• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    Medical syringe with pressure indicator, preferably for epidural anesthesia, in which the piston has inside it a chamber of approximately cylindrical shape, whose axis of revolution approximately coincides with the axis of revolution of said piston; the front face of said piston has a hole that hydraulically connects said chamber with the interior of the barrel of the syringe; the interior of said chamber has a disc of approximately circular shape, in the manner of a hydraulic piston, such that the pressure of the space defined by the disc and the rear face of the chamber is approximately the atmospheric pressure and because the anterior portion of the crown cylindrical defined by the cylindrical surface of the chamber and the cylindrical surface of the piston is transparent. (Machine-translation by Google Translate, not legally binding)
    公开号:ES2642171A1
    申请号:ES201630625
    申请日:2016-05-13
    公开日:2017-11-15
    发明作者:Juan Carlos GARCÍA PÉREZ；Martín CARPINTERO PORRERO
    申请人:Juan Carlos GARCÍA PÉREZ；Martín CARPINTERO PORRERO；
    IPC主号:
    专利说明:

    5
    10
    fifteen
    twenty
    25
    30
    35
    DESCRIPTION
    Medical syringe with pressure gauge Object of the invention
    The object of the present invention is a syringe, preferably those used in epidural anesthesia, which incorporates a visual control device inside its piston that detects the variation in pressure between the inside and outside of the cavity. epidural and therefore indicates when the tip of the needle has been introduced into said epidural cavity.
    Background of the invention
    Epidural anesthesia is a technique that is based on the introduction of a local anesthetic into the epidural cavity or space, thus blocking the nerve endings at its exit from the spinal cord. Therefore, its distribution will be meta-American, that is, the area of the body that corresponds to the nerves that have been reached by the injected local anesthetic will be anesthetized. All anesthesiologists know that the main and side effects of the anesthetic supplied depends on the correct identification of the epidural space
    The epidural space is a virtual cavity located between the two leaves in which the dura is divided. This, the outermost of the three meninges that line the central nervous system, is also the thickest, and is divided into two sheets: the outermost one is confused with the periosteum of the spinal canal, and ends at the top the great hole, while the innermost is the most properly called spinal dura, and ends in the adult approximately in the second sacral metamera, leaving there the terminal end of the medulla, filum terminalis, and disappearing in the sacrococcygeal ligament itself. The dural sheath is attached to adjacent structures by means of the meningovertebral ligaments of Giordanengo and the anterior sacral ligament of Trolard. While these ligaments have a certain consistency, the posterior and lateral anchors are lax and do not constitute an obstacle to the diffusion of liquid substances injected into the epidural space. On both sides, the dura sends some fibers to the periosteum that covers the conjunction holes, which are also quite inconsistent, and fail to occlude the hole. In this way, any liquid injected into the
    5
    10
    fifteen
    twenty
    25
    30
    Epidural space has the possibility of going out through these holes to the paravertebral space. Calcification caused by age can reduce the permeability of these continuity solutions, and therefore, in elderly people the precise analgesic doses are usually lower, as losses outside the epidural space are reduced.
    The epidural space is limited in front by the vertebral bodies, the intervertebral discs, and the posterior longitudinal ligament, and behind by the yellow ligament that joins the vertebral plates, and by the plates themselves. This yellow ligament, which is perceived at the time of puncture as a more resistant structure, is of great importance as a reference for the situation of the needle tip. On the sides, the space is limited by the vertebral pedicles, and ends at the intervertebral orifices, where the dura is continued, with no solution of continuity with the epineur of the medullary nerves. The epidural space is quite irregular, and its dimensions vary with the area of the spine that is considered, being wider in the lumbar region, and decreasing in the dorsal and cervical area, until practically disappearing at the IIC level. The space is always wider in the back area, just in the middle line, where it can reach 5-6 mm. That is why most of the epidural anesthesia techniques, whatever the superficial approach point they use, cross the yellow ligament just through that central area, also pays for this situation of the venous vessels that we will then review. This space is filled with a loose tissue, with abundance of venous plexuses, adipose tissue and connective tissue. The presence of the first two structures influences the characteristics of the analgesia obtained, and determines the technique itself and many of its possible complications.
    The venous system forms at this level a very wide network, and an inadvertent puncture could be relatively easy. However, it forms two main longitudinal plexuses, one anterior, and another posterior, of greater importance, but whose veins are lateralized enough that the punctures in the middle do not usually affect them. Both anterior and posterior plexuses are interconnected by lateral branches that go from one to the other. The puncture of one of these lateral branches is also relatively difficult, since they are preferably located behind the vertebral plates, and not after the intervertebral ligaments, yellow ligament. From those transverse nerve plexuses, the veins that accompany the spinal nerves come out through the conjunction holes.
    5
    10
    fifteen
    twenty
    25
    30
    Countless techniques for addressing the identification of the epidural space, some manuals and others with the help of devices of varying degrees of complexity have been described.
    One of the direct identification techniques is the method of loss of air resistance, or LOR-A, the acronym of its name in English loss of resistance-air, and the other is the method of loss of resistance with liquids or LOR-S , loss of resistance-saline. There are two basic characteristics by which the entry of the needle into the epidural space can be identified: the loss of mechanical resistance that is perceived in the embolus when the needle enters the epidural space and the negative pressure that exists in it.
    The name of the method of loss of air resistance is due to the fact that when the tip of the needle is in the yellow ligament or in the interspinous ligament, considerable force can be exerted on the embolus without the air in the syringe being expelled from it and, upon entering the epidural space, a clear loss of resistance is perceived in the embolus that allows air to enter the space. There are at least three modalities for performing the LOR-A technique: a) as the needle-syringe assembly is continuously advanced, a constant pressure on the plunger is exercised with the thumb of the hand; b) also, continuously advancing the needle-syringe assembly but exerting intermittent pressure on the plunger, by rapid movements, such that the decompression of the air confers a series of rebounds on the plunger; c) the needle is advanced intermittently, approximately 1 mm at a time, testing after each advance the resistance to pressure exerted by the embolus. Regardless of the modality used, once the epidural space is located, the pressure exerted on the embolus must be interrupted, avoiding any subsequent air injection. Subsequently, an aspiration test can be performed, which, theoretically, injected air would be extracted.
    The greatest advantage offered by this method is that, since no liquid is used in its realization, any liquid that returns through the pinnale of the needle should be cerebrospinal fluid.
    Likewise, instead of air, CO2 or N2O can be used, although its technique is more complex and its use has not prospered.
    5
    10
    fifteen
    twenty
    25
    30
    35
    In the case of using the LOR-S technique, the syringe instead of air contains a saline solution or a local anesthetic, and the pressure exerted during needle insertion can be continuous or intermittent. The advantage is that since the liquids are incompressible, the sensations that the anesthetist perceives are stronger.
    The present invention has been developed to avoid the greatest inconvenience of performing the LOR-A and LOR-S techniques, which is that the anesthetist perceives in a subjective way the loss of pressure when introducing the needle into the epidural space, that is to say Each person will perceive that loss of pressure in a different way, whereby the present invention recommends a simple device that, visually, warns the professional that the epidural space has been reached.
    Description of the invention
    The medical syringe with pressure gauge, object of the present invention, is one that comprises a body or barrel, a plunger that is inserted into the barrel and a piston disposed at the front end of the plunger and that pushes the fluid to be injected. The piston has in its interior an approximately cylindrical chamber, whose axis of revolution coincides approximately with the axis of revolution of said piston; the front face of said piston has a hole that hydraulically connects said chamber with the inside of the barrel of the syringe; the interior of the aforementioned chamber has an approximately circular disk, as a hydraulic piston, such that the pressure of the space defined by the disc and the rear face of the chamber is approximately the atmospheric pressure and because the anterior portion of the crown cylindrical defined by the cylindrical surface of the chamber and the cylindrical surface of the piston is transparent.
    Brief description of the figures
    Figure 1: shows a cross-sectional view of the invention when the needle has not been introduced into the epidural space.
    Figure 2: shows a cross-sectional view of the invention when the needle has been introduced into the epidural space.
    Preferred embodiment
    5
    10
    fifteen
    twenty
    25
    30
    35
    Figures 1 and 2 show a preferred embodiment of the medical syringe with pressure indicator, object of the present invention, in figure 1 the sample before the needle has been introduced into the epidural space and figure 2 the sample after that has been introduced.
    The piston (1) of the syringe has inside it a chamber (2) of approximately cylindrical shape, whose axis of revolution coincides approximately with the axis of revolution of said piston (1); the front face of said piston (1) has a hole (3) that hydraulically connects said chamber (2) with the inside of the barrel (4) of the syringe; The interior of the aforementioned chamber (2) has a disk (5), preferably made of a phosphorescent material, approximately circular in shape, as a hydraulic piston, such that the pressure of the space defined by the disc and the rear face of the chamber is approximately the atmospheric pressure and because the anterior portion of the cylindrical crown (6) defined by the cylindrical surface of the chamber and the cylindrical surface of the piston is transparent.
    In view of the present description, any professional in the sector can deduce the advantages offered by the present invention over the syringes currently in existence, but in any case it is considered relevant to list the following advantages of the medical syringe with pressure indicator:
    • It does not modify the technique used so far to identify said epidural space.
    • Enrich and add an optical or visual characteristic, always more objective, than the existing tactile sensation, more rude and subjective. In other words, it does not replace the prior art, but it complements it. So it gives greater sensitivity and reliability.
    • It is a simple and cheap mechanism.
    • Avoid punctures or perforations of the dura that lead to:
    • Frequent side effects such as the appearance of the well-known "postural dural headache", which is usually an intense headache and may become prolonged over time.
    • Less frequent, but much more serious, side effects such as total spinal anesthesia, due to the action of the local anesthetic in the cephalo-spinal fluid itself, with the most likely subsequent cardio-respiratory arrest and spinal cord injury in the spaces
    10
    fifteen
    intervertebral above the 2-lumbar vertebra, which can lead to paraplegia or in the worst case an irreversible tetraplegia in the patient. It should be borne in mind that this technique is currently performed frequently as analgesia during childbirth, so that the patients that would be affected would be young and pregnant women, which would expose both lives.
    • Loco-regional anesthesia or analgesia added as a technique to general anesthesia is an enormous advantage. Since the weight of analgesia against the painful stimulus is more effective and effective at the beginning, than acting directly on the central nervous system, once the stimulus has been produced. This would lead to a smaller amount of general anesthesia and decrease its dose-dependent side effects.
    • Many times the epidural technique is stopped due to the same complexity and subjectivity of the technique and the danger of the area where it is performed, close to the spinal cord. If this mechanism were improved and this were more reliable and sensitive, the epidural technique would be disseminated in a greater number of interventions, the advantages of this technique being great.
    权利要求:
    Claims (2)
    [1]

    10
    fifteen
    1. Medical syringe with pressure gauge, of the type of which they comprise a body or barrel, an embolus that is introduced into the barrel and a piston arranged at the front end of the plunger and that pushes the fluid to be injected, characterized in that the piston it has inside a chamber of approximately cylindrical shape, whose axis of revolution coincides approximately with the axis of revolution of said piston; the front face of said piston has a hole that hydraulically connects said chamber with the inside of the barrel of the syringe; the interior of the aforementioned chamber has an approximately circular disk, as a hydraulic piston, such that the pressure of the space defined by the disc and the rear face of the chamber is approximately the atmospheric pressure and because the anterior portion of the crown cylindrical defined by the cylindrical surface of the chamber and the cylindrical surface of the piston is transparent.
    [2]
    2. Medical syringe with pressure gauge, according to claim 1, characterized in that the disc is made of a phosphorescent material.
    类似技术:
    公开号 | 公开日 | 专利标题
    US20090131832A1|2009-05-21|Electronic Syringe with Safety System for Spinal Injection
    Loubert et al.2011|Epidural volume extension in combined spinal epidural anaesthesia for elective caesarean section: a randomised controlled trial
    US20110224623A1|2011-09-15|Epidural space locating device
    JP6463748B2|2019-02-06|Anesthesia applicator / injector for dental and other applications and methods of use
    Kara et al.2016|The effect on pain of three different methods of intramuscular injection: A randomized controlled trial
    Khedkar et al.2015|Ultrasound-guided ilioinguinal and iliohypogastric nerve block, a comparison with the conventional technique: an observational study
    TW201617035A|2016-05-16|A equipment of using pressure detect to locate needle for medical purposes
    Christo et al.2011|Effective treatments for pain in the older patient
    Ghods et al.2014|Effect of lavender inhalation on pain intensity during insertion of vascular needles in hemodialysis patients
    Sodha et al.2017|Central neuraxial analgesia for labor: an update of the literature
    Rajakulendran et al.1999|Long-term neurological complication following traumatic damage to the spinal cord with a 25 gauge whitacre spinal needle
    ES2642171B1|2018-09-13|Medical syringe with pressure gauge
    Vlassakov et al.2020|A prospective, randomized comparison of ultrasonographic visualization of proximal intercostal block vs paravertebral block
    Kus et al.2013|Pleural puncture and intrathoracic catheter placement during ultrasound guided paravertebral block
    McHugh et al.2012|Interventional pain management in the palliative care patient
    Liou et al.2007|Broken needle in the cervical spine: a previously unreported complication of Xiaozendao acupuncture therapy
    Therese et al.2014|Effectiveness of Helfer skin tap technique and routine technique on pain reduction among patients receiving intramuscular injection at Government General Hospital, Puducherry
    WO2016034910A1|2016-03-10|Device for assisting in the detection of body cavities
    Benlabed et al.1990|Alkalinization of 0.5% lidocaine for intravenous regional anesthesia
    Ohgoshi et al.2018|Visualization of injectate spread of intercostal nerve block: a cadaveric study
    Fischer2009|Techniques of epidural block
    Kulesza et al.2014|Paravertebral blockade–Underrated method of regional anesthesia
    FERREIRA et al.2013|Facial edema reduction after alveolar bone grafting surgery in cleft lip and palate patients: a new lymphatic drainage protocol
    Mosso et al.2017|Study of gender differences in VR response following cardiac surgery
    Albokrinov et al.2019|Alternate method of loss of resistance test using 3-way stopcock and two syringes
    同族专利:
    公开号 | 公开日
    ES2642171B1|2018-09-13|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    US4000741A|1975-11-03|1977-01-04|The Kendall Company|Syringe assembly|
    US4215699A|1978-04-03|1980-08-05|The Kendall Company|Position indicating device|
    GB2226496A|1988-10-18|1990-07-04|Abdul Rahman Osman Ziko|Epidural space location device|
    US5902273A|1997-10-15|1999-05-11|Yang; Ian Y.|Pressurizable epidural space identification syringe|
    WO2010029428A1|2008-09-12|2010-03-18|Velez Rivera Hector De Jesus|Epidural space locating device|
    EP2883565A1|2013-10-07|2015-06-17|Ouyoudenshi Ind. Co., Ltd.|Epidural space-identifying device|
    法律状态:
    2018-09-13| FG2A| Definitive protection|Ref document number: 2642171 Country of ref document: ES Kind code of ref document: B1 Effective date: 20180913 |
    优先权:
    申请号 | 申请日 | 专利标题
    ES201630625A|ES2642171B1|2016-05-13|2016-05-13|Medical syringe with pressure gauge|ES201630625A| ES2642171B1|2016-05-13|2016-05-13|Medical syringe with pressure gauge|
    [返回顶部]