Continuous intercostal nerve analgesia catheter device

Abstract

According to the technical scheme, the continuous intercostal nerve analgesia catheter device is characterized in that the continuous intercostal nerve analgesia catheter device comprises a puncture needle, the puncture needle is connected with a guide wire, the puncture needle is provided with an empty pipeline for the guide wire to penetrate through and a hollow needle head communicated with the empty pipeline, the guide wire is connected with a catheter, and at least two side holes are formed in the front end of the catheter. The utility model has the following beneficial effects: local anesthetic can be diffused to three intercostal nerves through the lacuna to block corresponding intercostal nerves, so that full analgesia, intercostal nerve pre-burying and local medication are achieved, the continuous analgesia effect is achieved, and accurate, effective and sustainable postoperative analgesia can be realized.

Description

Technical Field

[0001] The utility model relates to a catheter device, more specifically, it relates to a continuous intercostal nerve analgesia catheter device. Background Art

[0002] Lung cancer is one of the most serious malignant tumors threatening human life and health. It is estimated that there will be about 2 million new cases worldwide in 2020, and the new mortality rate ranks first among all cancers. At the same time, with the widespread screening of low-dose chest CT, the number of patients with early lung cancer continues to increase, and surgical treatment is still the most effective means of treating early lung cancer. Thoracoscopic surgery is currently the mainstream solution.

[0003] Although the postoperative trauma of thoracoscopic patients is significantly less than that of open chest surgery, patients can recover quickly. However, postoperative chest pain is still the main symptom of patients, causing patients to be afraid to cough and take deep breaths after surgery, thereby increasing the incidence of complications such as postoperative lung infection and atelectasis. At the same time, it also causes anxiety to patients to a certain extent, which is not in line with the current concept of rapid recovery in surgery. It is currently believed that chest pain is mainly caused by instrument operation during surgery and compression of the intercostal nerves by the chest tube after surgery. The mainstream analgesic schemes include intravenous infusion of nonsteroidal analgesics, intravenous anesthesia analgesia pump application, epidural analgesia, single paravertebral nerve block and intercostal nerve block. We found that the two schemes of intravenous infusion of nonsteroidal analgesics and intravenous anesthesia analgesia pump are for the whole body, and the local analgesia effect is often poor. The anesthesia analgesia pump generally contains opioids, which cause patients to have postoperative nausea, vomiting, dizziness and other discomfort symptoms. Epidural analgesia has a good effect, but it is easy to cause hypotension and even respiratory depression, which requires special management by anesthesiologists and other unfavorable factors. Single paravertebral nerve block and intercostal nerve block are effective, but the analgesic duration is less than 8 hours. After 8 hours, the patient will lose the analgesic effect due to the half-life of the drug, and at this time, it is impossible to perform accurate intercostal nerve block again (usually with the help of thoracoscopy), which is not conducive to continuous analgesia for patients throughout the operation.

[0004] Currently, there is only one invention patent in 2014 that describes intercostal nerve block, which uses a parietal pleural external catheter method (patent number CN 105310749 A), but this patent has certain defects. First of all, this patent is not operated under direct vision, and the parietal pleura needs to be punctured. After a sense of emptiness, it is judged that the puncture needle is outside the pleura. It is impossible to accurately judge that the puncture needle is outside the pleura. At the same time, the parietal pleura is destroyed, and the local anesthetic is easy to penetrate into the chest cavity after injection; secondly, the intercostal nerve block is located 3 cm beside the vertebrae. This position is not conducive to the patient's postoperative rest. The drainage tube is easy to cause discomfort to the patient when lying flat and is easy to be bent; in addition, the front of the inserted catheter is straight, without a fixing device, and it is easy to fall off with the patient's breathing and arm movement. In addition, the inserted catheter is not guided by a guidewire, and it is not easy to reach the position where it needs to be placed; finally, the device uses manual injection of local anesthetic drugs into the catheter, and a dedicated person is required to be responsible for injecting drugs, which is cumbersome, and analgesia may not be continuous. Without continuous administration of extrapleural drugs, it is easy to cause cavity blockage and collapse. Most of the postoperative wound pain after thoracic surgery is caused by intercostal nerve damage. Since the intercostal nerves are located at the lower edge of the ribs, close to the parietal pleura, and have no natural cavity, local anesthetics cannot be continuously pumped in. Utility Model Content

[0005] In view of the deficiencies in the prior art, the purpose of the present utility model is to provide a continuous intercostal nerve analgesia catheter device, which can accurately and effectively provide sustainable analgesia after thoracic surgery and reduce the use of systemic analgesics.

[0006] To achieve the above-mentioned purpose, the utility model provides the following technical solutions: a continuous intercostal nerve analgesia catheter device, comprising a puncture needle for insertion between the parietal pleura and the intercostal muscles, the puncture needle being connected to a guide wire, the puncture needle being provided with an empty tube for the guide wire to pass through and a hollow needle connected to the empty tube, the guide wire being connected to a catheter, and at least two side holes being provided at the front end of the catheter.

[0007] In summary, the utility model has the following beneficial effects: first, the intercostal position is confirmed with the aid of a thoracoscope, the integrity of the parietal pleura is observed, and the intercostal nerve block site is confirmed. The puncture point is usually taken at a position 5 cm from the incision on the posterior axillary line. Under direct vision of the thoracoscope, the puncture needle is vertically inserted close to the upper edge of the ribs, close to the surface of the parietal pleura, and 10 ml of ropivacaine is injected through the puncture needle by a syringe. At this time, the parietal pleura will form a potential cavity with the intercostal muscles. Then a guide wire is inserted from the puncture needle, and the guide wire is inserted 2 cm in a direction parallel to the intercostal space, and fixed between the parietal pleura and the intercostal muscles. The puncture needle is pulled out, and a catheter with a semicircular head end is inserted into the potential cavity between the parietal pleura and the intercostal muscles under the guidance of the guide wire. The catheter is fixed on the chest wall, and 10 ml of ropivacaine is injected again through the syringe to connect the catheter to confirm that the catheter is unobstructed, and at the same time, the gap between the parietal pleura and the intercostal muscles is enlarged. Usually, the parietal local anesthetic can diffuse to the three intercostals through the gap, blocking the corresponding intercostal nerves, achieving full analgesia, pre-embedded intercostal nerves, and giving local medication to achieve a continuous analgesic effect, which can achieve accurate, effective and sustainable postoperative analgesia. The present invention can accurately insert the catheter into the artificially created gap between the parietal pleura and the intercostal muscles under direct vision of the thoracoscope, without destroying the parietal pleura throughout the process. BRIEF DESCRIPTION OF THE DRAWINGS

[0008] Figure 1 This is a schematic diagram of the connection structure of the continuous intercostal nerve analgesia catheter device;

[0009] Figure 2 is a schematic diagram of the connection structure of the catheter;

[0010] Figure 3 Schematic diagram of the connection structure of the connector. DETAILED DESCRIPTION

[0011] The present invention is further described in detail below in conjunction with the accompanying drawings and embodiments. The same parts are represented by the same reference numerals. It should be noted that the words "front", "rear", "left", "right", "upper" and "lower" used in the following description refer to directions in the accompanying drawings, and the words "bottom surface" and "top surface", "inside" and "outside" refer to directions toward or away from the geometric center of a specific component, respectively.

[0012] Reference Figure 1-3 As shown, a continuous intercostal nerve analgesia catheter device includes a puncture needle 1 for insertion between the parietal pleura and the intercostal muscles, the puncture needle 1 is connected to a guide wire 2, the puncture needle 1 is provided with an empty tube 11 for the guide wire 2 to pass through and a hollow needle 12 connected to the empty tube 11, the guide wire 2 is connected to a catheter 3, and the front end of the catheter 3 is provided with at least two side holes 31.

[0013] Through the above scheme, the intercostal position is first confirmed with the help of thoracoscopy, the integrity of the parietal pleura is observed, and the intercostal nerve block site is confirmed. The puncture point is usually 5 cm away from the incision on the posterior axillary line. Under direct vision of the thoracoscopy, the puncture needle 1 is vertically inserted close to the upper edge of the ribs and close to the surface of the parietal pleura. The syringe injects 10 ml of ropivacaine through the puncture needle 1. At this time, the parietal pleura will form a potential cavity with the intercostal muscles. Then, the guide wire 2 is inserted from the puncture needle 1, and the guide wire 2 is inserted 2 cm in the direction parallel to the intercostal space and fixed between the parietal pleura and the intercostal muscles. The puncture needle 1 is pulled out, and the catheter 3 with a semicircular head end is inserted into the potential cavity between the parietal pleura and the intercostal muscles under the guidance of the guide wire 2. The catheter 3 is fixed on the chest wall, and 10 ml of ropivacaine is injected again through the syringe to confirm that the catheter 3 is unobstructed, and the gap between the parietal pleura and the intercostal muscles is enlarged. Usually, the parietal local anesthetic can diffuse to the three intercostals through the gap, block the corresponding intercostal nerves, achieve full analgesia, pre-embed the intercostal nerves, and give local medication to achieve a continuous analgesic effect, which can achieve accurate, effective and sustainable postoperative analgesia. The present invention can accurately insert the catheter 3 into the artificially created gap between the parietal pleura and the intercostal muscles under direct vision of the thoracoscope, without destroying the parietal pleura throughout the process.

[0014] As an improved specific implementation, the rear end of the catheter 3 is provided with a connector 32 for connecting a syringe or a pain relief pump.

[0015] Through the above scheme, the tube is directly sealed with a heparin cap, and when the patient feels pain, a syringe is used to directly inject local anesthetics, or a pain pump is used. This can reduce medical expenses and facilitate quick treatment.

[0016] As an improved specific implementation, the connector 32 is provided with an external threaded tube 33 .

[0017] Through the above scheme, it is convenient to connect for use or close.

[0018] As an improved specific implementation, the connector 32 is connected to a pumping device for continuously pumping the liquid medicine.

[0019] Through the above scheme, local anesthetics can be continuously pumped in a quantitative and constant speed, which is convenient and quick. At the same time, it can avoid the closure of potential cavities, allowing patients to maintain a pain-free state for a long time after surgery and improve the comfort of patients during hospitalization.

[0020] As an improved specific implementation, a buckle 34 for clamping the catheter 3 is provided on the catheter 3 .

[0021] Through the above scheme, it is convenient to quickly close the catheter 3.

[0022] As an improved specific implementation, the catheter 3 is provided with a guide hole 35 for the guide wire 2 to pass through.

[0023] The above solution facilitates the insertion of the guide catheter 3.

[0024] As an improved specific implementation, the number of the side holes 31 is at least 4, and the spacing between them is more than 5 mm.

[0025] The above solution can avoid the side hole 31 from being blocked and the local anesthetic cannot be injected.

[0026] As an improved specific implementation, the front end of the guide wire 2 can be bent into a semicircle, and the length of the complete semicircle arc is 1-4 cm.

[0027] Through the above solution, the semicircular part of the front end of the guide wire is relatively soft and is also designed to automatically return to a semicircular state, so as to facilitate fixation, avoid injury, and reduce discomfort.

[0028] As an improved specific implementation, the front end of the catheter 3 can be bent along with the front end of the guide wire 2 .

[0029] Through the above scheme, the front end of the catheter 3 is also semicircular after insertion, and can fit tightly into the potential cavity after entering the cavity. Even if the drug is absorbed, it is not easy to escape from the potential cavity, which can also reduce the patient's discomfort.

[0030] As an improved specific implementation, a plurality of side holes 31 are distributed on different sides of the catheter 3 .

[0031] Through the above solution, the front end of the catheter is designed with multiple side holes in different planes, which can prevent the side hole 31 from being blocked and unable to inject local anesthetics.

[0032] The above is only a preferred embodiment of the present invention. The protection scope of the present invention is not limited to the above embodiments. All technical solutions under the concept of the present invention belong to the protection scope of the present invention. It should be pointed out that for ordinary technicians in this technical field, some improvements and modifications without departing from the principle of the present invention should also be regarded as the protection scope of the present invention.

Claims

1. A continuous intercostal nerve analgesia catheter device, characterized by: The invention comprises a puncture needle (1) for inserting into the parietal pleura and the intercostal muscles, the puncture needle (1) being connected to a guide wire (2), the puncture needle (1) being provided with an empty tube (11) for the guide wire (2) to pass through and a hollow needle (12) connected to the empty tube (11), the guide wire (2) being connected to a catheter (3), the front end of the catheter (3) being provided with at least two side holes (31).

2. The continuous intercostal nerve analgesia catheter device according to claim 1 is characterized by: The rear end of the catheter (3) is provided with a connector (32) for connecting a syringe or a pain relief pump.

3. The continuous intercostal nerve analgesia catheter device according to claim 2 is characterized by: The connector (32) is provided with an externally threaded tube (33).

4. The continuous intercostal nerve analgesia catheter device according to claim 2, characterized in that: The connector (32) is connected to a pumping device for continuously pumping in the medical solution.

5. The continuous intercostal nerve analgesia catheter device according to claim 1, characterized in that: The catheter (3) is provided with a buckle (34) for clamping the catheter (3).

6. The continuous intercostal nerve analgesia catheter device according to claim 1, characterized in that: The catheter (3) is provided with a guide hole (35) for the guide wire (2) to pass through.

7. The continuous intercostal nerve analgesia catheter device according to any one of claims 1 to 6, characterized in that: The number of the side holes (31) is at least 4, and the spacing between them is greater than 5 mm.

8. The continuous intercostal nerve analgesia catheter device according to claim 7, characterized in that: The front end of the guide wire (2) can be bent into a semicircle, and the length of the complete semicircle arc is 1-4 cm.

9. The continuous intercostal nerve analgesia catheter device according to claim 8, characterized in that: The front end of the catheter (3) can be bent along with the front end of the guide wire (2).

10. The continuous intercostal nerve analgesia catheter device according to claim 9, characterized in that: The plurality of side holes (31) are distributed on different sides of the catheter (3).

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