目標濃度に達する前にバイスペクトラルインデックスの値が目標値に達した場合に、目標濃度を変更してもよい。目標濃度は、上述したように、表示部３の表示に従って操作パネル部４を操作することで変更することができる。 Furthermore, the target concentration of blood concentration can be changed during liquid feeding. In other words, the target concentration can be changed when the value of the bispectral index does not reach the target value even though the effect site concentration reaches the target concentration. Alternatively, the target concentration may be changed when the value of the bispectral index reaches the target value before the effect site concentration reaches the target concentration. As described above, the target density can be changed by operating the operation panel unit 4 in accordance with the display on the display unit 3.
　本実施形態によれば、薬剤が送液された生体のバイタルの変動を観測することができる。そして、観測されたバイタルの値が所定の目標値に達しているか否かを判定することができる。さらに、観測されたバイタルの値が所定の目標値に達しているか否かの判定結果に応じて、薬剤の送液量の上限値を切り替えることができる。よって、本実施形態によれば、薬剤の送液時において、薬剤の種類ごとに薬剤の効能が発現されているか否かに応じて定められている所定の上限値を超えない適切な送液量で薬剤を送液することが可能である。 According to the present embodiment, it is possible to observe the vital fluctuation of the living body to which the medicine is fed. Then, it can be determined whether or not the observed vital value has reached a predetermined target value. Furthermore, it is possible to switch the upper limit value of the drug delivery amount according to the determination result of whether or not the observed vital value has reached a predetermined target value. Therefore, according to this embodiment, at the time of drug delivery, an appropriate liquid delivery amount that does not exceed a predetermined upper limit value determined depending on whether or not the efficacy of the drug is expressed for each type of drug. It is possible to feed the drug with.
　また、本実施形態によれば、上限値として上限導入流量が設定されている場合に、観測されたバイタルの値が目標値に達したときに、薬剤を送液する際の送液量の上限値を上限導入流量から上限維持流量に切り替えることができる。これにより、生体の特定の部位において薬剤の効能が発現されている状態において、許容される送液量の上限値を超えない送液量で薬剤を送液することができる。 Further, according to the present embodiment, when the upper limit introduction flow rate is set as the upper limit value, when the observed vital value reaches the target value, the upper limit of the liquid delivery amount when the medicine is delivered The value can be switched from the upper limit introduction flow rate to the upper limit maintenance flow rate. Thereby, in the state where the effect of the medicine is expressed in a specific part of the living body, the medicine can be fed with a liquid feeding amount that does not exceed the upper limit value of the allowable liquid feeding amount.
　また、本実施形態によれば、上限値として上限維持流量が設定されている場合に、観測されたバイタルの値が目標値を満たさなくなったときに、薬剤を送液する際の送液量の上限値を上限維持流量から上限導入流量に切り替えることができる。これにより、薬剤の効能が発現された状態から発現されていない状態に変化したときに、血中濃度の目標濃度を変更することで、薬剤の効能が発現された状態へと速やかに戻すことができる。 Further, according to the present embodiment, when the upper limit maintenance flow rate is set as the upper limit value, when the observed vital value no longer satisfies the target value, The upper limit value can be switched from the upper limit maintenance flow rate to the upper limit introduction flow rate. As a result, when the effect of the drug is changed to a state where it is not expressed, the target concentration of the blood concentration can be changed to quickly return to the state where the drug effect is expressed. it can.
　また、本実施形態によれば、血中濃度を目標濃度に維持するように薬剤を送液する際の送液量が調整される。これにより、血中濃度が所定の目標濃度を超えることなく一定に維持されるため安全性が向上する。 In addition, according to the present embodiment, the amount of liquid delivered when the medicine is delivered is adjusted so that the blood concentration is maintained at the target concentration. As a result, the blood concentration is kept constant without exceeding a predetermined target concentration, so that safety is improved.
　また、本実施形態によれば、上限導入流量及び上限維持流量を記憶する際に、上限導入流量を超える上限維持流量の入力の受け付けを制限する。これにより、上限導入流量を超える上限維持流量が誤って記憶されるのを防ぐことができるため安全性が向上する。 Further, according to the present embodiment, when the upper limit introduction flow rate and the upper limit maintenance flow rate are stored, the reception of the upper limit maintenance flow rate exceeding the upper limit introduction flow rate is limited. As a result, it is possible to prevent the upper limit maintenance flow rate exceeding the upper limit introduction flow rate from being erroneously stored, thereby improving safety.
　また、本実施形態によれば、バイスペクトラルインデックスの目標値の入力を送液中に受け付けることができる。これにより、状況に応じて目標値を変更できるため安全性及び利便性がさらに向上する。 Further, according to the present embodiment, it is possible to accept the input of the target value of the bispectral index during liquid feeding. Thereby, since the target value can be changed according to the situation, safety and convenience are further improved.
　また、本実施形態によれば、目標濃度の入力を送液中に受け付けることができる。これにより、状況に応じて目標濃度を変更できるため安全性及び利便性がさらに向上する。 Further, according to the present embodiment, it is possible to accept the input of the target concentration during the liquid feeding. Thereby, since the target density can be changed according to the situation, safety and convenience are further improved.
　また、本実施形態によれば、薬剤の送液量の上限値が切り替わったことを知らせることができる。これにより、薬剤の送液量の上限値が切り替わったことを適時に把握できるため安全性がさらに向上する。 In addition, according to the present embodiment, it is possible to notify that the upper limit value of the drug delivery amount has been switched. Thereby, since it can grasp | ascertain in a timely that the upper limit of the amount of liquid delivery of a medicine switched, safety | security improves further.
　また、本実施形態によれば、薬剤の効能が発現しているか否かをバイスペクトラルインデックスによって判定する。これにより、静脈麻酔薬等の麻酔薬の送液に好適に使用することができる。 Further, according to the present embodiment, it is determined by the bispectral index whether or not the efficacy of the drug is expressed. Thereby, it can use suitably for liquid feeding of anesthetics, such as a vein anesthetic.
　＜変形例＞
　上述した実施形態では、制御部１００は、バイスペクトラルインデックスの値が目標値に達しているか否かに応じて上限値を切り替えたが、バイスペクトラルインデックスの値が目標値を基準とする所定の許容範囲の範囲内に含まれるか否かに応じて上限値を切り替えてもよい。 <Modification>
In the embodiment described above, the control unit 100 switches the upper limit value depending on whether or not the bispectral index value has reached the target value. However, the bispectral index value is set to a predetermined allowable value based on the target value. The upper limit value may be switched according to whether or not it falls within the range.
　例えば、バイスペクトラルインデックスの目標値が５０、許容範囲が±５．００％の場合、制御部１００は、バイスペクトラルインデックスの値が（５０．０－５０．０×０．０５）以上、（５０．０＋５０．０×０．０５）未満の範囲内に含まれるか否かに応じて送液量の上限値を切り替えてもよい。 For example, when the target value of the bispectral index is 50 and the allowable range is ± 5.00%, the control unit 100 determines that the value of the bispectral index is (50.0-50.0 × 0.05) or more, (50 0.0 + 50.0 × 0.05), the upper limit value of the liquid feeding amount may be switched depending on whether it is included in the range.
　許容範囲は、目標値と同様に、表示部３の表示内容に従って操作パネル部４の操作ボタンを操作することで制御部１００に入力することができる。入力された許容範囲は、不揮発性メモリ１０３に記憶される。 The allowable range can be input to the control unit 100 by operating the operation button of the operation panel unit 4 in accordance with the display content of the display unit 3 in the same manner as the target value. The input allowable range is stored in the nonvolatile memory 103.
　図１２は、目標値と合わせて許容範囲を入力する場合の表示部３の表示例を示す。図１２では、１例として、バイスペクトラルインデックスの目標値として５０を入力、許容範囲として±５．００％を入力する場合を示している。 FIG. 12 shows a display example of the display unit 3 when the allowable range is input together with the target value. In FIG. 12, as an example, 50 is input as the target value of the bispectral index, and ± 5.00% is input as the allowable range.
　制御部１００を上述したように構成することにより、目標値を基準とした許容範囲の範囲内にバイスペクトラルインデックスの値が含まれる場合に、送液量の上限値を切り替えることができる。これにより、送液量の上限値を切り替えるタイミングを状況に応じて柔軟に設定できるため利便性がさらに向上する。 By configuring the control unit 100 as described above, the upper limit value of the liquid feeding amount can be switched when the value of the bispectral index is included in the allowable range based on the target value. Thereby, since the timing which switches the upper limit of liquid feeding amount can be set flexibly according to a condition, the convenience improves further.
　＜第２実施形態＞
　次に、本発明の第２実施形態に係るシリンジポンプを説明する。 Second Embodiment
Next, a syringe pump according to the second embodiment of the present invention will be described.
　第２実施形態に係るシリンジポンプは、制御部が行う送液量の上限値の切り替え、及び、送液量の調整に関する動作が、第１実施形態に係るシリンジポンプの制御部１００の動作と異なる。第１実施形態に係るシリンジポンプ１の制御部１００は、血中濃度が目標濃度に維持されるように送液量を調整していた。一方、第２実施形態に係るシリンジポンプの制御部は、効果部位濃度が目標濃度に維持されるように送液量を調整する点が制御部１００と相違する。制御部以外の本体カバー２、表示部３、及び、操作パネル部４等の構成は第１実施形態と同じであるため、説明を省略する。また、第２実施形態に係るシリンジポンプの制御部の動作のうち、モータドライバ１３４の駆動やバイスペクトラルインデックスの目標値等の入力の受け付けなどの動作は、第１実施形態と同じであるため説明を省略する。 The syringe pump according to the second embodiment is different from the operation of the control unit 100 of the syringe pump according to the first embodiment in the operation related to the switching of the upper limit value of the liquid feeding amount performed by the control unit and the adjustment of the liquid feeding amount. . The control unit 100 of the syringe pump 1 according to the first embodiment adjusts the liquid feeding amount so that the blood concentration is maintained at the target concentration. On the other hand, the control unit of the syringe pump according to the second embodiment is different from the control unit 100 in that the liquid supply amount is adjusted so that the effective site concentration is maintained at the target concentration. Since the configuration of the main body cover 2, the display unit 3, and the operation panel unit 4 other than the control unit is the same as that of the first embodiment, the description thereof is omitted. In addition, among the operations of the control unit of the syringe pump according to the second embodiment, operations such as driving the motor driver 134 and receiving input such as a target value of the bispectral index are the same as those in the first embodiment. Is omitted.
　図１３は、第２実施形態に係るシリンジポンプの制御部が行う送液量の上限値の切り替え、及び、送液量の調整に関する動作を説明するフローチャートである。 FIG. 13 is a flowchart for explaining operations related to switching of the upper limit value of the liquid feeding amount and adjustment of the liquid feeding amount performed by the control unit of the syringe pump according to the second embodiment.
　図１３に示す第２実施形態に係るシリンジポンプの制御部の動作は、効果部位濃度を目標濃度に維持するように送液を行うステップＳ２０３及びステップＳ２０７を除いて、第１実施形態に係るシリンジポンプ１の制御部１００の動作と同じである。具体的には、上限導入流量を設定するステップＳ２０１は、ステップＳ１０１と同じである。また、送液終了条件を満たすか否かを判定するステップＳ２０２及びステップＳ２０６は、ステップＳ１０２及びステップＳ１０６と同じである。また、バイスペクトラルインデックスの値が目標値に達しているか否かを判定するステップＳ２０４及びステップＳ２０８は、ステップＳ１０４及びステップＳ１０８と同じである。また、上限値を切り替えるステップＳ２０５及びステップＳ２０９は、ステップＳ１０５及びステップＳ１０９と同じである。これらのステップについては説明を省略して、相違するステップＳ２０３及びステップＳ２０７のみを以下に説明する。 The operation of the control unit of the syringe pump according to the second embodiment shown in FIG. 13 is the syringe according to the first embodiment except for step S203 and step S207 in which liquid feeding is performed so as to maintain the effective site concentration at the target concentration. The operation is the same as that of the control unit 100 of the pump 1. Specifically, step S201 for setting the upper limit introduction flow rate is the same as step S101. Further, Step S202 and Step S206 for determining whether or not the liquid feed end condition is satisfied are the same as Step S102 and Step S106. Further, Step S204 and Step S208 for determining whether or not the value of the bispectral index has reached the target value are the same as Step S104 and Step S108. Further, step S205 and step S209 for switching the upper limit value are the same as step S105 and step S109. Description of these steps will be omitted, and only the different steps S203 and S207 will be described below.
　ステップＳ２０３及びステップＳ２０７は、第１実施形態における制御部１００の対応するステップＳ１０３及びＳ１０７と、次の点が異なる。すなわち、ステップＳ１０３及びステップＳ１０７は、血中濃度を目標濃度に維持するように送液を行った。一方、ステップＳ２０３及びステップＳ２０７は、効果部位濃度を目標濃度に維持するように送液を行う。 Step S203 and step S207 differ from the corresponding steps S103 and S107 of the control unit 100 in the first embodiment in the following points. That is, in step S103 and step S107, liquid feeding was performed so as to maintain the blood concentration at the target concentration. On the other hand, in step S203 and step S207, liquid feeding is performed so as to maintain the effective site concentration at the target concentration.
　具体的には、ステップＳ２０３及びステップＳ２０７では、不揮発性メモリ１０３に記憶された上限値を超えず、かつ、送液後の薬剤の効果部位濃度が、不揮発性メモリ１０３に記憶されている目標濃度に維持される送液量で送液を行う。送液後の薬剤の効果部位濃度は、送液される薬剤の量と、不揮発性メモリ１０３に記憶されている患者の情報及び送液する薬剤の種類などに基づいて、シミュレーションにより演算することができる。薬剤の送液は、ステップＳ１０３と同様にシリンジ押子２０２を押圧することで行われる。 Specifically, in step S203 and step S207, the upper limit value stored in the nonvolatile memory 103 is not exceeded, and the effective site concentration of the drug after liquid feeding is the target concentration stored in the nonvolatile memory 103. The liquid is fed at a liquid feed amount maintained at a constant value. The effective site concentration of the drug after feeding can be calculated by simulation based on the amount of the medicine to be delivered, the patient information stored in the nonvolatile memory 103, the kind of medicine to be delivered, and the like. it can. The liquid delivery of the medicine is performed by pressing the syringe pusher 202 as in step S103.
　図１４は、第２実施形態に係るシリンジポンプを使用して薬剤を送液した際の生体内における薬剤の濃度の変化の例を示すグラフである。ｄ０は血中濃度を示し、ｄ１は効果部位濃度を示し、Ｄ１は目標濃度を示す。そして、ｂ０はバイスペクトラルインデックスの値を示し、Ｂ１はバイスペクトラルインデックスの目標値を示す。また、Ｔ０は送液開始時刻を示し、Ｔ１は血中濃度ｄ０が目標濃度Ｄ１に達した時刻を示し、Ｔ２はバイスペクトラルインデックスｂ０の値が目標値Ｂ１に達した時刻を示す。 FIG. 14 is a graph showing an example of a change in the concentration of the drug in the living body when the drug is fed using the syringe pump according to the second embodiment. d0 represents blood concentration, d1 represents effect site concentration, and D1 represents target concentration. And b0 shows the value of a bispectral index, B1 shows the target value of a bispectral index. Further, T0 indicates a liquid feeding start time, T1 indicates a time when the blood concentration d0 reaches the target concentration D1, and T2 indicates a time when the value of the bispectral index b0 reaches the target value B1.
　第２実施形態に係るシリンジポンプは、時刻Ｔ０において上限導入流量を送液量の上限値として薬剤の送液を開始する。送液開始後、時刻Ｔ１において、血中濃度ｄ０が目標濃度Ｄ１に達する。さらに、送液を続けると、時刻Ｔ２において、バイスペクトラルインデックスｂ０の値が目標値Ｂ１に達する。このとき、送液量の上限値が、上限導入流量から上限維持流量に切り替えられる。また、効果部位濃度ｄ１は、時刻Ｔ２付近で目標濃度Ｄ１に達する。 The syringe pump according to the second embodiment starts feeding a drug at time T0 with the upper limit introduction flow rate as the upper limit value of the liquid feed amount. After the start of feeding, the blood concentration d0 reaches the target concentration D1 at time T1. Further, when the liquid feeding is continued, the value of the bispectral index b0 reaches the target value B1 at time T2. At this time, the upper limit value of the liquid feeding amount is switched from the upper limit introduction flow rate to the upper limit maintenance flow rate. Further, the effect site concentration d1 reaches the target concentration D1 in the vicinity of time T2.
　第１実施形態の場合と異なり、時刻Ｔ１から時刻Ｔ２の間において、血中濃度ｄ０は目標濃度に維持されない。第１実施形態では血中濃度を目標濃度に維持するように送液量を調整していたが、第２実施形態では効果部位濃度ｄ１を目標濃度に維持するように送液量を調整するためである。その結果、時刻Ｔ１から時刻Ｔ２の間における送液量は、第１実施形態の場合よりも第２実施形態の場合の方が相対的に大きくなる。従って、バイスペクトラルインデックスの値が目標値に達するまでに要する時間を、第１実施形態と比較して相対的に短くすることができる。 Unlike the case of the first embodiment, the blood concentration d0 is not maintained at the target concentration between time T1 and time T2. In the first embodiment, the liquid supply amount is adjusted so as to maintain the blood concentration at the target concentration. However, in the second embodiment, the liquid supply amount is adjusted so as to maintain the effective site concentration d1 at the target concentration. It is. As a result, the amount of liquid delivered between time T1 and time T2 is relatively greater in the second embodiment than in the first embodiment. Therefore, the time required for the value of the bispectral index to reach the target value can be relatively shortened as compared with the first embodiment.
　本実施形態によれば、効果部位濃度を目標濃度に維持するように薬剤を送液する際の送液量が調整される。これにより、効果部位濃度を目標濃度に速やかに到達させることができるため、薬剤の効能をより速やかに発現させることができる。 According to the present embodiment, the amount of liquid delivered when the drug is delivered is adjusted so as to maintain the effective site concentration at the target concentration. Thereby, since an effect site density | concentration can be made to reach | attain a target density | concentration rapidly, the effect of a chemical | medical agent can be expressed more rapidly.
　＜第３実施形態＞
　次に、本発明の第３実施形態に係るシリンジポンプを説明する。 <Third Embodiment>
Next, a syringe pump according to a third embodiment of the present invention will be described.
　第３実施形態に係るシリンジポンプは、制御部が行う送液量の調整に関する動作が、第１実施形態及びその変形例に係るシリンジポンプ１の制御部１００の動作と異なる。具体的には、第３実施形態に係るシリンジポンプの制御部は、制御部１００の動作に加えて、薬剤の送液量の調整をより最適に行うために以下の動作を行う。すなわち、第３実施形態に係るシリンジポンプの制御部は、バイスペクトラルインデックスの値が目標値に達しているか否かの判定を行うバイタル判定部としての機能に加えて、効果部位濃度が目標濃度に達しているか否かの判定を行う濃度判定部としての機能を有する。そして、バイスペクトラルインデックスの値が目標値に達しているか否か、及び、効果部位濃度が目標濃度に達しているか否かに応じて、不揮発性メモリに記憶されている目標濃度を変更する点が制御部１００と相違する。制御部以外の本体カバー２、表示部３、及び、操作パネル部４等の構成は第１実施形態と同じであるため、説明を省略する。また、第３実施形態に係るシリンジポンプの制御部の動作のうち、モータドライバ１３４の駆動などの動作は、第１実施形態と同じであるため説明を省略する。 In the syringe pump according to the third embodiment, the operation related to the adjustment of the liquid feeding amount performed by the control unit is different from the operation of the control unit 100 of the syringe pump 1 according to the first embodiment and its modification. Specifically, in addition to the operation of the control unit 100, the control unit of the syringe pump according to the third embodiment performs the following operation in order to more optimally adjust the liquid feeding amount of the medicine. That is, the control unit of the syringe pump according to the third embodiment has a function as a vital determination unit that determines whether or not the value of the bispectral index has reached the target value. It has a function as a density determination unit that determines whether or not it has been reached. Then, depending on whether the value of the bispectral index has reached the target value and whether the effect site concentration has reached the target concentration, the target concentration stored in the nonvolatile memory is changed. This is different from the control unit 100. Since the configuration of the main body cover 2, the display unit 3, and the operation panel unit 4 other than the control unit is the same as that of the first embodiment, the description thereof is omitted. Further, among the operations of the control unit of the syringe pump according to the third embodiment, operations such as driving of the motor driver 134 are the same as those in the first embodiment, and thus the description thereof is omitted.
　第３実施形態に係るシリンジポンプの制御部は、概説すれば、第１実施形態及びその変形例に係るシリンジポンプ１の制御部１００の動作に加えて、次の２つの動作を行う。 The controller of the syringe pump according to the third embodiment will perform the following two operations in addition to the operation of the controller 100 of the syringe pump 1 according to the first embodiment and the modification thereof, if outlined.
　第一の動作は、バイスペクトラルインデックスの値が目標値に達していないにも関わらず、効果部位濃度が目標濃度に達している場合に、不揮発性メモリに記憶されている目標濃度を所定の量だけ引き上げる動作である。これにより、後述するように、薬剤の送液量が必要以上に抑制されるのを防止して、薬剤の効能の発現を促すことができる。 The first operation is to set the target concentration stored in the nonvolatile memory to a predetermined amount when the effect site concentration has reached the target concentration even though the bispectral index value has not reached the target value. It is an operation to raise only. Thereby, as will be described later, it is possible to prevent the amount of the medicine to be fed more than necessary and promote the expression of the efficacy of the medicine.
　第二の動作は、バイスペクトラルインデックスの値が目標値に達しているにも関わらず、効果部位濃度が目標濃度に達していない場合に、不揮発性メモリに記憶されている目標濃度を所定の量だけ引き下げる動作である。これにより、後述するように、薬剤が過剰に送液されるのを防止できる。 The second operation is to set the target concentration stored in the nonvolatile memory to a predetermined amount when the effect site concentration does not reach the target concentration even though the value of the bispectral index has reached the target value. It is an operation to pull down only. Thereby, as will be described later, it is possible to prevent the medicine from being sent excessively.
　以下に、第３実施形態に係るシリンジポンプの制御部の動作について詳しく説明する。 Hereinafter, the operation of the control unit of the syringe pump according to the third embodiment will be described in detail.
　図１６は、第３実施形態に係るシリンジポンプの制御部が行う送液量の調整に関する動作を説明するフローチャートである。 FIG. 16 is a flowchart for explaining an operation related to adjustment of the liquid feeding amount performed by the control unit of the syringe pump according to the third embodiment.
　図１６に示す第３実施形態に係るシリンジポンプの制御部の動作は、効果部位濃度が目標濃度に達しているか否かを判定するステップＳ３１１及びステップＳ３１３、並びに、目標濃度を変更するステップＳ３１０及びステップＳ３１２を除いて、第１実施形態に係るシリンジポンプ１の制御部１００の動作と同じである。具体的には、上限導入流量を設定するステップＳ３０１は、ステップＳ１０１と同じである。また、送液終了条件を満たすか否かを判定するステップＳ３０２及びステップＳ３０６は、ステップＳ１０２及びステップＳ１０６と同じである。また、バイスペクトラルインデックスの値が目標値に達しているか否かを判定するステップＳ３０４及びステップＳ３０８は、ステップＳ１０４及びステップＳ１０８と同じである。また、上限値を切り替えるステップＳ３０５及びステップＳ３０９は、ステップＳ１０５及びステップＳ１０９と同じである。これらのステップについては説明を省略して、相違するステップＳ３１０～Ｓ３１３のみを以下に説明する。 The operation of the control unit of the syringe pump according to the third embodiment shown in FIG. 16 includes step S311 and step S313 for determining whether or not the effect site concentration has reached the target concentration, and step S310 for changing the target concentration. Except for step S312, the operation is the same as the operation of the control unit 100 of the syringe pump 1 according to the first embodiment. Specifically, step S301 for setting the upper limit introduction flow rate is the same as step S101. Further, Step S302 and Step S306 for determining whether or not the liquid feed end condition is satisfied are the same as Step S102 and Step S106. Further, Step S304 and Step S308 for determining whether or not the value of the bispectral index has reached the target value are the same as Step S104 and Step S108. Steps S305 and S309 for switching the upper limit value are the same as steps S105 and S109. Description of these steps is omitted, and only the different steps S310 to S313 are described below.
　効果部位濃度が目標濃度に達しているか否かを判定するステップＳ３１１では、次の処理が行われる。まず、ステップＳ３０３で送液された薬剤の量と、不揮発性メモリ１０３に記憶されている患者の情報及び送液する薬剤の種類などに基づいて、送液された薬剤の効果部位濃度をシミュレーションにより演算する。次に、演算された効果部位濃度が、不揮発性メモリ１０３に記憶されている目標濃度に達しているか否かを判定する。目標濃度に達していないと判定された場合は、ステップＳ３０２に戻る。目標濃度に達していると判定された場合は、ステップＳ３１０に進む。 In step S311 for determining whether or not the effect site concentration has reached the target concentration, the following processing is performed. First, based on the amount of the medicine delivered in step S303, the patient information stored in the nonvolatile memory 103, the kind of medicine to be delivered, and the like, the effect site concentration of the delivered medicine is simulated. Calculate. Next, it is determined whether or not the calculated effect site concentration has reached the target concentration stored in the nonvolatile memory 103. If it is determined that the target density has not been reached, the process returns to step S302. If it is determined that the target density has been reached, the process proceeds to step S310.
　目標濃度を変更するステップＳ３１０では、次の処理が行われる。すなわち、不揮発性メモリ１０３に記憶されている目標濃度を引き上げて、現在よりも高い目標濃度に変更する処理が行われる。変更後の目標濃度は、変更前の目標濃度から、変更前の目標濃度に調整幅を乗じたものを足し合わせて計算される。例えば、変更前の目標濃度を３．００ｍｃｇ／ｍｌ、調整幅を５．００％とした場合、（３．０＋３．０×０．０５）ｍｃｇ／ｍｌを変更後の目標濃度とする。変更後の目標濃度の算出方法は、変更後の目標濃度が変更前の目標濃度よりも高くなっていれば特に限定されない。 In step S310 for changing the target density, the following processing is performed. That is, processing for raising the target density stored in the nonvolatile memory 103 and changing it to a target density higher than the current density is performed. The target density after change is calculated by adding the target density before change multiplied by the adjustment width to the target density before change. For example, when the target concentration before change is 3.00 mcg / ml and the adjustment range is 5.00%, (3.0 + 3.0 × 0.05) mcg / ml is set as the target concentration after change. The method for calculating the target density after the change is not particularly limited as long as the target density after the change is higher than the target density before the change.
　効果部位濃度が目標濃度に達しているか否かを判定する別のステップＳ３１３では、次の処理が行われる。まず、ステップＳ３０７で送液された薬剤の量と、不揮発性メモリ１０３に記憶されている患者の情報及び送液する薬剤の種類などに基づいて、送液された薬剤の効果部位濃度をシミュレーションにより演算する。次に、演算された効果部位濃度が、不揮発性メモリ１０３に記憶されている目標濃度に達しているか否かを判定する。目標濃度に達していると判定された場合は、ステップＳ３０６に戻る。目標濃度に達していないと判定された場合は、ステップＳ３１２に進む。 In another step S313 for determining whether or not the effect site concentration has reached the target concentration, the following processing is performed. First, based on the amount of the medicine delivered in step S307, the patient information stored in the nonvolatile memory 103, the kind of medicine to be delivered, and the like, the effect site concentration of the delivered medicine is simulated. Calculate. Next, it is determined whether or not the calculated effect site concentration has reached the target concentration stored in the nonvolatile memory 103. If it is determined that the target density has been reached, the process returns to step S306. If it is determined that the target density has not been reached, the process proceeds to step S312.
　目標濃度を変更する別のステップＳ３１２では、次の処理が行われる。すなわち、不揮発性メモリ１０３に記憶されている目標濃度を引き下げて、現在よりも低い目標濃度に変更する処理が行われる。変更後の目標濃度は、変更前の目標濃度から、変更前の目標濃度に調整幅を乗じたものを差し引いて計算される。例えば、変更前の目標濃度を３．００ｍｃｇ／ｍｌ、調整幅を５．００％とした場合、（３．０－３．０×０．０５）ｍｃｇ／ｍｌを変更後の目標濃度とする。変更後の目標濃度の算出方法は、変更後の目標濃度が変更前の目標濃度よりも低くなっていれば特に限定されない。 In another step S312 for changing the target density, the following processing is performed. That is, a process is performed in which the target density stored in the nonvolatile memory 103 is lowered and changed to a target density lower than the current density. The target density after change is calculated by subtracting the target density before change multiplied by the adjustment width from the target density before change. For example, when the target concentration before change is 3.00 mcg / ml and the adjustment range is 5.00%, (3.0-3.0 × 0.05) mcg / ml is set as the target concentration after change. The method for calculating the target density after the change is not particularly limited as long as the target density after the change is lower than the target density before the change.
　調整幅は、表示部３の表示内容に従って操作パネル部４の操作ボタンを操作することで第３実施形態に係るシリンジポンプの制御部に入力することができる。そして、入力された調整幅は、不揮発性メモリ１０３に記憶することができる。 The adjustment width can be input to the control unit of the syringe pump according to the third embodiment by operating the operation button of the operation panel unit 4 according to the display content of the display unit 3. The input adjustment width can be stored in the nonvolatile memory 103.
　図１５は、調整幅を入力する際の表示部３の表示内容例を示す。図１５に示した表示内容例に従って操作パネル部４の操作ボタンを操作することで、調整幅を入力することができる。 FIG. 15 shows a display content example of the display unit 3 when inputting the adjustment width. By operating the operation button of the operation panel unit 4 according to the display content example shown in FIG. 15, the adjustment width can be input.
　図１７及び図１８は、第３実施形態に係るシリンジポンプを使用して薬剤を送液した際のバイスペクトラルインデックスの値、及び、生体内における薬剤の濃度の変化の例を示すグラフである。図１７及び図１８において、ｄ０は血中濃度を示し、ｄ１は効果部位濃度を示し、Ｄ１は送液開始時における目標濃度を示す。そして、ｂ０はバイスペクトルインデックスの値を示し、Ｂ１はバイスペクトラルインデックスの目標値を示す。また、Ｔ０は送液開始時刻を示す。図１７は、図１６に示す目標濃度の引き下げに関するステップＳ３１２及びステップＳ３１３が実行された場合の例を示す。また、図１８は、図１６に示す目標濃度の引き上げに関するステップＳ３１０及びステップＳ３１１が実行された場合の例を示す。図１７及び図１８を用いて、第３実施形態に係るシリンジポンプの制御部により実行される目標濃度の引き下げ及び目標濃度の引き上げに係る動作の作用を説明する。 FIG. 17 and FIG. 18 are graphs showing examples of changes in the bispectral index value and the concentration of the drug in the living body when the drug is fed using the syringe pump according to the third embodiment. 17 and 18, d0 indicates the blood concentration, d1 indicates the effect site concentration, and D1 indicates the target concentration at the start of liquid feeding. And b0 shows the value of a bispectral index, B1 shows the target value of a bispectral index. Moreover, T0 shows a liquid feeding start time. FIG. 17 shows an example in which steps S312 and S313 related to the reduction of the target density shown in FIG. 16 are executed. FIG. 18 shows an example of the case where steps S310 and S311 related to the target density increase shown in FIG. 16 are executed. With reference to FIGS. 17 and 18, the operation of the operation related to the lowering of the target concentration and the increase of the target concentration executed by the control unit of the syringe pump according to the third embodiment will be described.
　まず、図１７を参照して目標濃度の引き下げに係る動作の作用を説明する。図１７に示すように、第３実施形態に係るシリンジポンプは、時刻Ｔ０において上限導入流量を送液量の上限値として薬剤の送液を開始する。送液開始後、時刻Ｔ１において、血中濃度ｄ０が目標濃度Ｄ１に達する。さらに送液を続けると、時刻Ｔ２において、バイスペクトラルインデックスｂ０の値が目標値Ｂ１に達する。このとき、送液量の上限値が、上限導入流量から上限維持流量に切り替えられる。 First, the operation of the operation relating to the reduction of the target concentration will be described with reference to FIG. As shown in FIG. 17, the syringe pump according to the third embodiment starts feeding a drug at time T0 with the upper limit introduction flow rate as the upper limit value of the liquid feeding amount. After the start of feeding, the blood concentration d0 reaches the target concentration D1 at time T1. When the liquid supply is further continued, the value of the bispectral index b0 reaches the target value B1 at time T2. At this time, the upper limit value of the liquid feeding amount is switched from the upper limit introduction flow rate to the upper limit maintenance flow rate.
　ここで、時刻Ｔ２においてバイスペクトラルインデックスｂ０の値は目標値Ｂ１に達しているから、薬剤の効能は時刻Ｔ２において発現されているはずである。すなわち、薬剤の効能が発現される濃度として目標濃度Ｄ１が正しく設定されていれば、効果部位濃度ｄ１は時刻Ｔ２において目標濃度Ｄ１に達するはずである。しかし、図１７に示すように、バイスペクトラルインデックスｂ０の値が目標値Ｂ１に達しているにも関わらず、効果部位濃度ｄ１が目標濃度Ｄ１に達しない場合がある。この場合、効果部位濃度ｄ１が目標濃度Ｄ１に達する前に薬剤の効能が発現されているから、目標濃度Ｄ１は、薬剤の効能が発現される濃度として本来設定されるべき値よりも高めに設定されていたことになる。薬剤の送液量は、上限値を超えず、かつ、血中濃度ｄ０が目標濃度Ｄ１に維持されるように調整される。そのため、目標濃度Ｄ１が高めに設定されている場合、薬剤が過剰に送液される可能性があり好ましくない。 Here, since the value of the bispectral index b0 has reached the target value B1 at time T2, the efficacy of the drug should be expressed at time T2. That is, if the target concentration D1 is correctly set as the concentration at which the efficacy of the drug is expressed, the effective site concentration d1 should reach the target concentration D1 at time T2. However, as shown in FIG. 17, there is a case where the effect site concentration d1 does not reach the target concentration D1 even though the value of the bispectral index b0 reaches the target value B1. In this case, since the efficacy of the drug is expressed before the effective site concentration d1 reaches the target concentration D1, the target concentration D1 is set higher than the value that should be originally set as the concentration at which the efficacy of the drug is expressed. That would have been done. The amount of medicine to be fed is adjusted so that the upper limit is not exceeded and the blood concentration d0 is maintained at the target concentration D1. Therefore, when the target concentration D1 is set to a high value, there is a possibility that the medicine is excessively fed, which is not preferable.
　そこで、第３実施形態に係るシリンジポンプの制御部は、図１６に示したフローチャートに従って、目標濃度Ｄ１を目標濃度Ｄ１´に引き下げる。その結果、薬剤の送液量は、上限値を超えず、かつ、血中濃度ｄ０が目標濃度Ｄ１´に維持されるように調整される。目標濃度Ｄ１´は目標濃度Ｄ１よりも低いから、薬剤の効能が発現されている状態において薬剤が過剰に送液されるのを防止できる。なお、時刻Ｔ２において目標濃度Ｄ１が目標濃度Ｄ１´に引き下げられた後も、効果部位濃度ｄ１は上昇を続ける。従って、目標濃度Ｄ１が目標濃度Ｄ１´に引き下げられた後も、薬剤の効能が発現された状態は維持される。 Therefore, the control unit of the syringe pump according to the third embodiment lowers the target concentration D1 to the target concentration D1 ′ according to the flowchart shown in FIG. As a result, the amount of liquid to be delivered is adjusted so as not to exceed the upper limit value and the blood concentration d0 is maintained at the target concentration D1 ′. Since the target concentration D1 ′ is lower than the target concentration D1, it is possible to prevent the drug from being excessively fed in a state where the drug efficacy is expressed. Even after the target concentration D1 is lowered to the target concentration D1 ′ at time T2, the effective site concentration d1 continues to increase. Therefore, even after the target concentration D1 is lowered to the target concentration D1 ′, the state where the efficacy of the drug is expressed is maintained.
　次に、図１８を参照して目標濃度の引き上げに係る動作の作用を説明する。図１８に示すように、第３実施形態に係るシリンジポンプは、時刻Ｔ０において上限導入流量を送液量の上限値として薬剤の送液を開始する。送液開始後、時刻Ｔ１において、血中濃度ｄ０が目標濃度Ｄ１に達する。さらに、送液を続けると、時刻Ｔ２において、効果部位濃度ｄ１が目標濃度Ｄ１に達する。 Next, the operation of the operation related to raising the target concentration will be described with reference to FIG. As shown in FIG. 18, the syringe pump according to the third embodiment starts feeding a medicine at time T0 with the upper limit introduction flow rate as the upper limit value of the liquid feeding amount. After the start of feeding, the blood concentration d0 reaches the target concentration D1 at time T1. Further, when the liquid feeding is continued, the effect site concentration d1 reaches the target concentration D1 at time T2.
　ここで、効果部位濃度ｄ１が目標濃度Ｄ１に達するから、薬剤の効能は時刻Ｔ２において発現されているべきである。すなわち、薬剤の効能が発現される濃度として目標濃度Ｄ１が正しく設定されていれば、バイスペクトラルインデックスｂ０の値は時刻Ｔ２において目標値Ｂ１に達するはずである。しかし、図１８に示すように、効果部位濃度ｄ１が目標濃度Ｄ１に達しているにも関わらず、バイスペクトラルインデックスｂ０の値が目標値Ｂ１に達していない場合がある。この場合、効果部位濃度ｄ１が目標濃度Ｄ１に達しているにも関わらず薬剤の効能が発現されていないから、目標濃度Ｄ１は薬剤の効能が発現される濃度として本来設定されるべき値よりも低めに設定されていたことになる。薬剤の送液量は、上限値を超えず、かつ、血中濃度ｄ０が目標濃度Ｄ１に維持されるように調整される。そのため、目標濃度Ｄ１が低めに設定されている場合、薬剤の送液量が必要以上に抑制される可能性があり好ましくない。 Here, since the effect site concentration d1 reaches the target concentration D1, the efficacy of the drug should be expressed at time T2. That is, if the target concentration D1 is correctly set as the concentration at which the efficacy of the drug is expressed, the value of the bispectral index b0 should reach the target value B1 at time T2. However, as shown in FIG. 18, there are cases where the value of the bispectral index b0 does not reach the target value B1 even though the effect site density d1 has reached the target density D1. In this case, since the effect of the drug is not expressed in spite of the effect site concentration d1 reaching the target concentration D1, the target concentration D1 is higher than the value that should be originally set as the concentration at which the effect of the drug is expressed. It was set low. The amount of medicine to be fed is adjusted so that the upper limit is not exceeded and the blood concentration d0 is maintained at the target concentration D1. For this reason, when the target concentration D1 is set to be low, the amount of the medicine to be fed may be suppressed more than necessary, which is not preferable.
　そこで、第３実施形態に係るシリンジポンプの制御部は、図１６に示したフローチャートに従って、目標濃度Ｄ１を目標濃度Ｄ１´に引き上げる。その結果、薬剤の送液量は、上限値を超えず、かつ、血中濃度ｄ０が目標濃度Ｄ１´に維持されるように調整される。目標濃度Ｄ１´は目標濃度Ｄ１よりも高いから、血中濃度を上げるために薬剤の送液量は増加する。これにより、薬剤の効能の発現が促される。 Therefore, the control unit of the syringe pump according to the third embodiment raises the target concentration D1 to the target concentration D1 ′ according to the flowchart shown in FIG. As a result, the amount of liquid to be delivered is adjusted so as not to exceed the upper limit value and the blood concentration d0 is maintained at the target concentration D1 ′. Since the target concentration D1 ′ is higher than the target concentration D1, the amount of drug delivered increases in order to increase the blood concentration. Thereby, the expression of the efficacy of the drug is promoted.
　本実施形態によれば、バイスペクトラルインデックスの値が所定の目標値に達しているか否か、及び、効果部位濃度が所定の目標濃度に達しているか否かの判定結果に応じて目標濃度が調整される。これにより、薬剤の効能が発現されているか否かに応じた送液量の調整がより最適になされるため安全性がさらに向上する。 According to the present embodiment, the target concentration is adjusted according to whether or not the value of the bispectral index has reached a predetermined target value and whether or not the effect site concentration has reached the predetermined target concentration. Is done. Thereby, since the adjustment of the liquid feeding amount according to whether or not the efficacy of the drug is expressed is more optimal, the safety is further improved.
　なお、本実施形態に係る制御部は、血中濃度が目標濃度に維持されるように送液量を調整している場合において目標濃度を変更したが、これに限定されない。例えば、効果部位濃度が目標濃度に維持されるように送液量を調整している場合において目標濃度を変更してもよい。このように本実施形態に係る制御部を構成することにより、適用する手技や薬剤の種類などに応じて、さらに適切に送液量を調整しながら薬剤を送液できる。 In addition, although the control part which concerns on this embodiment changed the target density | concentration in the case where the amount of liquid feeding was adjusted so that the blood density | concentration may be maintained at a target density | concentration, it is not limited to this. For example, the target concentration may be changed when the liquid delivery amount is adjusted so that the effect site concentration is maintained at the target concentration. As described above, by configuring the control unit according to the present embodiment, it is possible to feed the medicine while adjusting the liquid feeding amount more appropriately according to the technique to be applied, the kind of the medicine, or the like.
　＜第４実施形態＞
　次に、本発明の第４実施形態に係るシリンジポンプを説明する。 <Fourth embodiment>
Next, a syringe pump according to a fourth embodiment of the present invention will be described.
　第４実施形態に係るシリンジポンプは、制御部が行う送液量の調整に関する動作が、第１実施形態及びその変形例に係るシリンジポンプの制御部１００の動作と異なる。具体的には、第４実施形態に係るシリンジポンプの制御部は、制御部１００の動作に加えて、薬剤の送液量の調整をより適切に行うためにバイスペクトラルインデックスの値が所定の限界値に達した場合に送液を停止する点が制御部１００と相違する。制御部以外の本体カバー２、表示部３、及び、操作パネル部４等の構成は第１実施形態と同じであるため、説明を省略する。また、第４実施形態に係るシリンジポンプの制御部の動作のうち、モータドライバ１３４の駆動などの動作は、第１実施形態と同じであるため説明を省略する。 In the syringe pump according to the fourth embodiment, the operation related to the adjustment of the liquid feeding amount performed by the control unit is different from the operation of the control unit 100 of the syringe pump according to the first embodiment and its modification. Specifically, in addition to the operation of the control unit 100, the control unit of the syringe pump according to the fourth embodiment has a bispectral index value of a predetermined limit in order to more appropriately adjust the amount of liquid to be delivered. It differs from the control unit 100 in that the liquid feeding is stopped when the value is reached. Since the configuration of the main body cover 2, the display unit 3, and the operation panel unit 4 other than the control unit is the same as that of the first embodiment, the description thereof is omitted. Further, among the operations of the control unit of the syringe pump according to the fourth embodiment, operations such as driving of the motor driver 134 are the same as those in the first embodiment, and thus the description thereof is omitted.
　第４実施形態に係る制御部は、第１実施形態で説明したバイスペクトラルインデックスの目標値等の入力に加えて、バイスペクトラルインデックスの限界値の入力を受け付ける。 The control unit according to the fourth embodiment accepts input of the limit value of the bispectral index in addition to the input of the target value of the bispectral index described in the first embodiment.
　バイスペクトラルインデックスの限界値は、表示部３の表示内容に従って操作パネル部４の操作ボタンを操作することで第４実施形態に係る制御部に入力することができる。 The limit value of the bispectral index can be input to the control unit according to the fourth embodiment by operating the operation button of the operation panel unit 4 according to the display content of the display unit 3.
　図１９は、バイスペクトラルインデックスの限界値を入力する際の表示部３の表示内容例を示す。図１９に示した表示内容例に従って操作パネル部４の操作ボタンを操作することで、バイスペクトラルインデックスの限界値を入力することができる。 FIG. 19 shows an example of display contents of the display unit 3 when inputting the limit value of the bispectral index. The limit value of the bispectral index can be input by operating the operation button of the operation panel unit 4 in accordance with the display content example shown in FIG.
　図２０は、第４実施形態に係るシリンジポンプの制御部が行う送液量の調整に関する動作を説明するフローチャートである。 FIG. 20 is a flowchart for explaining the operation related to the adjustment of the liquid feeding amount performed by the control unit of the syringe pump according to the fourth embodiment.
　図２０に示す第４実施形態に係るシリンジポンプの制御部の動作は、バイスペクトラルインデックスの値が限界値に達しているか否かを判定するステップＳ４１０を除いて、第１実施形態に係るシリンジポンプ１の制御部１００の動作と同じである。具体的には、上限導入流量を設定するステップＳ４０１は、ステップＳ１０１と同じである。また、送液終了条件を満たすか否かを判定するステップＳ４０２及びステップＳ４０６は、ステップＳ１０２及びステップＳ１０６と同じである。また、バイスペクトラルインデックスの値が目標値に達しているか否かを判定するステップＳ４０４及びステップＳ４０８は、ステップＳ１０４及びステップＳ１０８と同じである。また、上限値を切り替えるステップＳ４０５及びステップＳ４０９は、ステップＳ１０５及びステップＳ１０９と同じである。これらのステップについては説明を省略して、相違するステップＳ４１０のみを以下に説明する。 The operation of the control unit of the syringe pump according to the fourth embodiment shown in FIG. 20 is the syringe pump according to the first embodiment except for step S410 in which it is determined whether or not the bispectral index value has reached the limit value. The operation is the same as that of the first control unit 100. Specifically, step S401 for setting the upper limit introduction flow rate is the same as step S101. Further, Step S402 and Step S406 for determining whether or not the liquid feed end condition is satisfied are the same as Step S102 and Step S106. Steps S404 and S408 for determining whether or not the bispectral index value has reached the target value are the same as steps S104 and S108. Further, step S405 and step S409 for switching the upper limit value are the same as step S105 and step S109. Description of these steps will be omitted, and only the different step S410 will be described below.
　バイスペクトラルインデックスの値が限界値に達しているか否かを判定するステップＳ４１０は、次のことを目的としている。すなわち、バイスペクトラルインデックスの値が不揮発性メモリ１０３に記憶されているバイスペクトラルインデックスの限界値に達している場合には、薬剤の送液は行わないことを目的としている。 Step S410 for determining whether or not the value of the bispectral index has reached the limit value is aimed at the following. That is, when the value of the bispectral index has reached the limit value of the bispectral index stored in the nonvolatile memory 103, the purpose is to prevent the medicine from being fed.
　ステップＳ４１０では、次の処理が行われる。すなわち、バイスペクトラルインデックスの値と、不揮発性メモリ１０３に記憶されているバイスペクトラルインデックスの限界値とを比較する。そして、バイスペクトラルインデックスの値が不揮発性メモリ１０３に記憶されているバイスペクトラルインデックスの限界値に達している場合には、ステップＳ４０６に戻る。バイスペクトラルインデックスの値が不揮発性メモリ１０３に記憶されているバイスペクトラルインデックスの限界値に達していない場合には、ステップＳ４０７に進む。 In step S410, the following processing is performed. That is, the value of the bispectral index is compared with the limit value of the bispectral index stored in the nonvolatile memory 103. When the bispectral index value has reached the limit value of the bispectral index stored in the nonvolatile memory 103, the process returns to step S406. If the bispectral index value has not reached the limit value of the bispectral index stored in the nonvolatile memory 103, the process proceeds to step S407.
　図２１は、第４実施形態に係るシリンジポンプを使用して薬剤を送液した際の生体内における薬剤の濃度の変化の例を示すグラフである。ｄ０は血中濃度を示し、ｄ１は効果部位濃度を示し、Ｄ１は送液開始時における目標濃度を示す。そして、ｂ０はバイスペクトラルインデックスの値を示し、Ｂ１はバイスペクトラルインデックスの目標値を示す。また、Ｔ０は送液開始時刻を示す。 FIG. 21 is a graph showing an example of changes in the concentration of the drug in the living body when the drug is fed using the syringe pump according to the fourth embodiment. d0 represents the blood concentration, d1 represents the effect site concentration, and D1 represents the target concentration at the start of liquid delivery. And b0 shows the value of a bispectral index, B1 shows the target value of a bispectral index. Moreover, T0 shows a liquid feeding start time.
　図２１を参照して、図２０を用いて上述した第４実施形態に係るシリンジポンプの制御部の動作の作用を説明する。図２１に示すように、第４実施形態に係るシリンジポンプは、時刻Ｔ０において上限導入流量を送液量の上限値として薬剤の送液を開始する。送液開始後、時刻Ｔ１において、血中濃度ｄ０が目標濃度Ｄ１に達する。さらに、送液を続けると、時刻Ｔ２において、バイスペクトラルインデックスｂ０の値が目標値Ｂ１に達する。このとき、送液量の上限値が、上限導入流量から上限維持流量に切り替えられる。 Referring to FIG. 21, the operation of the control unit of the syringe pump according to the fourth embodiment described above will be described with reference to FIG. As shown in FIG. 21, the syringe pump according to the fourth embodiment starts feeding a medicine at time T0 with the upper limit introduction flow rate as the upper limit value of the liquid feeding amount. After the start of feeding, the blood concentration d0 reaches the target concentration D1 at time T1. Further, when the liquid feeding is continued, the value of the bispectral index b0 reaches the target value B1 at time T2. At this time, the upper limit value of the liquid feeding amount is switched from the upper limit introduction flow rate to the upper limit maintenance flow rate.
　ここで、時刻Ｔ２においてバイスペクトラルインデックスｂ０の値は目標値Ｂ１に達しているから、薬剤の効能は時刻Ｔ２において発現されているはずである。すなわち、薬剤の効能が発現される濃度として目標濃度Ｄ１が正しく設定されていれば、効果部位濃度ｄ１は時刻Ｔ２において目標濃度Ｄ１に達するはずである。しかし、図２１に示すように、バイスペクトラルインデックスｂ０の値が目標値Ｂ１に達しているにも関わらず、効果部位濃度ｄ１が目標濃度Ｄ１に達していない場合がある。この場合、時刻Ｔ２において薬剤の効能が発現されているにも関わらず、効果部位濃度ｄ１は時刻Ｔ２以降も上昇し続ける。その結果、薬剤の効能が必要以上に発現される可能性があり好ましくない。 Here, since the value of the bispectral index b0 has reached the target value B1 at time T2, the efficacy of the drug should be expressed at time T2. That is, if the target concentration D1 is correctly set as the concentration at which the efficacy of the drug is expressed, the effective site concentration d1 should reach the target concentration D1 at time T2. However, as shown in FIG. 21, although the value of the bispectral index b0 has reached the target value B1, the effective site concentration d1 may not reach the target concentration D1. In this case, the effect site concentration d1 continues to increase after time T2 even though the efficacy of the drug is expressed at time T2. As a result, the efficacy of the drug may be expressed more than necessary, which is not preferable.
　そこで、第４実施形態に係るシリンジポンプの制御部は、図２０に示したフローチャートに従って、バイスペクトラルインデックスｂ０の値が限界値ＢＬに達したときに送液を停止する。図２１に示す例では、時刻Ｔ３において薬剤の送液が停止される。その結果、時刻Ｔ３以降において効果部位濃度ｄ１の上昇が緩慢になり、薬剤の効能が必要以上に発現されるのを防止できる。 Therefore, the control unit of the syringe pump according to the fourth embodiment stops the liquid feeding when the value of the bispectral index b0 reaches the limit value BL according to the flowchart shown in FIG. In the example shown in FIG. 21, the liquid feeding of the medicine is stopped at time T3. As a result, after the time T3, the increase in the effective site concentration d1 becomes slow, and it can be prevented that the efficacy of the drug is unnecessarily expressed.
　なお、薬剤の送液を停止することにより薬剤の効能の発現が弱まると、バイスペクトラルインデックスｂ０の値は上昇に転ずる。その結果、図２１に示すように、時刻Ｔ４においてバイスペクトラルインデックスｂ０の値は限界値ＢＬに戻る。そのため、時刻Ｔ４において薬剤の送液が再開されるから、薬剤の効能の発現が必要以上に弱まることはない。 In addition, when expression of the efficacy of the medicine is weakened by stopping the delivery of the medicine, the value of the bispectral index b0 starts to increase. As a result, as shown in FIG. 21, the value of the bispectral index b0 returns to the limit value BL at time T4. Therefore, since the liquid delivery of the medicine is resumed at time T4, the expression of the efficacy of the medicine is not weakened more than necessary.
　本実施形態によれば、バイスペクトラルインデックスの値が所定の限界値に達したときに送液を停止する。これにより、必要以上に薬剤の効能が発現されるのを防止できるため安全性がさらに向上する。 According to the present embodiment, the liquid feeding is stopped when the value of the bispectral index reaches a predetermined limit value. Thereby, since it can prevent that the effect of a medicine is expressed more than necessary, safety | security improves further.
　なお、本実施形態に係る制御部は、血中濃度が目標濃度に維持されるように送液量を調整している場合において、バイスペクトラルインデックスの値が限界値に達したときに送液を停止したが、これに限定されない。例えば、効果部位濃度が目標濃度に維持されるように送液量を調整している場合において、バイスペクトラルインデックスの値が限界値に達したときに送液を停止してもよい。このように本実施形態に係る制御部を構成することにより、適用する手技や薬剤の種類などに応じて、より適切に送液量を調整しながら薬剤を送液できる。 In addition, the control unit according to the present embodiment adjusts the liquid supply amount so that the blood concentration is maintained at the target concentration, and the liquid supply is performed when the value of the bispectral index reaches a limit value. Although it stopped, it is not limited to this. For example, in the case where the liquid supply amount is adjusted so that the effect site concentration is maintained at the target concentration, the liquid supply may be stopped when the value of the bispectral index reaches a limit value. By configuring the control unit according to the present embodiment as described above, the medicine can be delivered while adjusting the liquid delivery amount more appropriately according to the technique to be applied, the kind of the medicine, or the like.
　＜第５実施形態＞
　次に、本発明の第５実施形態に係るシリンジポンプを説明する。 <Fifth Embodiment>
Next, a syringe pump according to a fifth embodiment of the present invention will be described.
　第５実施形態に係るシリンジポンプは、制御部が行う送液量の調整に関する動作が、第１実施形態及びその変形例に係るシリンジポンプの制御部１００の動作と次の点で異なる。すなわち、第１実施形態及びその変形例に係るシリンジポンプの制御部１００では、目標濃度に維持する対象の濃度は既定されていた。一方、第５実施形態に係るシリンジポンプの制御部は、安全性及び利便性を向上させるために、目標濃度に維持する対象の濃度を指定できる点が、第１実施形態及びその変形例に係るシリンジポンプの制御部１００と異なる。 In the syringe pump according to the fifth embodiment, the operation related to the adjustment of the liquid feeding amount performed by the control unit is different from the operation of the control unit 100 of the syringe pump according to the first embodiment and the modification thereof in the following points. That is, in the control unit 100 of the syringe pump according to the first embodiment and the modification thereof, the target concentration to be maintained at the target concentration is predetermined. On the other hand, the control part of the syringe pump according to the fifth embodiment relates to the first embodiment and its modification, in that the concentration of the target to be maintained at the target concentration can be specified in order to improve safety and convenience. Different from the control unit 100 of the syringe pump.
　制御部以外の本体カバー２、表示部３、及び、操作パネル部４等の構成は第１実施形態と同じであるため説明を省略する。また、第５実施形態に係るシリンジポンプの制御部の動作のうち、モータドライバ１３４の駆動やバイスペクトラルインデックスの目標値等の入力の受け付けなどの動作は、第１実施形態と同じであるため説明を省略する。 Since the configuration of the main body cover 2, the display unit 3, the operation panel unit 4 and the like other than the control unit is the same as that of the first embodiment, the description thereof is omitted. In addition, among the operations of the control unit of the syringe pump according to the fifth embodiment, operations such as driving the motor driver 134 and receiving input such as a target value of the bispectral index are the same as in the first embodiment. Is omitted.
　以下に、第５実施形態に係るシリンジポンプの制御部が行う送液量の調整に関する動作を説明する。ただし、次の動作については、第１実施形態及びその変形例に係るシリンジポンプの制御部１００における動作と同じであるため説明を省略する。すなわち、バイスペクトラルインデックスの値が目標値に達しているか否かの判定をする動作、送液条件を満たすか否かの判定をする動作、及び、上限値を超えない送液量で送液する動作などは説明を省略する。 Hereinafter, the operation related to the adjustment of the liquid feeding amount performed by the control unit of the syringe pump according to the fifth embodiment will be described. However, since the next operation is the same as the operation in the control unit 100 of the syringe pump according to the first embodiment and the modification thereof, the description thereof is omitted. That is, the operation for determining whether or not the bispectral index value has reached the target value, the operation for determining whether or not the liquid supply condition is satisfied, and the liquid supply amount that does not exceed the upper limit value Description of operations and the like is omitted.
　第５実施形態に係るシリンジポンプの制御部は、目標濃度に維持する対象として指定された濃度を目標濃度に維持するように送液量を調整する。 The control unit of the syringe pump according to the fifth embodiment adjusts the liquid feeding amount so that the concentration designated as the target to be maintained at the target concentration is maintained at the target concentration.
　具体的には、第５実施形態に係るシリンジポンプの制御部は、目標濃度に維持する対象として効果部位濃度が指定された場合、シミュレーションされた効果部位濃度が目標濃度に維持されるように送液量を調整する。また、第５実施形態に係るシリンジポンプの制御部は、目標濃度に維持する対象として血中濃度が指定された場合、シミュレーションされた血中濃度が目標濃度に維持されるように送液量を調整する。 Specifically, when the effective site concentration is designated as an object to be maintained at the target concentration, the control unit of the syringe pump according to the fifth embodiment sends the simulated effective site concentration so as to be maintained at the target concentration. Adjust the liquid volume. In addition, when the blood concentration is designated as the target to be maintained at the target concentration, the control unit of the syringe pump according to the fifth embodiment controls the amount of liquid delivered so that the simulated blood concentration is maintained at the target concentration. adjust.
　目標濃度に維持する対象の濃度は、種々の方法で第５実施形態に係る制御部に指定することができる。 The target concentration to be maintained at the target concentration can be designated to the control unit according to the fifth embodiment by various methods.
　例えば、図２２に示す表示部３の表示内容例に従って、操作パネル部４の操作ボタンを操作することで、目標濃度に維持する対象の濃度を第５実施形態に係る制御部に指定することができる。 For example, according to the display content example of the display unit 3 shown in FIG. 22, by operating the operation button of the operation panel unit 4, the target density to be maintained at the target density can be designated to the control unit according to the fifth embodiment. it can.
　本実施形態によれば、適用する手技や薬剤の種類などに応じて、目標濃度に維持する対象の濃度を適切に設定することが容易になるため安全性や利便性がさらに向上する。 According to the present embodiment, safety and convenience are further improved because it is easy to appropriately set the target concentration to be maintained at the target concentration according to the technique to be applied and the type of medicine.
　以上、本願発明に係るシリンジポンプを実施形態及び各変形例を通じて説明したが、本願発明に係るシリンジポンプはこれらの構成のみに限定されるものではなく、特許請求の範囲の記載に基づいて種々改変することが可能である。 As mentioned above, although the syringe pump which concerns on this invention was demonstrated through embodiment and each modification, the syringe pump which concerns on this invention is not limited only to these structures, Various modifications based on description of a claim Is possible.
　例えば、第１実施形態～第５実施形態において、送液された薬剤の効能が発現しているか否かの判定はバイスペクトラルインデックスの値を用いて行われたが、送液される薬剤の種類に応じて別の観測値が用いられてもよい。例えば、血圧や体温、脈拍、眼球運動度合いなどの観測値と送液される薬剤の効能の発現状態との間に一定の関係が認められる場合には、当該観測値を用いて薬剤の効能が発現しているか否かを判定してもよい。 For example, in the first to fifth embodiments, the determination as to whether or not the efficacy of the delivered drug is manifested is made using the bispectral index value. Depending on, another observation may be used. For example, if a certain relationship is observed between the observed values such as blood pressure, body temperature, pulse, eye movement, etc. and the state of manifestation of the efficacy of the drug being delivered, the efficacy of the drug can be determined using the observed values. It may be determined whether or not it is expressed.
　また、第１実施形態～第５実施形態及びその変形例に記載した構成を適宜組み合わせることも可能である。例えば、第１実施形態の構成に加えて、第３実施形態として記載した目標濃度の変更に係る制御部の構成及び第４実施形態として記載した送液の停止に係る制御部の構成を有するように本願発明に係るシリンジポンプを構成してもよい。 Also, the configurations described in the first to fifth embodiments and the modifications thereof can be combined as appropriate. For example, in addition to the configuration of the first embodiment, the configuration of the control unit according to the target concentration change described as the third embodiment and the configuration of the control unit according to the stop of liquid feeding described as the fourth embodiment You may comprise the syringe pump which concerns on this invention.
　上述した実施形態及び変形例では、シリンジポンプに本願発明を適用した場合を説明したが、それに限定されない。本願発明は、薬剤の送液量を調整可能な輸液ポンプなどの医療用の送液ポンプに広く適用することが可能である。 In the embodiment and the modification described above, the case where the present invention is applied to the syringe pump has been described, but the present invention is not limited thereto. The present invention can be widely applied to medical liquid feeding pumps such as an infusion pump capable of adjusting the liquid feeding amount of a medicine.
　本出願は、２０１４年３月２０日に出願された日本特許出願番号２０１４－０５８５８９号に基づいており、その開示内容は、参照され、全体として、組み入れられている。 This application is based on Japanese Patent Application No. 2014-058589 filed on March 20, 2014, the disclosure of which is referenced and incorporated as a whole.
１　シリンジポンプ、
２　本体カバー、
２Ａ　本体カバーの上部分、
２Ｂ　本体カバーの下部分、
３　表示部、
４　操作パネル部、
５　クランプ、
６　シリンジ設定部、
７　シリンジ押子駆動部、
８　収容部、
９　チューブ固定部、
１００　制御部、
１０３　不揮発性メモリ、
２００、３００、４００　シリンジ、
２０１、３０１、４０１　シリンジ本体、
２０２、３０２、４０２　シリンジ押子、
５００　ＢＩＳモニタ。
  1 syringe pump,
2 Body cover,
2A The upper part of the body cover,
2B Lower part of the body cover,
3 Display section,
4 Operation panel section,
5 Clamp,
6 Syringe setting part,
7 Syringe pusher drive part,
8 containment section,
9 Tube fixing part,
100 control unit,
103 non-volatile memory,
200, 300, 400 syringe,
201, 301, 401 syringe body,
202, 302, 402 Syringe pusher,
500 BIS monitor.

Claims (11)

  1. 　送液した薬剤の生体内における濃度をシミュレートしながら、前記薬剤を送液する送液ポンプであって、
    　前記薬剤が送液された前記生体のバイタルの変動を観測する観測部と、
    　送液された前記薬剤の量に基づいて、前記薬剤の生体内における濃度を演算する演算部と、
    　前記観測部によって観測された値が所定の目標値に達しているか否かを判定するバイタル判定部と、
    　前記薬剤の上限導入流量と、前記薬剤の上限維持流量と、前記演算部により演算された前記薬剤の血中濃度または効果部位濃度の目標濃度と、前記目標値と、を記憶する記憶部と、
    　前記目標濃度と前記目標値の入力を受け付ける受付部と、
    　前記バイタル判定部の判定結果に応じて、前記薬剤の送液量の上限値を前記上限導入流量または前記上限維持流量に切り替える上限値切り替え部と、
    　前記血中濃度または前記効果部位濃度が前記目標濃度を維持するように前記上限値を超えない範囲で前記薬剤の送液量を調整する調整部と、を有する送液ポンプ。     A liquid delivery pump for delivering the medicine while simulating the concentration of the delivered medicine in the living body,
    An observation unit for observing changes in vitals of the living body to which the medicine has been fed;
    Based on the amount of the delivered drug, a calculation unit that calculates the concentration of the drug in the living body,
    A vital determination unit that determines whether or not the value observed by the observation unit has reached a predetermined target value;
    A storage unit that stores the upper limit introduction flow rate of the drug, the upper limit maintenance flow rate of the drug, the target concentration of the blood concentration or effect site concentration of the drug calculated by the calculation unit, and the target value;
    An accepting unit for receiving inputs of the target concentration and the target value;
    According to the determination result of the vital determination unit, an upper limit value switching unit that switches the upper limit value of the liquid delivery amount of the medicine to the upper limit introduction flow rate or the upper limit maintenance flow rate,
    An adjustment unit that adjusts the amount of the drug to be supplied within a range that does not exceed the upper limit value so that the blood concentration or the effect site concentration maintains the target concentration.
  2. 　前記上限値切り替え部は、前記上限値として前記上限導入流量が設定されている場合において、前記観測部によって観測された値が前記目標値に達していると前記バイタル判定部により判定された際は、前記上限値を前記上限維持流量に切り替える、請求項１に記載の送液ポンプ。 The upper limit switching unit, when the upper limit introduction flow rate is set as the upper limit value, when the vital determination unit determines that the value observed by the observation unit has reached the target value The liquid feed pump according to claim 1, wherein the upper limit value is switched to the upper limit maintenance flow rate.
  3. 　前記上限値切り替え部は、前記上限値として前記上限維持流量が設定されている場合において、前記観測部によって観測された値が前記目標値に達していないと前記バイタル判定部により判定された際は、前記上限値を前記上限導入流量に切り替える、請求項１または請求項２に記載の送液ポンプ。 The upper limit switching unit, when the upper limit maintenance flow rate is set as the upper limit value, when the vital determination unit determines that the value observed by the observation unit has not reached the target value The liquid feed pump according to claim 1, wherein the upper limit value is switched to the upper limit introduction flow rate.
  4. 　前記調整部は、前記観測部によって観測された値が所定の限界値に達した場合に送液を停止する請求項１～３のいずれか１項に記載の送液ポンプ。 The liquid feeding pump according to any one of claims 1 to 3, wherein the adjustment unit stops liquid feeding when a value observed by the observation unit reaches a predetermined limit value.
  5. 　さらに前記血中濃度または前記効果部位濃度が前記目標濃度に達しているか否かを判定する濃度判定部を有し、前記記憶部に記憶されている前記目標濃度を前記バイタル判定部と前記濃度判定部の判定結果に応じて変更可能に管理する目標濃度管理部をさらに有する請求項１～４のいずれか１項に記載の送液ポンプ。 Furthermore, it has a density | concentration determination part which determines whether the said blood density | concentration or the said effect site density | concentration has reached the said target density | concentration, The said target density | concentration memorize | stored in the said memory | storage part is used as the said vitality judgment part and the said concentration determination The liquid feed pump according to any one of claims 1 to 4, further comprising a target concentration management unit that can be changed according to a determination result of the unit.
  6. 　前記受付部は、さらに前記上限導入流量と前記上限維持流量の入力を受け付け、前記上限維持流量が前記上限導入流量を超える入力の受け付けを制限する、請求項１～５のいずれか１項に記載の送液ポンプ。 The reception unit according to any one of claims 1 to 5, wherein the reception unit further receives input of the upper limit introduction flow rate and the upper limit maintenance flow rate, and restricts reception of an input in which the upper limit maintenance flow rate exceeds the upper limit introduction flow rate. Liquid pump.
  7. 　前記受付部は、送液中において前記目標値の入力を受け付ける、請求項１～６のいずれか１項に記載の送液ポンプ。 The liquid feeding pump according to any one of claims 1 to 6, wherein the receiving unit receives an input of the target value during liquid feeding.
  8. 　前記受付部は、送液中において前記目標濃度の入力を受け付ける、請求項１～７のいずれか１項に記載の送液ポンプ。 The liquid feeding pump according to any one of claims 1 to 7, wherein the receiving unit receives an input of the target concentration during liquid feeding.
  9. 　前記バイタル判定部は、前記観測部によって観測された値が前記目標値を基準とする所定の許容範囲の範囲内に含まれるときに、前記観測部によって観測された値が前記目標値に達したものと判定する、請求項１～８のいずれか１項に記載の送液ポンプ。 The vital determination unit is configured such that when the value observed by the observation unit is included within a predetermined allowable range based on the target value, the value observed by the observation unit reaches the target value. The liquid feed pump according to any one of claims 1 to 8, wherein the liquid feed pump is determined to be one.
  10. 　前記上限値が切り替えられたことをユーザーに知らせる報知部を有する請求項１～９のいずれか１項に記載の送液ポンプ。 The liquid feed pump according to any one of claims 1 to 9, further comprising a notification unit that notifies a user that the upper limit value has been switched.
  11. 　前記観測部が観測するバイタルは、バイスペクトラルインデックスである請求項１～１０のいずれか１項に記載の送液ポンプ。 The liquid feed pump according to any one of claims 1 to 10, wherein a vital observed by the observation unit is a bispectral index.
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