WO2016023747A1

WO2016023747A1 - Modular oropharyngeal airway

Info

Publication number: WO2016023747A1
Application number: PCT/EP2015/067255
Authority: WO
Inventors: Jean-Christophe OZENNE
Original assignee: Deltamedics
Priority date: 2014-08-12
Filing date: 2015-07-28
Publication date: 2016-02-18
Also published as: FR3024837B1; FR3024837A1

Abstract

The invention relates to an oropharyngeal airway (1, 101) comprising a collar (3, 103) which is suitable for resting on the lips of a patient, an inwardly curved body (2, 102) for being inserted into the mouth of patient and blocking tongue of said patient, the body (2, 102) forming a fluid passage extending from the collar (3, 103), and two auxiliary pipes (6 and 7, 106 and 107) formed in the collar (3, 103) and the body (2, 102) and extending until they reach the fluid passage, each auxiliary pipe (6 and 7, 106 and 107) leading into the collar (3, 103) at an inlet/outlet (64, 74, 164, 174) that is oriented in a radial direction so as to be oriented laterally on either side of the patient's mouth when the patient is fitted with the airway (1, 101). The airway (1, 101) comprises a first module and a second module comprising at least a portion of the collar (3, 103), the two modules being separate and being capable of being joined in a reversible manner in order to form said airway or an oxygenation and capnography cannula.

Description

Modular oropharyngeal cannula

The invention relates to a device for releasing the airways of a patient, more particularly an oropharyngeal cannula for the administration of oxygen as well as the capnographic measurement.

A cannula is a straight or curved tube allowing the passage of a fluid such as air or a liquid through an orifice. An oropharyngeal cannula, such as a Guedel cannula or Berman cannula, is used in medicine to keep the airways of an unconscious patient open, such as a patient under anesthesia or a patient in a coma.

A Guedel cannula comes in the form of a semi-rigid plastic tube with three parts.

A first portion is curved to follow the path from the oral cavity to the pharynx. Its shape makes it possible to advance the lingual mass, moving it away from the posterior wall of the pharynx, and thus to release a canal between the tongue and the patient 's palate up to his pharynx. In this way, a passage of air is maintained to the lungs, and the tongue is held in position so that it does not sag backwards on the epiglottis and obstructs the airways, especially when the Unconscious patient is lying on his back.

A second straight part is armed inside a rigid ring intended to be at the level of the dental zone. The rigidity of this zone makes it possible to keep the orifice open when the cannula is placed between the teeth while preventing an intubated patient from, for example, obstructing an orotracheal tube by bite.

A third portion includes a flange that rests on the patient's lips once the cannula is in place.

There are several sizes of oropharyngeal cannula. The sizes vary according to the distance between the labial commissure and the angle of the jaw in the child and the adult. In adults, we can also use the distance between the commissure of the lips and the earlobe. During an operation under anesthesia, a facial mask is generally used to administer oxygen to the patient via the conduit of the Guedel cannula, and the patient's nostrils. The use of a mask, however, hinders access to the patient's face.

In addition, the use of a mask leads to a complex p lace to be able to capnography of the exhaled air by the patient.

Capnography is a measure of the concentration or partial pressure of carbon dioxide in the exhaled breath of a patient. Such measurements are widely used on patients under anesthesia. The presence of carbon dioxide in the expired air on several expirations by a patient who has just been intubated in particular makes it possible to confirm that the endotracheal tube is in the trachea.

Capnography also makes it possible to obtain an indirect measure of the partial pressure of carbon dioxide in the arterial blood. This information makes it possible to evaluate the circulatory state of the patient. Capnography directly reflects the ability of the patient's lungs to remove carbon dioxide and, indirectly, the production of carbon dioxide by the tissues and its transport to the lungs.

It can detect very early signs of respiratory deficiencies such as hypoventilation, or disconnection of a circuit or tube in the esophagus. During an operation under anesthesia, capnography can provide information, such as the frequency and regularity of ventilation, more useful than those provided by an oximeter.

It provides a method for rapid detection of critical conditions, such as a poorly positioned tracheal tube, poor ventilation, circulatory failure, and preventing irreversible complications.

It is known from US 2007/0095347 a nasopharyngeal device adapted to perform both a delivery of oxygen and a sampling of expired gases by the patient for perform a measurement of the carbon dioxide content by acquiring the use of an annoying facial mask. However, such a device can be used only nasally.

It is also known documents US 2007/267024, US 2008/308 108, US 4,821,715 and EP 1 188 457 an oro- or nasopharyngeal device adapted to form an inhalant gas passage in which is housed a pair of adapted ducts. to be slipped into the passage (s) internal (s) to administer oxygen, especially on a proximal portion, and to take exhaled gas, in particular on a distal portion, to measure the rate of C0 ₂ .

These devices have the disadvantage of being in several parts, a part composed of the cannula and a part composed of the administration and extraction tubes to be inserted. The additional time of assembly can be critical especially in emergency situation.

To solve this drawback, it is known from US 2008/000048 1 an oropharyngeal device of a shape adapted to be inserted into the mouth of a patient. The device comprises a body having a distal portion, a proximal portion and at least two channels extending from the proximal portion to the distal portion to form two air passages through which oxygen can be injected on the one hand, and can be extracted from carbon dioxide, on the other hand. The channels are formed in the body of the device which includes a horn on the proximal portion to prevent the device from being inserted too deep into the mouth.

It is also known from US 2012/0143003 a medical device comprising a solarium tooth wedge of a tongue depressor provided with an oxygenation conduit and an additional conduit disposed on each side of the tongue depressor . The device comprises orifices designed to cooperate with a strap for fixing the dental wedge on the patient.

This medical device has the functionality of an oropharyngeal cannula and can only be used as an oropharyngeal cannula. None of the oropharyngeal devices described in the documents mentioned above has simple and fast fixing means on the patient to maintain it on the patient once the device installed in the mouth of the patient, while allowing a quick extraction of the device in the case where the patient wakes up or in a case where intubation is necessary.

An oropharyngeal cannula should be installed and secured to the patient so that it can be removed if necessary, particularly in the case of waking the patient or to be replaced by an intubation device. Fixing the cannula keeps the device in position, but this attachment must be easily removable. Indeed, oropharyngeal cannulas can cause vomiting in a conscious patient. A recovering patient will spontaneously spit out the cannula when he regains the reflex of coughing.

It is known from FR 2 992 223 an oropharyngeal cannula adapted to be attached to the patient including using the administration / extraction tubes and hold the cannula in place on the patient. The oropharyngeal cannula includes a curved body to be inserted into a patient's mouth and to block his tongue, a cilettette adapted to rest on the patient's lips, a main duct forming a fluid passage and two auxiliary ducts formed in the patient's mouth. llerette and body and extending into the main duct. Each auxiliary duct opens into the co llerette on an inlet / outlet orifice oriented in a radial direction relative to the axis of the main duct so as to be oriented laterally on either side of the patient 's mouth when the cannula is installed on the patient.

By thereby directing the inlet / outlet ports, the administration / extraction tubes coupled to the inlet / outlet ports extend toward the patient's ears on either side of the patient's mouth. In this way each administration / extraction tube can be passed behind an ear for secure the oropharyngeal cannula on the patient easily removable.

Such a device however has the disadvantage of not being able to be used from the moment when the patient is in the wake phase. Indeed, as soon as the patient wakes up, the reflex of the cough reappears and the patient will seek to remove the oropharyngeal cannula in his throat.

To maintain oxygenation and capnographic measurements of the patient, it is then necessary to remove the oropharyngeal cannula and replace it with another device. This involves many manipulations and additional costs related to different devices to predict.

It is known from US 2010/01 98096 an endoscopic toothpick comprising a main duct and two ducts formed in the body capable of delivering oxygen and to perform capnographic surveys. The wedge cooperates with an oxygen bezel that can be connected to the conduit formed in the body for delivering oxygen. The telescope connects to the wedge laterally to deliver oxygen and through the top of the wedge to collect exhaled carbon dioxide. The wedge also includes orifices provided to cooperate with a strap for fixing the wedge-tooth on the patient.

However, this device is not an oropharyngeal cannula and therefore does not block the blocked tongue to keep the patient's airways clear. Moreover, this device does not make it possible to keep the device pressed against the face only by means of the administration / extraction pipes. Indeed, the administration / extraction pipes are integrated into a bezel independent of the wedge - tooth which only connects to the wedge via a vertical tube portion and a lateral oxygen delivery tube.

The invention proposes to solve the various disadvantages mentioned above by proposing a modulable oropharyngeal cannula adapted to be fixed on the patient using the tubes. administration and extraction and that can be used even after the patient wakes up as oxygenation and capnography glasses.

According to one aspect of the invention, there is provided an oropharyngeal cannula comprising a co llerette adapted to rest on the lips of a patient, a curved body to be inserted into the mouth of a patient and to block his tongue, the body forming a fluid passage extending from the horn, and two auxiliary ducts formed at least in the horn and extending into the fluid passage, each auxiliary duct opening into the horn on an input / output port oriented in a radial direction so as to be oriented laterally on either side of the patient 's mouth when the cannula is installed on the patient.

According to a general characteristic of the invention, the oropharyngeal cannula comprises a first module comprising at least a part of the hornlet and a second module comprising at least the body, the two modules being distinct and capable of being assembled in a reversible manner. to form said oropharyngeal cannula when assembled or an oxygenation and capnography bezel when the second module is detached from the first module.

When assembled with both moduli, the oropharyngeal cannula may have a general shape resembling a Guedel cannula or even a Berman cannula, both cannula forms forming an oropharyngeal cannula with a fluid passage extending therethrough. from the collar.

The modularity of the oropharyngeal cannula allows the patient to install the first module with the oxygenation and capnography tubes on the patient before the patient is anesthetized and to begin the measurements and oxygenation. Once the patient is anesthetized, the second module can be assembled with the first module and the body can be introduced into the patient's mouth to keep the patient's airway free. This, without disconnecting the tubes of capnography and oxygenation.

Then, during the waking phase of the patient, the body can be removed from the patient's mouth and the second module can be decoupled the first module to avoid any unpleasant sensation when the patient wakes up. The first module remains in place to maintain oxygenation and capnography of the patient.

The modularity of this oropharyngeal cannula thus makes it possible to use only one medical device for both the preoperative phase, the intraoperative phase, and the postoperative phase.

By using a second module with a portion of the cannula co llerette, additional security is provided when the second module is detached from the first module while the body is still in the patient's mouth. In fact, the part of the flange of the second module makes it possible to prevent the body from being swallowed by the patient.

Advantageously, the cannula may comprise two additional orifices made in the radiator and arranged so as to face each nostril of the patient when the cannula is installed on the patient, the two additional orifices being coupled to the same auxiliary duct or each to a separate auxiliary conduit.

The two additional ports allow delivery of oxygen to at least one of the patient's nostrils and / or removal of exhaled carbon dioxide from at least one of the patient's nostrils when the second module is detached from the first module to be placed under the patient's nostril. nose of the patient, by readjusting the administration and extraction tubes.

Each auxiliary duct comprises a portion formed radially in the co llerette, the inlet / outlet orifice being arranged radially on the flange. The thickness of the flange shall be of sufficient thickness to permit passage of the auxiliary ducts.

Preferably, when the cannula is assembled, the direction between each inlet / outlet orifice and the axis of the fluid passage forms an angle between 0 ° and 30 °, and more particularly between 10 ° and 20 °, with an axis through the commissures of the patient's lips when the cannula is installed on the patient. An angle of between 10 ° and 20 °, in particular an angle of 15 °, makes it possible to direct the administration / extraction tubes towards the upper rim of the ears, and thus to facilitate the passage of the tubes behind the ears.

Advantageously, the two inlet / outlet orifices arranged radially on the co llerette may advantageously be connected to an auxiliary duct via an auxiliary duct portion extending radially in the co llerette, each forming an angle of between 0 ° and 20 °. and more particularly an angle of about 10 ° with a plane parallel to the plane of the surface of the wiper so as to orient the inlet / outlet ports towards the patient's face.

This angle makes it possible to orient the administration / extraction tubes so as to keep them as close as possible to the patient's face, and thus to reduce the risks of an element or a tool getting caught in the administration / extraction tubes.

Alternatively, the cilette may be curved to follow the curvature of the patient's lips.

The curvature of the co llerette is a variant that also allows the administration / extraction tubes to be oriented in such a way as to keep them closer to the patient 's face, and thus to reduce the risks of an element or tool becoming involved in the administration / extraction tubes.

Advantageously, the oropharyngeal cannula may comprise two flexible administration / extraction tubes able to be passed behind the patient's ears when the cannula is installed on the patient, a first end of each tube being connected to an inlet / outlet orifice.

The connection of the tubes to the inlet or outlet ports can be carried out removably or securely and immovably. The presence of the solid tubes on the oropharyngeal cannula makes it possible to avoid any assembly apart from the connection of the free ends of the tubes to extraction means, such as a capnograph, or means of administration during the installation of the cannula on the patient. The oropharyngeal cannula may advantageously comprise a clamping ring capable of holding the two tubes together and sliding along the two tubes so as to hold the cannula in place when it is installed on the patient and that each tube passes behind an ear.

The clamping ring allows, once the tubes passed behind each ear to tighten the tube under the chin by raising the clamping ring towards the chin. This ensures a secure fixation of the cannula while allowing to quickly remove the cannula when needed.

Advantageously, a second end of the administration / extraction tubes may comprise connection means to administration or extraction apparatuses.

The connection means may be dedicated connectors dedicated to measuring or gas administration devices. By having a specific connection for each tube, the risks of connection errors are zero, even in emergency situations, because each connection is dedicated to a specific device.

Preferably, the inlet of the first auxiliary conduit is connected to a delivery tube of oxygen in the patient 's airway, and the outlet port of the second auxiliary conduit is connected to a gas extraction tube. expired by the patient to perform a capnographic measurement.

The second auxiliary duct preferably opens onto the fluid passage in a distal portion of the body comprising the free end of the body, and the first auxiliary duct opens onto the fluid passage in the co llerette or in a proximal portion of the body comprising the end of the body. body intended to be assembled with the collar.

By separating the places where the auxiliary ducts open into the fluid passage, the disturbances related in particular to the turbulences created by the administration of oxygen are reduced for the extraction of the exhaled gases by the patient, and the measurement of carbon dioxide includes a better signal to noise ratio. Alternatively, one can also have two carbon dioxide sampling tubes coupled to the two inlet inlet ports, the two tubes being coupled to the same capnography device. In this way, the device can be used only for the sampling of carbon dioxide. In this configuration, the two auxiliary ducts can open into the fluid passage at similar or separate locations. Similarly, the oropharyngeal cannula can be used solely for the administration of oxygen via the two auxiliary ducts.

Preferably, the first auxiliary conduit is formed in an upper wall of the body, and the second auxiliary conduit is formed in a lower wall of the body.

By performing the second auxiliary duct in the lower paro of the distal portion, the risk of occlusion of the duct by secretions, such as mucus and saliva, is reduced. Indeed, when the patient is lying on his back the lower surface of the distal wall of the oropharyngeal cannula installed in the patient's mouth is raised at the free end of the body relative to the bottom of the throat where can accumulate secretions.

In addition, by forming the second auxiliary duct in a lower portion of the body, the portion of the auxiliary duct formed in the washer comprises a body-connecting orifice disposed on a lower portion of the washer. Thus, when the celerette is used without the body and reassembled under the nose of the patient, the connecting orifice of the second auxiliary duct is located at the level of the mouth, which makes it possible to take the exhaled air from the mouth of the patient to achieve capnography of the patient.

In a variant, the first auxiliary duct and the second auxiliary duct may be formed in an upper wall of the body.

Advantageously, the body may comprise a tubular portion extending from the end of the body to be assembled with the wristlet and a curved plane extending into the body. extension of the tubular portion to the free end of the body.

By providing a curved plane of the tongue depressor type at the end of the oropharyngeal cannula instead of a tube, the discomfort felt by the patient by the presence of the oropharyngeal cannula in his throat in the event of awakening is reduced.

Preferably, the cannula comprises a main duct forming the fluid passage of the body, the main duct extending from the co llerette, and the auxiliary ducts opening into the main duct.

In the case where the fluid passage is formed by a main conduit, the inlet / outlet of each auxiliary conduit is oriented in a radial direction relative to the axis of the main conduit.

The main duct may advantageously be sized to receive a fiberscope.

In a variant, the body may comprise an open tube along its entire length on the lower wall of the body as well as on the part of the corresponding collar.

The opening provided on the lower wall of the oropharyngeal cannula facilitates intubation of a fibroscope and also facilitates its removal from the cannula by offering the possibility of removing the fiberoptic tube along the cannula and not only by the entry of the latter once the cannula removed from the throat of the patient.

Each auxiliary duct may advantageously comprise a section of oblong shape at least on the distal portion of the body.

In this way, the volume of fluid, particularly gaseous, can be conveyed in the conduit is greater than in the case of a cylindrical duct in section. Moreover, with a body comprising a main duct of sectional oblong section, that is to say similar to a mouth shape, the auxiliary ducts can be made in the upper wall and the lower wall without the need to increase importantly the thickness of body walls of the cannula. And this while maintaining a large volume of gas transferred.

Advantageously, the cannula may comprise at least one additional conduit formed in the body and extending from the collar to at least the distal portion of the body. The additional conduit may be for secretion aspiration into the patient's pharynx so as to prevent the airways from being clogged by these secretions. Suction of secretions can also be performed via a tube inserted into the main duct.

Preferably, at least one of the auxiliary ducts comprises an orifice opening into the fluid passage with a frustoconical shape, that is to say with a larger section than the average section of the auxiliary duct.

The frustoconical shape of the orifice opening on the fluid passage at the level of the tubular portion of the body makes it possible to promote the good distribution of the dioxygen injected in one case, and to optimize the aspiration of the secretions in another case.

In one embodiment, the first module may comprise the wiper and the second module may comprise the body, the body comprising on its outer surface an at least partially annular flange on one end of the body intended to be assembled with the collar.

The at least partially annular flange makes it possible to provide a support for assembling the body with the co llerette, the co llerette comprising a complementary groove adapted to receive the flange of the body.

Other advantages and characteristics of the invention will appear on examining the detailed description of an embodiment, in no way limiting, and the appended drawings, in which:

Figure 1 shows schematically a top view of an oropharyngeal cannula according to one embodiment of the invention;

FIG. 2 represents an exploded view of the oropharyngeal cannula of FIG. 1; Figure 3 illustrates a sectional view along a longitudinal plane ΙΙΙ-ΙΙΓ of the oropharyngeal cannula of Figure i;

Figure 4 illustrates a sectional view along a transverse plane IV-IV of the oropharyngeal cannula of Figure 1; Figure 5 illustrates a front view of the oropharyngeal cannula of Figure 1;

Figure 6 illustrates a sectional view along a transverse plane VI-VI 'of the oropharyngeal cannula of Figure 1; Figure 7 shows a diagram of the oropharyngeal cannula of Figure 1 installed on a patient in a first position;

Figure 8 shows a diagram of the oropharyngeal cannula of Figure 1 installed on a patient in a second position;

FIG. 9 schematically represents an exploded front view of an oropharyngeal cannula according to a second embodiment;

Figure 10 illustrates a top view of the assembled oropharyngeal cannula of Figure 9;

Figure 1 1 illustrates a sectional view along the plane ΧΙ-ΧΓ of the assembled oropharyngeal cannula of Figure 9; Figure 12 shows a diagram of the oropharyngeal cannula of Figure 9 installed on a patient in a second position.

In Figure 1 is schematically shown a top view of an oropharyngeal cannula 1 according to one embodiment of the invention.

The oropharyngeal cannula 1 comprises a body 2 and a horn 3 formed of rigid plastic material. The body 2 and the chelette 3 are made in the form of two distinct modules that can be reversibly assembled as shown in FIG. 2, which represents an exploded view of the oropharyngeal cannula 1 of FIG. As illustrated in FIG. 2 as well as in FIG. 3 having a cross-section along the plane ΙΙΙ-ΙΙΓ of the cannula of FIG. 1, the body 2 is formed of a proximal portion 2p and a distal portion 2d. .

The distal portion 2d has a generally curved shape. This part is curved so as to allow the insertion of the oropharyngeal cannula 1, and in particular its distal portion 2d into the mouth of a patient and to block the lingual mass forward and thus keep the pharynx open.

The distal portion 2d comprises a tubular portion 2 1 and a curved flat portion 22 extending in the extension of the tubular portion 21 to the free end 23 of the body 2. The tubular portion 2 1 extends between the portion 2p proximal and the curved flat portion 22. The curved flat portion 22 forms a tongue depressor which has the advantage of being less intrusive than a tube for the patient.

The proximal portion 2p of the body 2 comprises a straight tubular portion 24 disposed between the eyelet 3 and the distal portion 2d when the oropharyngeal cannula 1 is assembled. The straight tubular portion 24 is integral with the tubular portion 2 1 of the distal portion 2d to form a main duct 5. The straight tubular portion 24 comprises the end 25 of the body 2 intended to be coupled with the co llerette 3.

The wiper 3 is intended to rest on the lips of the patient once the cannula 1 inserted into the patient's mouth, while the straight tubular portion 24 is intended to be at the patient's teeth.

When the oropharyngeal cannula 1 is assembled, the main duct 5 extends from the cilter 3 to the end 26 of the tubular portion 2 1 coupled to the curved flat portion 22, passing through the straight tubular portion 24. The main duct 5 thus forms a fluid passage between the coilette 3 and the distal portion 2d of the body 2 of the oropharyngeal cannula 1. Once the cannula 1 assembled and installed on this patient, the main duct 5 and the flat portion curved 22 form a fluid passage between the pharynx and the patient's lips.

The straight tubular portion 24 may be made of a more rigid material than the rest of the body 2 of the cannula 1 so as to reinforce the area against any risk of biting which could cause the obstruction of the main duct 5. To strengthen the straight tubular portion 24, a sleeve, not shown, can also be inserted into the main duct 5 through the washer 3 so as to extend between the washer 3 and the straight tubular portion 24, the sleeve being hollow in its central axis to maintain a fluid passage in the main duct 5.

As is illustrated in Figures 1 to 3, the body 2 comprises an annular flange 4 disposed on the end 25 of the body 2 to be assembled with the clerette 3. The flange 4 forms an annular shoulder.

To assemble the oropharyngeal cannula 1, the cilette 3 comprises a groove 40 shaped to receive the flange 4 of the body 2. The flange 4 and the groove 40 may further comprise a polarizer, not shown, to ensure that the body 2 is not mounted upside down on the collar 3.

As illustrated in FIGS. 1 to 3, the oropharyngeal cannula 1 comprises a first auxiliary duct 6 formed in the thickness of an upper wall S of the body 2 separating the main duct 5 from the outside of the body 2. The first auxiliary duct 6 extends from the knob 3 into the straight tubular portion 24. It opens into the main duct 5 via a first opening 60, as shown in FIGS. 1 to 3 and in FIG. represents a view along the section plane IV-IV of the oropharyngeal cannula 1 of FIG.

As represented in FIGS. 1 and 3 as well as in FIG. 5, which represents a front view of the oropharyngeal cannula 1 of FIG. 1, the first auxiliary duct 6 comprises, in the cilette 3, an elbow 61 joining a first portion 62 of the first auxiliary duct 6 extending into the body 2 until the first opening 60 and a second portion 63 of the first auxiliary duct 6 extending in the chelette 3. The second portion 63 extends in the chelette 3 in a relatively radial direction relative to the axis ΙΙΙ-ΙΙΓ to a inlet port 64, i.e. the second portion 63 extends from the bend 61 disposed near the main conduit 5 to the radial outer perimeter 34 of the collar 3.

The end of the elbow 61 opposite the end coupled to the second portion 63 of the first auxiliary duct 6 opens via a first intermediate portion of duct 67 on a first connection orifice 65 made in the groove 40 of the washer 3. second portion 63 of the first auxiliary duct 6 opens on a first complementary connecting orifice 66 at the end opposite its end bearing the first opening 60. The first complementary connecting orifice 66 is intended to be arranged facing the first connection orifice 65 of the first auxiliary duct 6 when the body 2 and the flange 3 are assembled.

The oropharyngeal cannula 1 comprises a second auxiliary duct 7 formed in the thickness of a lower wall I of the body 2, opposite the upper wall S, and having an oblong shape in section. The second auxiliary duct 7 passes through the co llerette 3 and the body 2 and opens into the main duct 5 via a second opening 70 disposed in the end 26 of the tubular portion 22 coupled to the curved flat portion 22, as shown on Figures 1 to 3 and Figure 6 which shows a view along the section plane VI-VI 'of the oropharyngeal cannula 1 of Figure 1.

By positioning the second opening 70 at the end 26 of the tubular portion 22 coupled to the curved planar portion 22, it is possible to reduce the thickness of the curved planar portion 22 since it does not include an auxiliary conduit.

In a variant, the second auxiliary duct 7 may extend in the curved flat portion 22 and open on an opening disposed upstream of the free end 23 of the distal portion 2d. By positioning the second opening upstream of the free end 23 rather than on the free end 23, the risk of obstruction of the second opening 70 by secretions in the throat.

These risks are even more limited in this variant because the second auxiliary duct 7 is made in the bottom wall / of the distal portion 2d. Indeed, when the patient is lying on his back, the lower wall / of the distal wall 2d of the oropharyngeal cannula 1 installed in the patient's mouth is raised at the free end 23 with respect to the bottom of the throat where to accumulate secretions.

As shown in FIGS. 1, 3 and 5, the second auxiliary duct 7 comprises, in the chelette 3, a bend 71 joining a first portion 72 of the second auxiliary duct 7 extending into the body 2 until the second opening 70 and a second portion 73 of the second auxiliary duct 7 extending in the co llerette 3. The second portion 73 of the second auxiliary duct 7 extends in the co llerette 3 in a relatively radial direction relative to the axis III - III 'up to an outlet port 74, ie the second portion 73 extends from the bend 71 disposed near the main duct 5 to the radial outer perimeter 34 of the flange 3.

The end of the elbow 71 opposite the end coupled to the second portion 73 of the second auxiliary duct 7 opens via a second intermediate portion of duct 77 on a second connecting orifice 75 made in the groove 40 of the washer 3. The second portion 73 of the second auxiliary duct 7 opens on a second complementary connecting orifice 76 at the end opposite its end bearing the second opening 70. The second complementary connecting orifice 76 is intended to be arranged facing the second connection orifice 75 of the second auxiliary duct 7 when the body 2 and the flange 3 are assembled.

The flange 4 and the groove 40 are configured to align, on the one hand, the first connection orifice 65 of the first auxiliary duct 6 with the first complementary connection orifice 66 of the first auxiliary duct 6, and, on the other hand, the second connection port 75 of the second auxiliary duct 7 with the second complementary connecting orifice 76 of the second auxiliary duct 7.

The first auxiliary duct 6 is intended to deliver a flow of oxygen. The second auxiliary duct 7 is intended to take a portion of the gas exhaled by the patient to measure the carbon dioxide level in the exhaled gas through a capnograph.

For this, the inlet orifice 64 and the outlet orifice 74 are respectively connected to a delivery tube 8 and an extraction tube 9 as illustrated in FIG. 1. The connection is made by welding or by overmolding the co llerette 3 on the administration and extraction tubes 8 and 9, or with the aid of a connector.

The free end of the delivery tube 8 comprises a specific connection, for example a standard conical connection for oxygen, intended to be coupled to a device delivering a flow of oxygen, optionally via a reducing section tube. The free end of the delivery tube 9, on the other hand, comprises a specific connection, for example a connection of the "luer lo ck" type, intended to be coupled to a capnograph.

As illustrated in FIG. 1, the second portion 63 of the first auxiliary duct 6 and the second portion 73 of the second auxiliary duct 7 may each form an angle Θ of approximately 1 0 ° with a plane VV comprising the elbows 61 and 71 and parallel to the plane of the surface 36 of the wiper 3 so as to orient the administration and extraction tubes 8 and 9 towards the patient's face and thus optimize the holding in position of the oropharyngeal cannula 1.

Alternatively, the cilette 3 may be curved so as to follow the curve of the patient's lips when the cannula 1 is applied to the patient. In this configuration, the second portion 63 of the first auxiliary duct 6 and the second portion 73 of the second auxiliary duct 7 can follow the curvature of the dialelette so that the straight line separating the corresponding inlet / outlet port 64 , 74 of the corresponding elbow 61, 71 forms an angle approximately 10 ° with the plane passing through the two elbows 61 and 71 and comprising a cross section of the main duct 5.

In addition, as illustrated in FIG. 4, the second portion 63 of the first auxiliary duct 6 and the second portion 73 of the second auxiliary duct 7 each form an angle α with a plane passing through the first elbow 61 and the second elbow 62. and parallel to the plane in which the straight tubular portion 24 of the body 2 extends when it is coupled to the washer 3. The angle α has a value of about 15 °. This angle allows the delivery tube 8 and the extraction tube 9 to be each oriented towards the upper rim of an ear of the patient so as to facilitate the passage of the administration and extraction tubes 8 and 9. behind the ears, as shown in Figure 8.

Figure 7 shows a diagram of an oropharyngeal cannula 1 installed on a patient in a first position in which the cannula 1 is assembled, that is, it comprises the cilette 3 and the body 2. The passage administration and extraction tubes 8 and 9 behind the patient's ears makes it possible to hold the oropharyngeal cannula 1 in place on the patient's lips. In this embodiment, the oropharyngeal cannula 1 further comprises a clamping ring 13 coupled to the delivery and delivery tubes 8 and 9. The clamping ring 13 is slidably mounted along the delivery tubes and extraction 8 and 9 so as to allow the ring 13 to be raised until the administration and extraction tubes are tightened under the chin of the patient so that the oropharyngeal cannula 1 is securely held in position on the patient.

Cannula 1 also includes additional nasal oxygen delivery outlets. The cannula 1 comprises an additional duct 10 formed in the chelette 3. The additional duct 1 0 is connected to the first auxiliary duct 6 and extends in the co llerette 3 up to two additional outlet orifices 1 1. The additional outlet orifices 1 1 are made on a radial upper part of the flange 3, and more precisely on the radial outer perimeter 34 of the horn 3, so as to be opposite the nostrils of the patient when the cannula 1 is installed. The two additional outlet orifices 1 1 may be formed in two short tubular portions 12 projecting from the radial outer perimeter 34 of the collar 3.

FIG. 8 shows a diagram of an oropharyngeal cannula 1 installed on a patient in a second position in which only the cilette 3 is used, the body 2 not being assembled with the cilette 3. In this second position, used in the preoperative or postoperative phase, the cilette 3 is raised to be placed just under the patient's nose and the distance between the delivery tubes 8 and extraction tubes 9 between the collar 3 and each of the ears is shortened so that co llerette 3 is well maintained in place. To maintain this distance, the retaining ring 13 is tightened accordingly.

In this second position, the short tubular portions 12 are introduced at the entrance of the nostrils of the patient while the first connection port 65 is opposite the philtrum of the patient, that is to say the part between his nose and his nose. upper lip. The second connecting orifice 75 is, in this second position, facing the mouth, on an upper part, which allows to continue to withdraw via the second portion 73 of the second auxiliary duct 7 expired air by the patient and to carry out a capnographic follow-up.

In order to improve the evacuation of the moisture present in the extraction tube 9, the extraction tube may comprise a portion of a few centimeters, for example 5 cm, of Nafion tube. This portion is preferably located 2 cm from the flange 3.

In Figure 9 is schematically illustrated an exploded front view of an oropharyngeal cannula 101 according to a second embodiment.

The common elements between the first embodiment and the second embodiment relate to FIGS. 9 to 11 of the incremented numerical references of a coefficient 100 with respect to the references of FIGS. 1 to 8. In the second embodiment, the cannula 101 comprises a first module 101a comprising the body 102 and a first portion 103a of the flange 103 and a second module 101b, complementary to the first module 101a, comprising a second portion 103b of the flange 103 fit to form the flange 103 with the first portion 103a of the flange 103. The two modules 101a and 101b are distinct and reversibly assembled.

In FIG. 10 is a top view of the assembled oropharyngeal cannula 101 of FIG. 9 and in FIG. 11 is shown a cross-section along the plane ΧΙ-ΧΓ of the assembled cannula 101 of FIG.

As illustrated in Figures 10 and 11, the body 102 is similar to the body 2 of the first embodiment with a proximal portion 102p and a distal portion 102d.

The main duct 105 extends from the flange 103 to the end 126 of the tubular portion 121 coupled to the curved flat portion 122, passing through the straight tubular portion 124. The main duct 105 thus forms a fluid passage between the flange 103 and the distal portion 102d of the body 102 of the oropharyngeal cannula 101.

In the second embodiment, the body 102 being secured to a second portion 103b of the flange 103, the body does not include an assembly element with the flange 103.

The second module 101b can be made of two distinct elements reversibly assembled along the cutting plane ΧΙ-ΧΓ. The division of the second module 101b reduces the size of the cannula 101 when stored in its packaging before use.

As illustrated in FIGS. 9 to 11, the oropharyngeal cannula 101 comprises a first auxiliary duct 106 formed in the thickness of an upper wall S of the body 102 separating the main duct 105 from the outside of the body 102, and having in the upper wall S of the body 102 an oblong shape in section. The first auxiliary duct 106 extends from the flange 103 into the right tubular portion 124. It opens into the main conduit 105 via a first opening 160.

The first auxiliary duct 106 comprises a bend 161 made in the first module 101a and joining a first portion 162 of the first auxiliary duct 106 to a second portion 163 of the first auxiliary duct 106. The first portion 162 of the first auxiliary duct 106 extends into the second module 101b to the first opening 160. The second portion 163 of the first auxiliary conduit 106 extends into the first module 101a. The second portion 163 extends in the collar 103 in a relatively radial direction relative to the axis ΧΙ-ΧΓ to an inlet orifice 164, that is to say that the second portion 163 extends from the elbow 161 to the radial outer perimeter 34 of the collar 103.

The end of the elbow 161 opposite the end coupled to the second portion 163 of the first auxiliary duct 106 opens via a first intermediate duct portion 167 formed in the first module 101a on a first connection port 165. The first connection orifice 165 is made on the face of the first module 101a intended to be in contact with the second module 101b. The second portion 163 of the first auxiliary duct 106 opens into the second portion 103b of the collar 103 on a first complementary connection orifice 166. The first complementary connection orifice 166 is disposed at the end of the second portion 163 of the first auxiliary duct 106 opposite its end carrying the first opening 160. The first complementary connection port 166 is intended to be disposed opposite the first connection port 165 of the first auxiliary duct 106 when the second module 101b and the first module 101a are assembled.

The oropharyngeal cannula 101 comprises a second auxiliary duct 107 formed solely in the collar 103. The second auxiliary duct 107 passes through the first and second portions 103a and 103b of the flange 3 and opens into the main duct 5 via a second opening 170. The second auxiliary duct 7 comprises a bend 171 made in the first module 101a and joining a first portion 172 of the second auxiliary duct 107 to a second portion 173 of the second auxiliary duct 107. The first portion 172 of the second auxiliary duct 107 extends into the second portion 103b of the collar 103 to the second opening 170. The second portion 173 of the second auxiliary conduit 107 extends into the first module 101a. The second portion 173 of the second auxiliary duct 107 extends in the first portion 103a of the flange 103 in a relatively radial direction relative to the axis ΧΙ-ΧΓ to an outlet orifice 174, that is, say that the second portion 173 extends from the bend 171 to the radial outer perimeter 134 of the flange 103.

The end of the elbow 171 opposite the end coupled to the second portion 173 of the second auxiliary conduit 107 opens via a second intermediate portion of conduit 177 formed in the first module 101a on a second connection port 175. The second connection port 175 is made on the face of the first module 101a intended to be in contact with the second module 101b. The second portion 173 of the second auxiliary duct 107 opens into the second portion 103b of the flange 103 on a second complementary connecting orifice 176. The second complementary connecting orifice 176 is disposed at the end of the second portion 173 of the second auxiliary duct 107 opposite its end carrying the second opening 170. The second complementary connecting orifice 176 is intended to be disposed opposite the second connecting port 175 of the second auxiliary conduit 107 when the second module 101b and the first module 101a are assembled.

The first module 101a and the second module 101b are configured to align, on the one hand, the first connection orifice 165 of the first auxiliary conduit 106 with the first complementary connection orifice 166 of the first auxiliary conduit 106, and on the other hand the second connecting orifice 175 of the second auxiliary duct 107 with the second complementary connecting orifice 176 of the second auxiliary duct 107. For this purpose, and to keep the cannula 101 assembled, the second module 101b may comprise holding portions 180, as illustrated in FIG. 9, able to hook the first module 101a or to apply a holding force against the first module 101a. , the first module 101a being forced into the space defined inside the holding portions 180 of the second module 101b.

As in the first embodiment, the first auxiliary duct 106 is intended to deliver a flow of oxygen and the second auxiliary duct 107 is intended to take a portion of the gases exhaled by the patient to measure the level of carbon dioxide in the gases. expired thanks to a capnograph.

For this, the inlet orifice 164 and the outlet orifice 174 are respectively connected to a delivery tube 108 and an extraction tube 109.

As illustrated in FIG. 10, the second portion 163 of the first auxiliary duct 106 and the second portion 173 of the second auxiliary duct 107 may each form an angle Θ of approximately 10 ° with a plane AA 'comprising the elbows 161 and 171 and parallel to the plane of the surface 136 of the collar 103 so as to orient the administration and extraction tubes 108 and 109 towards the patient's face and thus optimize the holding in position of the oropharyngeal cannula 101.

Alternatively, the flange 103 may also be curved to follow the curvature of the patient's lips.

In addition, as illustrated in FIG. 9, the second portion 163 of the first auxiliary duct 106 and the second portion 173 of the second auxiliary duct 107 each form an angle α with a plane passing through the first elbow 161 and the second elbow 162. and parallel to the plane in which the straight tubular portion 124 of the body 102 extends when the two modules 101a and 101b are assembled.

The angle α has a value of about 15 °. This angle allows the delivery tube 108 and the extraction tube 109 to be each oriented towards the upper rim of an ear of the patient so as to facilitate the passage of the administration and extraction tubes 108 and 109 behind the ears.

As in the first embodiment, the passage of the administration and extraction tubes 108 and 109 behind the patient's ears makes it possible to hold the oropharyngeal cannula 101 in place on the patient's lips, that the cannula 101 is used in a patient. first position in which the first and second modules 101a and 101b are assembled or in a second position in which only the first module 101a is used, the second module 101b not being assembled with the first module 101a. The cannula 101 is used in its first position mainly during the operative phases during which the patient is anesthetized. The cannula 101 is used in its second position mainly in the preoperative and postoperative phase.

As illustrated in Figure 9, the cannula 101 also includes an additional nasal oxygen delivery outlet and an additional nasal carbon dioxide withdrawal inlet. The cannula 101 comprises a first additional conduit and a second additional conduit formed in the first module 101a. The first additional conduit is connected to the first auxiliary conduit 106 and extends into the first module 101a of the elbow 161 to a first additional port 111. The second additional conduit is connected to the second auxiliary conduit 107 and extends into the first 101a of the elbow 171 to a second additional orifice 111.

The two additional orifices 111 and 111 are formed on a radial upper portion of the flange 103, and more precisely on the radial outer perimeter 134 of the first portion 103a of the flange 103, so as to be opposite the nostrils of the patient when the cannula 101 is installed. The two additional holes

111 and 111 can be formed in two short tubular portions

112 projecting on the radial outer perimeter 134 of the flange 103.

Figure 12 shows a diagram of an oropharyngeal cannula 101 installed on a patient in the second position. In this second position, the first module 1a is raised relative to the first position to be placed just under the patient's nose and the distance of the delivery tubes 108 and 109 extraction between the first module 1a and each of ears is shortened so that the first module 10 1 has been well maintained in place.

To maintain this distance, the retaining ring 1 13 coupled to the administration and extraction tubes 108 and 109 is tightened accordingly.

In this second position, the short tubular portions January 12 are introduced at the entrance of the nostrils of the patient while the first connecting port 165 and the second connecting port 1 66 are opposite the philtrum of the patient. The two additional orifices 1 1 1 and 1 1 1 thus make it possible both to continue to deliver oxygen to the patient via one of his nostrils and to capnograph the air exhaled by the other nostril.

Although various embodiments are described herein, it is understood from the description that various combinations of elements, variations or improvements thereof are feasible to those skilled in the art and are within the scope of the invention.

The proposed invention provides an oropharyngeal cannula which can be quickly installed and secured to the patient while securely held in position on the patient and can be used even after the patient wakes up as an oxygenator. and capnography.

Claims

1. Oropharyngeal cannula (1, 101) comprising a collar (3, 103) adapted to rest on the lips of a patient, a body (2, 102) curved to be inserted into the patient's mouth and to block his tongue, the body (2, 102) forming a fluid passage extending from the flange (3, 103), and two auxiliary ducts (6 and 7, 106 and 107) formed at least in the flange (3, 103) and extending into the fluid passage of the body (2), each auxiliary duct (6 and 7, 106 and 107) opening into the collar (3, 103) on an inlet / outlet port (64, 74, 164, 174) oriented in a radial direction so as to be oriented laterally on either side of the patient's mouth when the cannula (1) is installed on the patient, characterized in that it comprises a first module comprising at least a portion of the flange (3, 103) and a second module comprising at least the body (2, 102), the two modules being distinct and capable of being assembled. reversibly to form said oropharyngeal cannula when assembled or an oxygenation and capnography bezel when the second module is detached from the first module.

2. Cannula (1, 101) according to claim 1, comprising two additional orifices (11, 111) made in the collar (3, 103) and arranged to face each nostril of the patient when the cannula (1, 101) is installed on the patient, the two additional orifices (11, 111) being coupled to the same auxiliary duct (6 and 7, 106 and 107) or each to a separate auxiliary duct (6 and 7, 106 and 107).

3. Cannula (1, 101) according to one of the preceding claims, wherein, when the two modules are assembled, the direction between each inlet / outlet port (64, 74, 164, 174) and the axis ( III-ΙΙΓ) of the body fluid passage (2, 102) forms an angle between 0 ° and 30 °, and more particularly between 10 ° and 20 °, with an axis passing through the commissures of the patient's lips when the cannula (1 , 101) is installed on the patient.

4. Cannula (1, 101) according to claim 3, wherein the two inlet / outlet ports (64 and 74, 164 and 174) arranged radially on the flange (3, 103) are connected to an auxiliary duct (6). and 7, 106 and 107) via a portion (63, 73, 163, 173) of auxiliary duct (6 and 7, 106 and 107) extending radially in the collar (3, 103) each forming an angle between 0 ° and 20 ° and more particularly an angle of about 10 ° with a plane parallel to the plane of the surface (36, 136) of the flange (3, 103) so as to orient the inlet / outlet orifices (64). and 74, 164 and 174) to the patient's face.

5. Cannula (1, 101) according to one of claims 1 to 3, wherein the collar (3, 103) is curved to follow the curvature of the patient's lips.

6. Cannula (1, 101) according to one of the preceding claims, comprising two flexible tubes of administration / extraction (8, 9, 108,

109) adapted to be passed behind the patient's ears when the cannula (1, 101) is installed on the patient, a first end of each tube being connected to an inlet / outlet port (64, 74, 164, 174) .

7. Cannula (1, 101) according to claim 6, comprising a clamping ring (13, 113) able to hold the two tubes (8, 9, 108, 109) together and to slide along the two tubes (8, 9, 108, 109) so as to hold the cannula (101) in place when it is installed on the patient and that each tube (8, 9, 108, 109) passes behind an ear.

8. Cannula (1, 101) according to one of claims 6 or 7, wherein a second end of the administration / extraction tubes (8, 9, 108, 109) comprises means for connection to the administration apparatus or extraction.

The cannula (1, 101) according to one of claims 6 to 8, wherein the inlet port (64, 164) of the first auxiliary duct (6, 106) is connected to a delivery tube (8). , 108) of oxygen into the respiratory tract of the patient, and the outlet (74, 174) of the second auxiliary duct (7, 107) is connected to a tube extraction (9, 109) of gas exhaled by the patient to perform a capnographic measurement.

10. Cannula (1, 101) according to one of the preceding claims, wherein the second auxiliary duct (7, 107) opens on the fluid passage in a distal portion (2d, 102d) of the body (2, 102) comprising the free end of the body (2, 102), and the first auxiliary duct (6, 106) opens on the fluid passage in the flange (3, 103) or in a proximal portion (2p, 102p) of the body (2, 102). ) comprising the end of the body (2, 102) intended to be assembled with the flange (3, 103).

11. Cannula (1) according to one of the preceding claims, wherein the first auxiliary duct (6) is formed in an upper wall (S) of the body (2), and the second auxiliary duct (7) is formed in a lower wall (I) of the body (2).

12. Cannula (101) according to one of claims 1 to 10, wherein the first auxiliary duct (106) and the second auxiliary duct (107) are formed in an upper wall (S) of the body (102).

13. Cannula (1, 101) according to one of the preceding claims, wherein the body (2) comprises a tubular portion (21, 121) extending from the end (25, 125) of the body (2, 102). ) in contact with the flange (3, 103) at least when the cannula (1, 101) is assembled and a curved plane (22, 122) extending in the extension of the tubular portion (21, 121) to the free end (23, 123) of the body (2, 102).

14. Cannula (1) according to one of claims 1 to 10, wherein the body (2) comprises a tube open over its entire length on the bottom wall (I) of the body (2) and on the part of the collar (3) corresponding.

15. Cannula (1) according to one of claims 1 to 11, wherein the second auxiliary duct (7) comprises a section of oblong shape at least on the distal portion (2d) of the body (2).

16. Cannula (1, 101) according to one of the preceding claims, wherein at least one of the auxiliary ducts (6, 7, 106, 107) comprises an orifice opening into the fluid passage with a frustoconical shape, the orifice having a larger section than the average section of the auxiliary duct (6, 7, 106, 107).

17. Cannula (1, 101) according to one of the preceding claims, comprising a main conduit (5, 105) forming the fluid passage of the body (2, 102), the main conduit (5, 105) extending from the flange (3, 103), and the auxiliary ducts (6, 7, 106, 107) opening into the main duct (5, 105).

The cannula (1, 101) of claim 17, wherein the main conduit (5, 105) is sized to receive a fiberscope.

19. Cannula (1) according to one of the preceding claims, wherein the first module comprises the flange (3) and the second module comprises the body (2), the body (2) comprising on its outer surface a flange (4). ) at least partially annular on one end (25) of the body (2) intended to be assembled with the flange (3).