Source: https://patents.google.com/patent/WO2011030654A1/en
Timestamp: 2020-06-01 23:58:58
Document Index: 69395979

Matched Legal Cases: ['art 61', 'art 60', 'art 10', 'art 60', 'art 24', 'art 32', 'art 61', 'art 62', 'art 62']

WO2011030654A1 - Laryngoscope - Google Patents
WO2011030654A1
WO2011030654A1 PCT/JP2010/064008 JP2010064008W WO2011030654A1 WO 2011030654 A1 WO2011030654 A1 WO 2011030654A1 JP 2010064008 W JP2010064008 W JP 2010064008W WO 2011030654 A1 WO2011030654 A1 WO 2011030654A1
PCT/JP2010/064008
2009-09-08 Priority to JP2009-207006 priority
2010-08-19 Application filed by 国立大学法人岡山大学 filed Critical 国立大学法人岡山大学
2011-03-17 Publication of WO2011030654A1 publication Critical patent/WO2011030654A1/en
210000002409 Epiglottis Anatomy 0 claims abstract description 52
210000000214 Mouth Anatomy 0 claims abstract description 11
Disclosed is a laryngoscope which is capable of safely and reliably lifting the epiglottis to easily view the entrance to the trachea directly. Specifically disclosed is a laryngoscope in which the base end section of a blade for being inserted from patients mouth to lift the epiglottis in order to visually identify the entrance to the trachea is consecutively installed at the end of a handle which can be gripped, and which is configured in such a manner that a first electrode is provided to the base end section of the blade and a second electrode can be adhered to the skin surface adjacent to the epiglottis, and that a low-frequency current is energized between the first electrode and the second electrode.
The present invention relates to a laryngoscope, and more particularly, to a laryngoscope used to raise the epiglottis used in anesthesia, emergency, intensive care, and the like to visually recognize the trachea entrance.
In the fields of anesthesia, emergency, intensive care, etc., it is common practice to insert a tube from the oral cavity into the trachea and secure the airway path, which is the oxygen path required for breathing (secure airway).
When securing the airway, a procedure called laryngeal deployment is performed prior to the insertion of the tube in order to visually recognize the tracheal inlet. In other words, a lid portion called the epiglottis exists at the trachea inlet, and food and drinks are prevented from entering the trachea by the epiglottis. When securing the airway, if the epiglottis does not rise, the visual field may be obstructed and the tracheal entrance may not be visible. Therefore, laryngeal deployment is performed in order to raise the epiglottis and visually recognize the tracheal entrance.
For laryngeal deployment, an instrument called a laryngoscope having a blade that can be inserted into the patient's mouth is used. Specifically, the laryngeal deployment is a treatment in which the tongue is pushed laterally by the blade of the laryngoscope and the proximal end of the epiglottis is pressed by the blade tip to raise the epiglottis.
In the past, the airway was secured by a doctor, but if the epiglottis does not rise and the airway entrance is not sufficiently visible, the doctor can imagine the trachea entrance using technology and intuition to secure the airway. Had gone.
The present invention has been made in view of such problems, and an object of the present invention is to provide a laryngoscope capable of raising the epiglottis safely and reliably and easily viewing the tracheal entrance.
Further, in the invention according to claim 2, in the laryngoscope according to claim 1, the low frequency current is a pulse having a frequency of 10 to 100 Hz and a current value of 10 mA to 100 mA.
Further, the invention according to claim 4 is the laryngoscope according to any one of claims 1 to 3, wherein the second electrode is configured to be able to be applied to the skin surface in the vicinity of the epiglottis.
Further, the invention according to claim 5 is the laryngoscope according to any one of claims 1 to 4, wherein an imaging unit is provided at a distal end portion of the blade, and a display unit is tiltable at a proximal end of the handle. Provided, and the video imaged by the imaging unit is displayed on the display unit.
According to the first aspect of the present invention, the first electrode and the second electrode are provided, a low-frequency current is passed between the first electrode and the second electrode, and the muscle around the epiglottis is stimulated by the low-frequency current. Since the epiglottis was raised and contracted, the tracheal intubation was possible not only for reliable tracheal intubation, but also for cases where lifesaving technicians could not intubate (cases where the trachea could not be seen directly) And more patients can be saved.
According to the invention of claim 2, since the low-frequency current is a pulse having a frequency of 10 to 100 Hz and a current value of 10 mA to 100 mA, the larynx can be deployed without imposing an excessive burden on the patient. Can do.
It is a figure which shows schematic structure of the laryngoscope which concerns on this embodiment. FIG. 2 is a cross-sectional view taken along the line AA in FIG. It is a figure which shows the modification of a laryngoscope. It is a figure which shows the other modification of a laryngoscope. It is a block diagram which shows the electrical structure of the laryngoscope which concerns on this embodiment. It is a figure which shows the other modification of a laryngoscope. It is a figure which shows a tracheal intubation tube. It is a figure which shows the use condition of the laryngoscope which concerns on this embodiment. It is a figure which shows a mode that a epiglottis changes. It is a figure which shows schematic structure of the laryngoscope which concerns on a modification.
FIG. 1 is an external perspective view of a laryngoscope according to the present embodiment, and FIG. 2 is a cross-sectional view taken along the line AA in FIG. As shown in FIG. 1, the laryngoscope 1 includes a handle 10 and a blade 11 provided on the handle 10. A first electrode 12 a is disposed on the contact surface of the epiglottis formed at the tip of the blade 11 with the base end. Separately from the main body of the laryngoscope 1, a second electrode 12b is disposed at a position where the first electrode 12a is energized. A power switch 13 is disposed on the outer peripheral surface of the handle 10, and a power supply unit 14 and a low frequency generation unit 15 are provided inside the handle 10.
The handle 10 has a thickness that is easy to grip so that a person who secures the airway (hereinafter referred to as “surgeon”) such as a doctor or a paramedic can easily operate the blade 11 when gripped by a hand. In addition to being formed in a substantially cylindrical shape, vertical, horizontal and oblique knurls are formed on the surface thereof.
A connection case 17 is formed at the distal end portion 10a of the handle 10, and a shaft 17a is installed inside the case 17, and the base end portion 11a of the blade 11 is pivotally supported by the shaft 17a in a foldable manner.
Further, it is desirable that the cover 50 be formed of a material having insulation properties as described above and having flexibility, such as silicon resin. This is because the cover 50 is used for blades having different shapes.
The second electrode 12b is embedded in an adhesive pad (not shown) on the surface, and is configured to be able to be applied to the skin surface near the epiglottis of the patient. The second electrode 12 b is connected to the base end portion 10 b of the handle 10 through the wiring 16, and is electrically connected to the low frequency generator 15 inside the handle 10. The position to which the second electrode 12b is connected is not limited to the base end portion 10b of the handle 10, and may be connected to an external power supply device (not shown) and supplied with a low frequency current from the power supply device, for example. .
The low frequency generation unit 15 is configured by, for example, a digital signal generation circuit, a DA conversion circuit, and a filter (all not shown). The digital signal generation circuit is a circuit having a function of storing waveform data defining a waveform of a low-frequency current and a function of outputting a digital signal according to the waveform data. The digital signal generation circuit stores a plurality of types of waveform data, and can change the output waveform according to the frequency. The DA conversion circuit is a circuit having a function of converting a digital signal output from the digital signal generation circuit into an analog signal and outputting a source waveform. The filter is a filter for performing anti-aliasing of the source waveform, and typically a low-pass filter is used.
As shown in FIG. 5, in the handle 10 of the laryngoscope 1, the low frequency generator 15 is connected to the power switch 13 via the power supply 14. The low frequency generator 15 is also connected to a first electrode 12 a and a second electrode 12 b that are arranged separately from the handle 10.
This is an electronic volume for adjusting the frequency and current value of the low-frequency current generated by the low-frequency generator 15. The low-frequency generator 15 generates a low-frequency current having the frequency and current value adjusted by the wave number converter 18. It is supposed to be.
Further, the laryngoscope 1 provided with the frequency converter 18 and the adjustment dial 19 can generate a low-frequency current having an arbitrary frequency and current value depending on the definition of the waveform data. For example, not only the above-described low-frequency current with a frequency of 50 Hz and a current value of 50 mA, it is also possible to generate low-frequency currents with different frequencies in stages or low-frequency currents with different current values in stages.
The ranges of the frequency and current value assigned to the channel are, for example, a frequency of 10 to 100 Hz and a current value of 10 mA to 100 mA. For example, the frequency and the current value are assigned stepwise for each frequency of 10 Hz and a current value of 10 mA.
Next, an airway securing method using the laryngoscope 1 will be described. In addition, about this embodiment, the method of airway ensuring by tracheal intubation is demonstrated. Tracheal intubation is an airway securing method that is performed by inserting the tracheal intubation tube 20 from the mouth or nose into the trachea via the larynx. First, the tracheal intubation tube 20 and the stylet 30 used for tracheal intubation will be briefly described.
It should be noted that the frequency and current value of the low-frequency current are 50 Hz and 50 mA. As a result, the muscle can be directly stimulated. Further, when the energy of the low frequency current is low, that is, when the frequency is low and the current value is low, the raising of the epiglottis is insufficient. On the other hand, when the energy of the low frequency current is high, that is, when the frequency is high and the current value is high, inflammation such as burns occurs around the epiglottis.
For example, when laryngeal deployment is performed using a McCoy laryngoscope as described in the prior art, as described above, pressure is applied more than necessary to the proximal end portion 44 of the epiglottis 43 due to erroneous operation due to tension or the like, and the epiglottis The base is often damaged, and hematoma and edema sometimes lead to a critical situation. In the laryngoscope 1, a preset low-frequency current is applied by a switch operation to electrically contract the muscles and the epiglottis. To raise hematoma and edema.
Next, a modified example of the laryngoscope 1 according to the present embodiment will be described. FIG. 10 is a diagram showing a schematic configuration of a laryngoscope 1A according to a modification.
1 A of laryngoscopes have the imaging part 61 in the front-end | tip part of the braid | blade 11, and also have the display part 60 in the base end part 10b of the handle | steering-wheel 10, and when performing tracheal intubation, the intraoral of a patient is imaged. The video imaged by the imaging unit 61 is displayed on the display unit. Thereby, the surgeon can easily grasp the state in the oral cavity, and can more easily perform tracheal intubation. A more specific configuration will be described below.
The blade 11A has a fixing member (not shown) in addition to the blade 11 described above, and the imaging unit 61 is fixed to the surface of the tongue pressure unit 11b by the fixing member. The fixing member has, for example, a configuration that sandwiches the imaging unit 61 from both ends.
The imaging unit 61 is constituted by a CCD (Charge Coupled Device) camera, for example. A connection terminal is formed in the imaging unit 61, and one end of the cable 65 is connected through the connection terminal. The video signal captured by the imaging unit 61 can be output to the outside. In addition, an irradiation unit (not shown) configured by, for example, an LED (Light Emitting Diode) is disposed in the vicinity of the imaging unit 61 so that an imaging region captured by the imaging unit 61 can be irradiated. Yes.
The handle 10A has substantially the same configuration as the handle 10 described above, but differs in that the handle 10A has an attachment portion 62 for providing the display portion 60 at the base end portion 10b of the handle 10A. The mounting portion 62 has an arm 62a extending in a direction opposite to the extending direction of the blade 11, and the arm 62a has a shaft 62b extending in the left-right direction at its tip. And the display part 60 is pivotally arranged with respect to the handle | steering-wheel 10 around the axis | shaft 62b.
The display unit 60 is composed of, for example, an LCD (Liquid Crystal Display). The display unit 60 is connected to the other end of the cable 65 so that a video signal of a video image captured by the imaging unit 61 can be input and a video image based on the video signal can be displayed.
The laryngoscope 1A having such a configuration is used when performing laryngeal deployment in the same manner as the laryngoscope 1 described above. That is, after inserting the blade 11 of the laryngoscope 1 from the lip 41 of the patient 40 and pushing the tongue portion 42 laterally, the first electrode 12 a is brought into contact with the contact surface of the proximal end portion 44 of the epiglottis 43. Next, the handle 10 is lifted upward to press the proximal end portion 44 of the epiglottis 43 at the distal end portion 11d of the blade 11, and the power switch 13 is turned on between the first electrode 12a and the second electrode 12b. A low frequency current is applied to raise the epiglottis 43.
Although the present invention has been described with the present embodiment and its modifications, the present invention is not limited to this embodiment, and various modifications are possible.
1,1A Laryngoscope 10, 10A Handle 10a Handle distal end 10b Handle proximal end 11, 11A Blade 11a Blade proximal end 11b Blade tongue pressure portion 11c Blade pressure plate 11d Tongue pressure tip 11e Contact convex portion 12a First electrode 12b Second electrode 13 Power switch 14 Power source 15 Low frequency generator 16 Wiring 17, 17A Connection case 17a Shaft 18 Frequency converter 19 Adjustment dial 20 Tracheal intubation tube 21 Airway tube 22 Opening 23 Cuff Part 24 inflating tube 25 expansion valve 30 stylet 31 guide part 32 rod 50 cover 60 display part 61 imaging part 62 mounting part 62a arm 62b shaft 65 cable
In the laryngoscope in which the proximal end of the blade for inserting the patient's mouth to raise the epiglottis is connected to the distal end of the handle that can be grasped,
2. The laryngoscope according to claim 1, wherein the low-frequency current is a pulse having a frequency of 10 to 100 Hz and a current value of 10 mA to 100 mA.
The laryngoscope according to claim 1 or 2, wherein the first electrode is disposed through an insulating cover that covers at least the tip of the blade.
The laryngoscope according to any one of claims 1 to 3, wherein the second electrode is configured to be attached to a skin surface in the vicinity of the epiglottis.
5. An imaging unit is provided at a distal end of the blade, and a display unit is tiltably provided at a proximal end of the handle, and an image captured by the imaging unit is displayed on the display unit. The laryngoscope according to any one of the above.
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