Computer Controlled Pediatric Regional Anesthesia

Abstract

A drug delivery and monitoring device comprising a nerve stimulating element configured to deliver an electric stimulus, a recording element configured to detect a compound action potential, and a drug-delivery element.

We Claim: 
     
         1 . A drug delivery and monitoring device comprising:
 (a) a nerve-stimulating element comprising a first electrode, wherein the first electrode is configured to deliver an electric stimulus;   (b) a recording element comprising a second electrode, wherein the second electrode is configured to detect a compound action potential; and   (c) a drug-delivery element located between the nerve-stimulating element and the recording element.   
     
     
         2 . The device of  claim 1 , wherein said drug-delivery element comprises one or more of a suture guide, a drug output, a drug input, and a drug reservoir. 
     
     
         3 . The device of  claim 1 , wherein said nerve-stimulating element comprises a stimulating echogenic needle. 
     
     
         4 . The device of  claim 3 , wherein said echogenic needle is configured to deliver an electrical current directly to the nerve. 
     
     
         5 . The device of  claim 4 , wherein said electrical current is between 1 and 10 amps. 
     
     
         6 . The device of  claim 1 , further comprising a positioning element for securing the device to a nerve. 
     
     
         7 . A system, comprising:
 (a) The device of  claim 1 ; and   (b) a computer device configured to record compound action potentials, make calculations based thereon, and control said drug-delivery element.   
     
     
         8 . The system of  claim 7 , wherein the computer device is further configured to determine a drug dose based on said compound action potentials. 
     
     
         9 . The system of  claim 8 , wherein a level of anesthesia is adjusted to keep the compound action potentials below a threshold level. 
     
     
         10 . The system of  claim 9 , wherein said threshold level is 0.1 V. 
     
     
         11 . A method of delivering a regional drug to a subject, comprising:
 a) contacting a nerve of the subject with the drug delivery and monitoring device of the system of  claim 7 ;   b) delivering the drug to the nerve using said system; and   (c) monitoring compound action potentials; and   (d) adjusting a level of the drug delivered to the nerve based on said compound action potentials.   
     
     
         12 . The method of  claim 11 , wherein said drug is regional anesthesia. 
     
     
         13 . The method of  claim 12 , wherein said regional anesthesia is epidural, spinal, or peripheral nerve block.