WO2003004093A2 - Equipment for treating painful points in the organism - Google Patents

Equipment for treating painful points in the organism Download PDF

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Publication number
WO2003004093A2
WO2003004093A2 PCT/FR2002/002366 FR0202366W WO03004093A2 WO 2003004093 A2 WO2003004093 A2 WO 2003004093A2 FR 0202366 W FR0202366 W FR 0202366W WO 03004093 A2 WO03004093 A2 WO 03004093A2
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WO
WIPO (PCT)
Prior art keywords
electrode
neurostimulator
nerve
needle
equipment according
Prior art date
Application number
PCT/FR2002/002366
Other languages
French (fr)
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WO2003004093A3 (en
Original Assignee
Naja, Zohar
Naja, Mohamed Zouheir
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Naja, Zohar, Naja, Mohamed Zouheir filed Critical Naja, Zohar
Priority to AU2002328383A priority Critical patent/AU2002328383A1/en
Publication of WO2003004093A2 publication Critical patent/WO2003004093A2/en
Publication of WO2003004093A3 publication Critical patent/WO2003004093A3/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0502—Skin piercing electrodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551—Spinal or peripheral nerve electrodes

Definitions

  • the present invention relates to a material allowing the realization of a treatment of pain points at the level of the organism, whatever the topography of the pain zone.
  • This material can act from the base of the skull to the toe through the neck, upper limbs, thorax, abdomen, pelvis and lower limbs.
  • the invention aims to remedy these drawbacks.
  • the equipment it concerns includes:
  • a neurostimulator that is to say by a device delivering an electric current capable of exciting a nerve
  • an electrode connected to the neurostimulator the distal end of which is intended to be applied to the patient's skin to electrically stimulate nerves, and thus make it possible to detect the nerve concerned
  • a marking device suitable for affixing a mark on the skin of the patient in the immediate vicinity of the distal end of the electrode
  • an injection set of an appropriate pain-relieving product comprising a graduated hollow needle, of material electrically conductive of electricity, but comprising a sheath of insulating material electrically which completely covers it, except for its distal end and a proximal zone; this needle being electrically connected to the neurostimulator by this proximal zone, and being in fluid connection with a product injection device.
  • the detection process consists in passing the detection and locating assembly all the way through the patient's skin by stimulating the nerves located in the vicinity, until detecting the nerve concerned by the pain that the patient experiences. Once this nerve has been identified, the passage of electrical current through the electrode is stopped, and the marking device is actuated so as to affix a mark on the patient's skin, in the immediate vicinity of the location at which the end of the electrode.
  • the injection set is then used: the graduated needle is gently inserted through the skin at the previously marked point, its graduation making it possible to specify the depth of its injection end in the underlying tissues.
  • the needle is then connected to the neurostimulator, so as to pass a current of low intensity through it, which makes it possible to locate the nerve concerned by means of the distal end of the needle.
  • the current is then stopped, and the substance contained in the injection device, which is in particular a syringe, is injected through the needle.
  • the dimensions of the needle used, in length and in section, depend directly on the injection site.
  • the section of the needle should be approximately 27 gauges (1, 42 mm in diameter), and its length 2.5 cm , which is adapted to the thickness of the skin, and the underlying tissues in this region of the body. Indeed, as the thickness of the skin and of the underlying tissues increases, the dimensions of the needle, in length and in section, increase.
  • the neurostimulator is designed to deliver an electric current whose intensity can be adjusted between 0 and 6.5 milliamps.
  • the optimal intensity of stimulation varies according to the part of the body treated, and this range of possible variation of intensity allows the material according to the invention to be adapted to treat numerous parts of the body.
  • the electrode and the marking device are placed in a tubular envelope of insulating material, so that the detection assembly is in the form of a "pencil".
  • the detection and identification assembly may comprise a switch for placing the electrode in electrical connection, or out of electrical connection with the neurostimulator; said tubular casing can then include a button for controlling this switch, placed on its lateral face.
  • the tubular envelope may also include a button placed on its lateral face, for controlling the affixing of a mark on the patient's skin by the marking device.
  • the detection and marking assembly is particularly easy to handle, being held in the manner of a pencil, and the electrical stimulation of the nerve as well as the affixing of a mark are particularly easy operations. order, simply by acting on the corresponding control buttons.
  • the distal part of the electrode may have the shape of a ball, making it possible to clearly mark the location of the nerve concerned.
  • the needle has, at its distal injection end, an axial injection hole, and at least one radial injection hole.
  • Figure 1 is a very simplified view of the three sets that it includes, namely a neurostimulator schematized by a rectangle, a detection and tracking assembly, shown in longitudinal section, and an injection set for a pain reliever, comprising a needle also shown in longitudinal section; this detection and tracking assembly, as well as this injection assembly are shown on a much enlarged scale relative to the scale on which the neurostimulator is represented;
  • FIG. 1 is a very simplified view of the three sets that it includes, namely a neurostimulator schematized by a rectangle, a detection and tracking assembly, shown in longitudinal section, and an injection set for a pain reliever, comprising a needle also shown in longitudinal section; this detection and tracking assembly, as well as this injection assembly are shown on a much enlarged scale relative to the scale on which the neurostimulator is represented;
  • FIG. 2 is a view of the neurostimulator, of the detection and tracking assembly in use, this figure also showing a nerve to be treated, and of tissues covering this nerve;
  • Figure 3 is a view similar to Figure 2, in a subsequent step of using the material, and
  • Figure 4 is a view of the neurostimulator and the injection assembly in use, the needle that includes this injection assembly being engaged through the tissues to near the area of the nerve to be treated.
  • FIG. 1 represents a neurostimulator 1, a set 2 for detecting, locating the nerve to be treated, and a set 3 for injecting a pain-relieving product.
  • the neurostimulator 1 is of the conventional type, except that it is arranged so as to be able to deliver an electric current of adjustable intensity, over a range going from 0 to 6.5 milliamps.
  • the neurostimulator 1 is connected to a connection box 5 by an electrically conductive wire 6. From this box 5, two wires leave: 7, 8 electrically conductive, which respectively allow the neurostimulator 1 to be electrically connected to the assembly 2 and to the 'assembly 3.
  • the wire 7 is permanently connected to a terminal of a switch 10, which includes the assembly 2, while the wire 8 is connected to a clamp 1 1, which can be placed on the proximal end of the needle 1 2, which comprises the assembly 3.
  • the neurostimulator 1 also comprises a wire 15 which electrically connects it to an adhesive electrode 1 6, suitable for being applied to the skin of a patient.
  • the assembly 2 comprises an electrode 20, a marking device 21, and a tubular envelope 22.
  • the electrode 20 is connected by its proximal end to the terminal of the switch 10 not connected to the wire 7, and comprises, at its distal end, a ball 25 intended to come into contact with the patient's skin.
  • the marking device 21 comprises an ink reserve 26, suitable for marking the patient's skin, which communicates with the distal end of this device 21 by a conduit allowing this ink to be delivered.
  • the device 21 also comprises a spring 27, members (not shown) for positioning the device 21, in a retracted position and an extended position, and a button 28 for actuating these members. In the retracted position, the distal end of the device 21 is retracted in the envelope 22, and in the extended position, this distal end protrudes from the envelope 22, and is able to mark the patient's skin.
  • This device 21 can have a structure very similar, or even identical, to that of a bi àe pen with retractable tip.
  • the tubular casing 22 is made of insulating material.
  • It keeps the distal ends of the electrode 20 and the device 21 side by side, and in close proximity to each other. It comprises the button 28 and a button 29 for actuating the switch 10, this button 28 and this button 29 projecting from the external face of the envelope 22, at the level of the proximal end thereof.
  • the needle 1 2 is hollow, and is made of metallic material. It comprises a sheath 30 of electrically insulating material, which completely covers it except for its distal end 1 2a, and its proximal area 1 2b, this sheath 30 comprising a graduation 31 printed on it.
  • Needle 1 2 can be electrically connected to the neurostimulator
  • the needle 12 has, at its distal end 12a, an axial injection hole 37 and a radial injection hole 38, set back from the hole 37.
  • the electrode 1 6 is glued to the skin 50 of the patient, and the button 29 is pressed so as to electrically connect the electrode 20 to the neurostimulator 1.
  • a mark 40 is thus affixed to the skin of the patient, as shown in FIG. 3, in the immediate vicinity of the location, at which the distal end of the electrode 20 is located when the nerve 51 is excited.
  • the needle 1 2 is then connected to the neurostimulator 1 by means of the clamp 1 1, and is delicately inserted through the skin 50 at the level of the mark 40. Its graduation 31 makes it possible to precisely determine the depth of its distal end 12a in tissues 52.
  • the needle 12 is then connected to the neurostimulator 1, so as to pass an electrical current through it.
  • the distal end 1 2a not isolated from this needle, makes it possible to sufficiently excite the nerve 51 to confirm the location of this nerve.
  • the sheath 30 allows isolation of the needle 1 2 outside this distal end 1 2a, which eliminates the risk of stimulating the surrounding nerves.
  • the electric current is interrupted, and the substance contained in the syringe 36 is injected through the needle 12.
  • the hole 38 allows, together with the hole 37, the diffusion of the product in several directions, which allows a perfectly effective treatment of the painful site.
  • the invention provides a material for treating painful points, having the advantages of allowing this treatment, whatever the topography of the painful area, to eliminate any risk of damaging the tissues or the structure. anatomically surrounding the pain point, and allow for precise injection, ensuring that the pain point is exactly reached by the tip of the needle.

Abstract

The invention concerns an equipment comprising: a nerve stimulator (1); a set for detecting and locating the nerve concerned (51), including: an electrode (20) connected to the nerve stimulator (1), whereof the distal end is designed to be applied on the patient's skin to stimulate nerves, thereby enabling to detect the nerve concerned (51), a marking device (21) for affixing a mark (40) on the patient's skin immediately proximate to the distal end of the electrode (20); a set (3) for injecting a pain-killing product, comprising a graduated hollow needle (12) made of an electrically conductive material, but comprising a sleeve (30) made of electrically insulating material completely sheathing it, except for its distal end (12a) and a proximal zone (12b), said needle (12) being electrically connected to the nerve stimulator (1) through said proximal zone (12b), and being in fluid connection with a product injecting device (36).

Description

MATERIEL PERMETTANT LA REALISATION D'UN TRAITEMENT DE POINTS DOULOUREUX AU NIVEAU DE L'ORGANISME MATERIAL ALLOWING THE TREATMENT OF PAIN POINTS AT THE ORGANIZATION LEVEL
La présente invention concerne un matériel permettant la réalisation d'un traitement de points douloureux au niveau de l'organisme, quelle que soit la topographie de la zone douloureuse. Ce matériel peut agir de la base du crâne jusqu'à l'orteil en passant par le cou, les membres supérieurs, le thorax, l'abdomen, le bassin et les membres inférieurs.The present invention relates to a material allowing the realization of a treatment of pain points at the level of the organism, whatever the topography of the pain zone. This material can act from the base of the skull to the toe through the neck, upper limbs, thorax, abdomen, pelvis and lower limbs.
Une telle procédure est actuellement réalisée de la manière suivante : le site de l'injection est détecté par palpation de la région douloureuse avec le doigt, afin de déterminer précisément l'emplacement du point douloureux (cf. l'ouvrage "Myofascial pain and dysfunction - The trigger point manual", de Travell et Simon) ; l'aiguille est ensuite enfoncée au niveau de ce point douloureux en traversant la peau, et les tissus sous-jacents pour arriver à la région responsable du déclenchement de la douleur (cf. !' ouvrât1 s "Atlas of oβin manaπerπent injβf+ion tp.r.hniπues", de Waldman) ; un produit pharmacologique adapté est alors injecté au niveau du point douloureux à l'aide d'une seringue liée à une aiguille de 22 à 27 gauges ( 1 , 1 5 mm à 1 ,42 mm de diamètre), dont la longueur varie selon le site d'injection.Such a procedure is currently carried out in the following manner: the site of the injection is detected by palpation of the painful region with the finger, in order to precisely determine the location of the painful point (cf. the book "Myofascial pain and dysfunction - The trigger point manual ", by Travell and Simon); the needle is then inserted at this pain point crossing the skin and the underlying tissues to reach the region responsible for triggering the pain (cf.! opening 1 s "Atlas of oβin manaπerπent injβf + ion t p .r.hniπues ", from Waldman); a suitable pharmacological product is then injected at the pain point using a syringe linked to a needle of 22 to 27 gauges (1.15 mm to 1.42 mm in diameter), the length of which varies according to the injection site.
Une telle manoeuvre a pour inconvénient de risquer d'endommager les tissus ou la structure anatomique entourant le point douloureux. De plus, cette manœuvre se fait d'une manière relativement imprécise, et il n'est pas sûr que le point douloureux va être exactement atteint par le bout de l'aiguille.The disadvantage of such a maneuver is that it risks damaging the tissues or the anatomical structure surrounding the pain point. In addition, this maneuver is done in a relatively imprecise manner, and it is not certain that the pain point will be exactly reached by the tip of the needle.
L'invention a pour objectif de remédier à ces inconvénients.The invention aims to remedy these drawbacks.
A cet effet, le matériel qu'elle concerne comprend :To this end, the equipment it concerns includes:
- un neurostimulateur, c'est-à-dire par un appareil délivrant un courant électrique propre à exciter un nerf ;- a neurostimulator, that is to say by a device delivering an electric current capable of exciting a nerve;
- un ensemble de détection et de repérage du nerf concerné, comprenant :- a set of detection and identification of the nerve concerned, comprising:
. une électrode reliée au neurostimulateur, dont l'extrémité distale est destinée à être appliquée sur la peau du patient pour stimuler électriquement des nerfs, et permettre ainsi de détecter le nerf concerné,. an electrode connected to the neurostimulator, the distal end of which is intended to be applied to the patient's skin to electrically stimulate nerves, and thus make it possible to detect the nerve concerned,
. un dispositif de marquage, propre à apposer une marque sur la peau du patient à proximité immédiate de l'extrémité distale de l'électrode ;. a marking device, suitable for affixing a mark on the skin of the patient in the immediate vicinity of the distal end of the electrode;
- un ensemble d'injection d'un produit anti-douleur approprié, comprenant une aiguille creuse graduée, en matériau électriquement conducteur de l'électricité, mais comportant une gaine en matériau isolant électriquement qui la recouvre entièrement, à l'exception de son extrémité distale et d'une zone proximale ; cette aiguille étant reliée électriquement au neurostimulateur par cette zone proximale, et étant en connexion de fluide avec un dispositif d'injection de produit. La démarche de détection consiste à faire passer l'ensemble de détection, et de repérage tout au long de la peau du patient en stimulant les nerfs situés au voisinage, jusqu'à détecter le nerf concerné par la douleur que subit le patient. Une fois ce nerf identifié, le passage du courant électrique dans l'électrode est arrêté, et le dispositif de marquage est actionné de manière à apposer une marque sur la peau du patient, à proximité immédiate de l'emplacement au niveau duquel se trouve l'extrémité de l'électrode.- an injection set of an appropriate pain-relieving product, comprising a graduated hollow needle, of material electrically conductive of electricity, but comprising a sheath of insulating material electrically which completely covers it, except for its distal end and a proximal zone; this needle being electrically connected to the neurostimulator by this proximal zone, and being in fluid connection with a product injection device. The detection process consists in passing the detection and locating assembly all the way through the patient's skin by stimulating the nerves located in the vicinity, until detecting the nerve concerned by the pain that the patient experiences. Once this nerve has been identified, the passage of electrical current through the electrode is stopped, and the marking device is actuated so as to affix a mark on the patient's skin, in the immediate vicinity of the location at which the end of the electrode.
L'ensemble d'injection est alors utilisé : l'aiguille graduée est insérée délicatement à travers la peau au niveau du point préalablement marqué, sa graduation permettant de préciser la profondeur de son extrémité d'injection dans les tissus sous-jacents. L'aiguille est alors connectée au neurostimulateur, de manière à faire passer un courant de faible intensité à travers elle, ce qui permet de localiser le nerf concerné au moyen de l'extrémité distale de l'aiguille. L'isolation de l'aiguille, en dehors de cette extrémité distale, élimine le risque de stimuler des nerfs environnants, et permet ladite localisation d'une manière très précise. Le courant est alors arrêté, et la substance contenue dans le dispositif d'injection, qui est en particulier une seringue, est injectée à travers l'aiguille. Les dimensions de l'aiguille utilisée, en longueur et en section, dépendent directement du site d'injection. S'il s'agit d'une injection au niveau du cou ou de la base du crâne, la section de l'aiguille doit être environ de 27 gauges ( 1 ,42 mm de diamètre), et sa longueur de 2,5 cm, ce qui est adapté à l'épaisseur de la peau, et des tissus sous-jacents dans cette région de l'organisme. En effet, au fur et à mesure que l'épaisseur de la peau et des tissus sous-jacents augmente, les dimensions de l'aiguille, en longueur et en section, augmentent. Par exemple, pour une injection au niveau du thorax ou du thorax-lombaire, l'aiguille utilisée est de 25 gauges ( 1 ,31 mm de diamètre) et de 7 cm de long. Avantageusement, le neurostimulateur est prévu pour délivrer un courant électrique dont l'intensité peut être réglée entre O et 6,5 milliampères.The injection set is then used: the graduated needle is gently inserted through the skin at the previously marked point, its graduation making it possible to specify the depth of its injection end in the underlying tissues. The needle is then connected to the neurostimulator, so as to pass a current of low intensity through it, which makes it possible to locate the nerve concerned by means of the distal end of the needle. The isolation of the needle, outside this distal end, eliminates the risk of stimulating surrounding nerves, and allows said localization in a very precise manner. The current is then stopped, and the substance contained in the injection device, which is in particular a syringe, is injected through the needle. The dimensions of the needle used, in length and in section, depend directly on the injection site. If it is an injection at the neck or at the base of the skull, the section of the needle should be approximately 27 gauges (1, 42 mm in diameter), and its length 2.5 cm , which is adapted to the thickness of the skin, and the underlying tissues in this region of the body. Indeed, as the thickness of the skin and of the underlying tissues increases, the dimensions of the needle, in length and in section, increase. For example, for an injection in the thorax or the lumbar thorax, the needle used is 25 gauges (1.31 mm in diameter) and 7 cm long. Advantageously, the neurostimulator is designed to deliver an electric current whose intensity can be adjusted between 0 and 6.5 milliamps.
L'intensité optimale de stimulation varie selon la partie du corps traitée, et cette plage de variation possible d'intensité permet au matériel, selon l'invention, d'être adapté à traiter de nombreuses parties du corps.The optimal intensity of stimulation varies according to the part of the body treated, and this range of possible variation of intensity allows the material according to the invention to be adapted to treat numerous parts of the body.
De préférence, l'électrode et le dispositif de marquage sont placés dans une enveloppe tubulaire en matériau isolant, de sorte que l'ensemble de détection se présente sous la forme d'un "crayon" . L'ensemble de détection et de repérage peut comprendre un interrupteur de mise de l'électrode en connexion électrique, ou hors connexion électrique avec le neurostimulateur ; ladite enveloppe tubulaire peut alors comporter un bouton de commande de cet interrupteur, placé sur sa face latérale. L'enveloppe tubulaire peut également comporter un bouton placé sur sa face latérale, de commande de l'apposition d'une marque sur la peau du patient par le dispositif de marquage.Preferably, the electrode and the marking device are placed in a tubular envelope of insulating material, so that the detection assembly is in the form of a "pencil". The detection and identification assembly may comprise a switch for placing the electrode in electrical connection, or out of electrical connection with the neurostimulator; said tubular casing can then include a button for controlling this switch, placed on its lateral face. The tubular envelope may also include a button placed on its lateral face, for controlling the affixing of a mark on the patient's skin by the marking device.
Grâce à ces dispositions, l'ensemble de détection et de marquage est particulièrement facile à manipuler, se tenant à la manière d'un crayon, et la stimulation électrique du nerf ainsi que l'apposition d'une marque sont des opérations particulièrement faciles à commander, simplement en agissant sur les boutons de commande correspondants.Thanks to these provisions, the detection and marking assembly is particularly easy to handle, being held in the manner of a pencil, and the electrical stimulation of the nerve as well as the affixing of a mark are particularly easy operations. order, simply by acting on the corresponding control buttons.
La partie distale de l'électrode peut présenter la forme d'une boule, permettant de bien marquer la localisation du nerf concerné. Avantageusement, l'aiguille présente, au niveau de son extrémité distale d'injection, un trou axial d'injection, et au moins un trou radial d'injection.The distal part of the electrode may have the shape of a ball, making it possible to clearly mark the location of the nerve concerned. Advantageously, the needle has, at its distal injection end, an axial injection hole, and at least one radial injection hole.
Ce ou ces trous radiaux d'injection permettent la diffusion du produit injecté selon plusieurs directions. Il en résulte un traitement parfaitement efficace du site douloureux.This or these radial injection holes allow the diffusion of the injected product in several directions. This results in a perfectly effective treatment of the painful site.
Pour sa bonne compréhension, l'invention est à nouveau décrite ci-dessous en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée du matériel qu'elle concerne. La figure 1 est une vue très simplifiée des trois ensembles qu'il comprend, à savoir un neurostimulateur schématisé par un rectangle, un ensemble de détection et de repérage, figuré en coupe longitudinale, et un ensemble d'injection d'un produit anti-douleur, comprenant une aiguille également figurée en coupe longitudinale ; cet ensemble de détection et de repérage, ainsi que cet ensemble d'injection sont représentés à échelle très agrandie par rapport à l'échelle selon laquelle est représenté le neurostimulateur ; la figure 2 est une vue du neurostimulateur, de l'ensemble de détection et de repérage en cours d'utilisation, cette figure montrant également un nerf à traiter, et des tissus recouvrant ce nerf ; la figure 3 est une vue similaire à la figure 2, dans une étape subséquente d'utilisation du matériel, et la figure 4 est une vue du neurostimulateur et de l'ensemble d'injection en cours d'utilisation, l'aiguille que comprend cet ensemble d'injection étant engagée au travers des tissus jusqu'à proximité de la zone du nerf à traiter.For a good understanding, the invention is again described below with reference to the appended diagrammatic drawing representing, by way of nonlimiting example, a preferred embodiment of the material which it relates to. Figure 1 is a very simplified view of the three sets that it includes, namely a neurostimulator schematized by a rectangle, a detection and tracking assembly, shown in longitudinal section, and an injection set for a pain reliever, comprising a needle also shown in longitudinal section; this detection and tracking assembly, as well as this injection assembly are shown on a much enlarged scale relative to the scale on which the neurostimulator is represented; FIG. 2 is a view of the neurostimulator, of the detection and tracking assembly in use, this figure also showing a nerve to be treated, and of tissues covering this nerve; Figure 3 is a view similar to Figure 2, in a subsequent step of using the material, and Figure 4 is a view of the neurostimulator and the injection assembly in use, the needle that includes this injection assembly being engaged through the tissues to near the area of the nerve to be treated.
La figure 1 représente un neurostimulateur 1 , un ensemble 2 de détection, de repérage du nerf à traiter, et un ensemble 3 d'injection d'un produit anti-douleur.FIG. 1 represents a neurostimulator 1, a set 2 for detecting, locating the nerve to be treated, and a set 3 for injecting a pain-relieving product.
Le neurostimulateur 1 est de type classique, sinon qu'il est aménagé de manière à pouvoir délivrer un courant électrique d'intensité réglable, sur une plage allant de 0 à 6,5 milliampères.The neurostimulator 1 is of the conventional type, except that it is arranged so as to be able to deliver an electric current of adjustable intensity, over a range going from 0 to 6.5 milliamps.
Le neurostimulateur 1 est relié à un boîtier de connexion 5 par un fil électriquement conducteur 6. De ce boîtier 5, partent deux fils : 7, 8 électriquement conducteurs, qui permettent respectivement de connecter électriquement le neurostimulateur 1 à l'ensemble 2 et à l'ensemble 3. Le fil 7 est relié de manière permanente à une borne d'un interrupteur 10, que comprend l'ensemble 2, tandis que le fil 8 est relié à une pince 1 1 , pouvant être placée sur l'extrémité proximale de l'aiguille 1 2, que comprend l'ensemble 3. Le neurostimulateur 1 comprend également un fil 15 qui le relie électriquement à une électrode adhésive 1 6, propre à être appliquée sur la peau d'un patient.The neurostimulator 1 is connected to a connection box 5 by an electrically conductive wire 6. From this box 5, two wires leave: 7, 8 electrically conductive, which respectively allow the neurostimulator 1 to be electrically connected to the assembly 2 and to the 'assembly 3. The wire 7 is permanently connected to a terminal of a switch 10, which includes the assembly 2, while the wire 8 is connected to a clamp 1 1, which can be placed on the proximal end of the needle 1 2, which comprises the assembly 3. The neurostimulator 1 also comprises a wire 15 which electrically connects it to an adhesive electrode 1 6, suitable for being applied to the skin of a patient.
L'ensemble 2 comprend une électrode 20, un dispositif de marquage 21 , et une enveloppe tubulaire 22. L'électrode 20 est connectée par son extrémité proximale à la borne de l'interrupteur 10 non reliée au fil 7, et comprend, à son extrémité distale, une boule 25 destinée à venir au contact de la peau du patient.The assembly 2 comprises an electrode 20, a marking device 21, and a tubular envelope 22. The electrode 20 is connected by its proximal end to the terminal of the switch 10 not connected to the wire 7, and comprises, at its distal end, a ball 25 intended to come into contact with the patient's skin.
Le dispositif de marquage 21 comprend une réserve d'encre 26, propre à marquer la peau du patient, qui communique avec l'extrémité distale de ce dispositif 21 par un conduit permettant de délivrer cette encre. Le dispositif 21 comprend également un ressort 27, des organes (non représentés) de positionnement du dispositif 21 , selon une position rétractée et une position sortie, et une touche 28 d'actionnement de ces organes. Dans la position rétractée, l'extrémité distale du dispositif 21 est rétractée dans l'enveloppe 22, et dans la position sortie, cette extrémité distale dépasse de l'enveloppe 22, et est à même de marquer la peau du patient. Ce dispositif 21 peut avoir une structure très similaire, voire identique, à ceϋe d'un stylo à biϋe à pointe rétractable. L'enveloppe tubulaire 22 est en matériau isolant. Elle permet de maintenir les extrémités distales de l'électrode 20 et du dispositif 21 côte à côte, et à proximité immédiate l'une de l'autre. Elle comprend la touche 28 et un bouton 29 d'actionnement de l'interrupteur 10, cette touche 28 et ce bouton 29 faisant saillie de la face extérieure de l'enveloppe 22, au niveau de l'extrémité proximale de celle-ci.The marking device 21 comprises an ink reserve 26, suitable for marking the patient's skin, which communicates with the distal end of this device 21 by a conduit allowing this ink to be delivered. The device 21 also comprises a spring 27, members (not shown) for positioning the device 21, in a retracted position and an extended position, and a button 28 for actuating these members. In the retracted position, the distal end of the device 21 is retracted in the envelope 22, and in the extended position, this distal end protrudes from the envelope 22, and is able to mark the patient's skin. This device 21 can have a structure very similar, or even identical, to that of a bi àe pen with retractable tip. The tubular casing 22 is made of insulating material. It keeps the distal ends of the electrode 20 and the device 21 side by side, and in close proximity to each other. It comprises the button 28 and a button 29 for actuating the switch 10, this button 28 and this button 29 projecting from the external face of the envelope 22, at the level of the proximal end thereof.
L'aiguille 1 2 est creuse, et est en matériau métallique. Elle comporte une gaine 30 en matériau isolant électriquement, qui la recouvre entièrement à l'exception de son extrémité distale 1 2a, et de sa zone proximale 1 2b, cette gaine 30 comportant une graduation 31 imprimée sur elle.The needle 1 2 is hollow, and is made of metallic material. It comprises a sheath 30 of electrically insulating material, which completely covers it except for its distal end 1 2a, and its proximal area 1 2b, this sheath 30 comprising a graduation 31 printed on it.
L'aiguille 1 2 peut être reliée électriquement au neurostimulateurNeedle 1 2 can be electrically connected to the neurostimulator
1 au niveau de cette zone proximale 12b, au moyen de la pince 1 1 , et peut être connectée, au niveau de son extrémité proximale, à un tube 35, ce tube 35 étant relié à une seringue 36 d'injection d'un produit anti-douleur. En outre, l'aiguille 1 2 présente, au niveau de son extrémité distale 12a, un trou axial d'injection 37 et un trou radial d'injection 38, situé en retrait du trou 37.1 at this proximal zone 12b, by means of the clamp 1 1, and can be connected, at its proximal end, to a tube 35, this tube 35 being connected to a syringe 36 for injecting a product Pain killer. In addition, the needle 12 has, at its distal end 12a, an axial injection hole 37 and a radial injection hole 38, set back from the hole 37.
En pratique, comme le montre la figure 2, l'électrode 1 6 est collée sur la peau 50 du patient, et le bouton 29 est pressé de manière à connecter électriquement l'électrode 20 au neurostimulateur 1 . L'ensembleIn practice, as shown in FIG. 2, the electrode 1 6 is glued to the skin 50 of the patient, and the button 29 is pressed so as to electrically connect the electrode 20 to the neurostimulator 1. All
2 est saisi à la manière d'un crayon et est déplacé au long de la peau 50, de manière à stimuler les nerfs sous-jacents, jusqu'à détecter le nerf 51 concerné par la douleur que subit le patient. Une fois ce nerf 51 identifié, le bouton 29 est relâché, de manière à ouvrir l'interrupteur 10 pour stopper le passage du courant électrique, et la touche 28 est actionnée de manière à amener le dispositif de marquage 21 en position sortie. Une marque 40 est ainsi apposée sur la peau du patient, comme le montre la figure 3, à proximité immédiate de l'emplacement, au niveau duquel se trouve l'extrémité distale de l'électrode 20 lors de l'excitation du nerf 51 .2 is grasped in the manner of a pencil and is moved along the skin 50, so as to stimulate the underlying nerves, until detecting the nerve 51 concerned by the pain which the patient undergoes. Once this nerve 51 has been identified, the button 29 is released, so as to open the switch 10 to stop the passage of electric current, and the button 28 is actuated so as to bring the marking device 21 to the extended position. A mark 40 is thus affixed to the skin of the patient, as shown in FIG. 3, in the immediate vicinity of the location, at which the distal end of the electrode 20 is located when the nerve 51 is excited.
L'aiguille 1 2 est alors connectée au neurostimulateur 1 au moyen de la pince 1 1 , et est enfoncée délicatement à travers la peau 50 au niveau du de la marque 40. Sa graduation 31 permet de déterminer précisément la profondeur de son extrémité distale 12a dans les tissus 52. L'aiguille 1 2 est alors connectée au neurostimulateur 1 , de manière à faire passer un courant é!sctri ue à travers elle. L'extrémité distale 1 2a; non isolée de cette aiguille, permet d'exciter suffisamment le nerf 51 pour confirmer la localisation de ce nerf. La gaine 30 permet une isolation de l'aiguille 1 2 en dehors de cette extrémité distale 1 2a, ce qui élimine le risque de stimuler des nerfs environnants.The needle 1 2 is then connected to the neurostimulator 1 by means of the clamp 1 1, and is delicately inserted through the skin 50 at the level of the mark 40. Its graduation 31 makes it possible to precisely determine the depth of its distal end 12a in tissues 52. The needle 12 is then connected to the neurostimulator 1, so as to pass an electrical current through it. The distal end 1 2a ; not isolated from this needle, makes it possible to sufficiently excite the nerve 51 to confirm the location of this nerve. The sheath 30 allows isolation of the needle 1 2 outside this distal end 1 2a, which eliminates the risk of stimulating the surrounding nerves.
Une fois le nerf 51 précisément localisé, le courant électrique est interrompu, et la substance contenue dans la seringue 36 est injectée à travers l'aiguille 1 2. Le trou 38 permet, conjointement au trou 37, la diffusion du produit selon plusieurs directions, ce qui permet un traitement parfaitement efficace du site douloureux.Once the nerve 51 is precisely located, the electric current is interrupted, and the substance contained in the syringe 36 is injected through the needle 12. The hole 38 allows, together with the hole 37, the diffusion of the product in several directions, which allows a perfectly effective treatment of the painful site.
Ainsi qu'il apparaît précédemment, l'invention fournit un matériel de traitement de points douloureux, ayant pour avantages de permettre ce traitement, quelle que soit la topographie de la zone douloureuse, d'éliminer tout risque d'endommager les tissus ou la structure anatomique entourant le point douloureux, et de permettre une injection précise, assurant que le point douloureux est exactement atteint par le bout de l'aiguille.As it appears previously, the invention provides a material for treating painful points, having the advantages of allowing this treatment, whatever the topography of the painful area, to eliminate any risk of damaging the tissues or the structure. anatomically surrounding the pain point, and allow for precise injection, ensuring that the pain point is exactly reached by the tip of the needle.
Il va de soi que l'invention n'est pas limitée à la forme de réalisation décrite ci-dessus à titre d'exemple, mais qu'elle en embrasse au contraire toutes les variantes de réalisation entrant dans le champ de protection défini par les revendications ci-annexées. It goes without saying that the invention is not limited to the embodiment described above by way of example, but on the contrary embraces all the variant embodiments falling within the protective field defined by the claims appended hereto.

Claims

REVENDICATIONS
1 - Matériel permettant la réalisation d'un traitement de points douloureux au niveau de l'organisme, caractérisé en ce qu'il comprend : - un neurostimulateur ( 1 ), c'est-à-dire par un appareil délivrant un courant électrique propre à exciter un nerf ;1 - Equipment enabling pain points to be treated at the level of the body, characterized in that it comprises: - a neurostimulator (1), that is to say by a device delivering its own electric current to excite a nerve;
- un ensemble (2) de détection et de repérage du nerf (51 ) concerné, comprenant- a set (2) for detecting and locating the nerve (51) concerned, comprising
. une électrode (20) reliée au neurostimulateur (1 ), dont l'extrémité distale est destinée à être appliquée sur la peau du patient pour stimuler électriquement des nerfs, et permettre ainsi de détecter le nerf (51 ) concerné,. an electrode (20) connected to the neurostimulator (1), the distal end of which is intended to be applied to the patient's skin to electrically stimulate nerves, and thus make it possible to detect the nerve (51) concerned,
. un dispositif de marquage (21 ), propre à apposer une marque (40) sur la p em du patient à proximité immédiate de l'extrémité distale de l'électrode (20) ;. a marking device (21), suitable for affixing a mark (40) on the patient's p em in the immediate vicinity of the distal end of the electrode (20);
- un ensemble (3) d'injection d'un produit anti-douleur approprié, comprenant une aiguille creuse graduée (1 2), en matériau électriquement conducteur de l'électricité, mais comportant une gaine (30) en matériau isolant électriquement qui la recouvre entièrement, à l'exception de son extrémité distale ( 12a), et d'une zone proximale ( 1 2b) ; cette aiguille ( 12) étant reliée électriquement au neurostimulateur ( 1 ) par cette zone proximale (1 2b), et étant en connexion de fluide avec un dispositif (36) d'injection de produit.- An assembly (3) for injecting an appropriate painkiller, comprising a graduated hollow needle (1 2), made of electrically conductive material, but comprising a sheath (30) made of electrically insulating material which fully covers, except for its distal end (12a), and a proximal area (12b); this needle (12) being electrically connected to the neurostimulator (1) by this proximal zone (12b), and being in fluid connection with a device (36) for injecting product.
2 - Matériel selon la revendication 1 , caractérisé en ce que le neurostimulateur ( 1 ) est prévu pour délivrer un courant électrique dont l'intensité peut être réglée entre 0 et 6,5 milliampères.2 - Equipment according to claim 1, characterized in that the neurostimulator (1) is designed to deliver an electric current whose intensity can be adjusted between 0 and 6.5 milliamps.
3 - Matériel selon la revendication 1 ou la revendication 2, caractérisé en ce que l'électrode (20) et le dispositif de marquage (21 ) sont placés dans une enveloppe tubulaire (22) en matériau isolant, de sorte que l'ensemble (2) de détection et de repérage se présente sous la forme d'un "crayon" .3 - Equipment according to claim 1 or claim 2, characterized in that the electrode (20) and the marking device (21) are placed in a tubular envelope (22) made of insulating material, so that the assembly ( 2) detection and identification is in the form of a "pencil".
4 - Matériel selon l'une des revendications 1 à 3, caractérisé en ce que l'ensemble (2) de détection et de repérage comprend un interrupteur (1 0) de mise de l'électrode (20) en connexion électrique ou hors connexion électrique avec le neurostimulateur ( 1 ). 5 - Matériel selon la revendication 4, caractérisé en ce que l'enveloppe tubulaire (22) comporte un bouton (29) de commande de l'interrupteur, placé sur la face latérale de cette enveloppe (22).4 - Equipment according to one of claims 1 to 3, characterized in that the assembly (2) of detection and identification comprises a switch (1 0) for placing the electrode (20) in electrical connection or offline electric with the neurostimulator (1). 5 - Equipment according to claim 4, characterized in that the tubular casing (22) comprises a button (29) for controlling the switch, placed on the lateral face of this casing (22).
6 - Matériel selon l'une des revendications 3 à 5, caractérisé en ce que l'enveloppe tubulaire (22) comporte un bouton (28) placé sur sa face latérale, de commande de l'apposition d'une marque (40) sur la peau du patient par le dispositif de marquage (21 ).6 - Equipment according to one of claims 3 to 5, characterized in that the tubular casing (22) comprises a button (28) placed on its lateral face, for controlling the affixing of a mark (40) on the patient's skin by the marking device (21).
7 - Matériel selon l'une des revendications 1 à 6, caractérisé en ce que la partie distale de l'électrode (20) présente la forme d'une boule (25).7 - Equipment according to one of claims 1 to 6, characterized in that the distal part of the electrode (20) has the shape of a ball (25).
8 - Matériel selon l'une des revendications 1 à 7, caractérisé en ce que l'aiguille ( 1 2) présente, au niveau de son extrémité distale d'injection (1 2a), un trou axial d'injection (37) et au moins un trou radial d'in'ection (38). 8 - Equipment according to one of claims 1 to 7, characterized in that the needle (1 2) has, at its distal injection end (1 2a), an axial injection hole (37) and at least one radial injection hole (38).
PCT/FR2002/002366 2001-07-06 2002-07-05 Equipment for treating painful points in the organism WO2003004093A2 (en)

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Applications Claiming Priority (2)

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FR01.09036 2001-07-06
FR0109036A FR2826855B1 (en) 2001-07-06 2001-07-06 MATERIAL ALLOWING THE TREATMENT OF PAIN POINTS AT THE ORGANIZATION LEVEL

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WO2003004093A3 WO2003004093A3 (en) 2003-11-06

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Cited By (4)

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GB2417688A (en) * 2004-10-20 2006-03-08 Teodor Goroszeniuk Electrical transcutaneous pain suppression and pain location device
WO2007096600A1 (en) * 2006-02-21 2007-08-30 Teodor Goroszniuk Improvements in and relating to neurostimulation
CN105232317A (en) * 2015-10-28 2016-01-13 李敏 Acupuncture point detection and anesthesia machine acupuncture point tester
US9308363B2 (en) 2006-02-21 2016-04-12 Teodor Goroszeniuk Neurostimulation for treating pain, improving function and other nervous system related conditions

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109602419B (en) * 2019-01-31 2020-08-18 中国科学院武汉物理与数学研究所 Simple mechanical pain stimulation device applicable to small animal nuclear magnetic resonance imager

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US3682162A (en) * 1968-12-13 1972-08-08 Wellcome Found Combined electrode and hypodermic syringe needle
US4515168A (en) * 1983-07-22 1985-05-07 Chester Martin H Clamp-on nerve stimulator and locator
US5284154A (en) * 1992-04-14 1994-02-08 Brigham And Women's Hospital Apparatus for locating a nerve and for protecting nerves from injury during surgery
US5830151A (en) * 1995-04-10 1998-11-03 Innovative Design Associates Apparatus for locating and anesthetizing peripheral nerves a method therefor

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Publication number Priority date Publication date Assignee Title
US3682162A (en) * 1968-12-13 1972-08-08 Wellcome Found Combined electrode and hypodermic syringe needle
US4515168A (en) * 1983-07-22 1985-05-07 Chester Martin H Clamp-on nerve stimulator and locator
US5284154A (en) * 1992-04-14 1994-02-08 Brigham And Women's Hospital Apparatus for locating a nerve and for protecting nerves from injury during surgery
US5830151A (en) * 1995-04-10 1998-11-03 Innovative Design Associates Apparatus for locating and anesthetizing peripheral nerves a method therefor

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2417688A (en) * 2004-10-20 2006-03-08 Teodor Goroszeniuk Electrical transcutaneous pain suppression and pain location device
GB2417688B (en) * 2004-10-20 2010-03-24 Teodor Goroszeniuk Improvements in and relating to neurostimulation
WO2007096600A1 (en) * 2006-02-21 2007-08-30 Teodor Goroszniuk Improvements in and relating to neurostimulation
US9308363B2 (en) 2006-02-21 2016-04-12 Teodor Goroszeniuk Neurostimulation for treating pain, improving function and other nervous system related conditions
CN105232317A (en) * 2015-10-28 2016-01-13 李敏 Acupuncture point detection and anesthesia machine acupuncture point tester

Also Published As

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FR2826855B1 (en) 2004-04-16
FR2826855A1 (en) 2003-01-10
AU2002328383A1 (en) 2003-01-21
WO2003004093A3 (en) 2003-11-06

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