JP2019205907A - Device to apply anesthetic drug to nasal cavity - Google Patents
Device to apply anesthetic drug to nasal cavity Download PDFInfo
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- JP2019205907A JP2019205907A JP2019148320A JP2019148320A JP2019205907A JP 2019205907 A JP2019205907 A JP 2019205907A JP 2019148320 A JP2019148320 A JP 2019148320A JP 2019148320 A JP2019148320 A JP 2019148320A JP 2019205907 A JP2019205907 A JP 2019205907A
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- 239000003193 general anesthetic agent Substances 0.000 title claims abstract description 37
- 210000003928 nasal cavity Anatomy 0.000 title abstract description 46
- 230000002093 peripheral effect Effects 0.000 claims abstract description 8
- 230000003444 anaesthetic effect Effects 0.000 claims description 59
- 238000001839 endoscopy Methods 0.000 abstract description 7
- 210000001989 nasopharynx Anatomy 0.000 abstract 1
- 238000003780 insertion Methods 0.000 description 33
- 230000037431 insertion Effects 0.000 description 33
- 230000002265 prevention Effects 0.000 description 11
- 230000001954 sterilising effect Effects 0.000 description 6
- 238000004659 sterilization and disinfection Methods 0.000 description 6
- 241000565661 Neohelix albolabris Species 0.000 description 5
- 210000000214 mouth Anatomy 0.000 description 4
- 210000004400 mucous membrane Anatomy 0.000 description 4
- 230000036407 pain Effects 0.000 description 4
- 239000011248 coating agent Substances 0.000 description 3
- 238000000576 coating method Methods 0.000 description 3
- 238000004519 manufacturing process Methods 0.000 description 3
- 239000000463 material Substances 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 210000002850 nasal mucosa Anatomy 0.000 description 3
- 210000001331 nose Anatomy 0.000 description 3
- 210000001944 turbinate Anatomy 0.000 description 3
- 208000032974 Gagging Diseases 0.000 description 2
- NNJVILVZKWQKPM-UHFFFAOYSA-N Lidocaine Chemical compound CCN(CC)CC(=O)NC1=C(C)C=CC=C1C NNJVILVZKWQKPM-UHFFFAOYSA-N 0.000 description 2
- 206010047700 Vomiting Diseases 0.000 description 2
- 210000003238 esophagus Anatomy 0.000 description 2
- 210000001035 gastrointestinal tract Anatomy 0.000 description 2
- 210000003800 pharynx Anatomy 0.000 description 2
- 238000012545 processing Methods 0.000 description 2
- 239000007787 solid Substances 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- 229940072358 xylocaine Drugs 0.000 description 2
- 206010002091 Anaesthesia Diseases 0.000 description 1
- LFQSCWFLJHTTHZ-UHFFFAOYSA-N Ethanol Chemical compound CCO LFQSCWFLJHTTHZ-UHFFFAOYSA-N 0.000 description 1
- YCKRFDGAMUMZLT-UHFFFAOYSA-N Fluorine atom Chemical compound [F] YCKRFDGAMUMZLT-UHFFFAOYSA-N 0.000 description 1
- 208000001705 Mouth breathing Diseases 0.000 description 1
- 206010051496 Rhinalgia Diseases 0.000 description 1
- XUIMIQQOPSSXEZ-UHFFFAOYSA-N Silicon Chemical compound [Si] XUIMIQQOPSSXEZ-UHFFFAOYSA-N 0.000 description 1
- 239000002390 adhesive tape Substances 0.000 description 1
- 230000037005 anaesthesia Effects 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 210000001198 duodenum Anatomy 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 229920001971 elastomer Polymers 0.000 description 1
- 229910052731 fluorine Inorganic materials 0.000 description 1
- 239000011737 fluorine Substances 0.000 description 1
- 230000002496 gastric effect Effects 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- 238000007689 inspection Methods 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 239000003589 local anesthetic agent Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000003252 repetitive effect Effects 0.000 description 1
- 230000035945 sensitivity Effects 0.000 description 1
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- 229920002379 silicone rubber Polymers 0.000 description 1
- 239000007921 spray Substances 0.000 description 1
- 210000002784 stomach Anatomy 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
- 210000002438 upper gastrointestinal tract Anatomy 0.000 description 1
- 230000008673 vomiting Effects 0.000 description 1
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Abstract
Description
本発明は経鼻内視鏡検査の前処置において使用される鼻腔内麻酔薬塗布装置に関する。 The present invention relates to an intranasal anesthetic application device used in a pretreatment for transnasal endoscopy.
上部消化管用の内視鏡等は、通常、口腔を介して内視鏡の挿入部が消化管内に導かれる、経口挿入とするのが一般的である。このために、上部消化管内視鏡検査を受ける被検者は横臥状態でマウスピースを銜えて、このマウスピースにより確保される経路に沿って挿入部が体腔内に導かれる。口腔を介して挿入される場合には、挿入部が咽喉を通過する際に、舌根に挿入部が触れることによる咽頭反射或いは嘔吐反射が起こり、嘔吐感を被検者に与え、苦痛を伴うものになる。そして、この咽頭反射を抑制して、苦痛の軽減を図るために、麻酔薬を用いるものの、なお苦痛は残ってしまう。さらに、被検者はマウスピースを銜えているので、術者等との会話が困難になるという問題点もあり、また口呼吸が困難になる等の問題点がある。 The endoscope for the upper gastrointestinal tract is generally an oral insertion in which the insertion portion of the endoscope is led into the gastrointestinal tract through the oral cavity. Therefore, a subject who undergoes upper gastrointestinal endoscopy holds a mouthpiece in a lying state, and the insertion portion is guided into the body cavity along a path secured by the mouthpiece. When inserted through the oral cavity, when the insertion part passes through the throat, a pharyngeal reflex or vomiting reflex occurs due to the insertion part touching the tongue base, giving the subject a feeling of vomiting and painfulness become. And although an anesthetic is used in order to suppress this pharyngeal reflex and to alleviate the pain, the pain still remains. Further, since the subject holds the mouthpiece, there are problems that it is difficult to talk with the surgeon and the like, and that mouth breathing is difficult.
そこで、昨今、内視鏡の挿入経路として、前述した口腔だけでなく経鼻的に挿入する方式が普及している。特に、近年においては、内視鏡の挿入部が細径化され、鼻腔を介して挿入するのに最適な外径を有する内視鏡も実用化されている。 Therefore, recently, as an insertion path of an endoscope, a method of inserting nasally as well as the oral cavity described above is widespread. In particular, in recent years, the diameter of the insertion portion of the endoscope has been reduced, and an endoscope having an optimum outer diameter for insertion through the nasal cavity has been put into practical use.
ところで、内視鏡の挿入部を鼻腔内に挿入する際に、この挿入部が異物として作用して敏感な鼻粘膜を刺激することになり、被検者に対して苦痛を与えることになる。そこで、挿入部を挿入する前の段階で、鼻腔内の挿入経路、特にこの挿入経路のうちの最も狭い個所、つまり中鼻甲介下縁と下鼻甲介上縁との間隙（以下「中鼻道」と略記する）または下鼻甲介下縁と鼻腔底との間隙（以下「下鼻道」と略記する）を経て後鼻孔に至る経路に予め麻酔薬を供給することによって、鼻粘膜の刺激に対する感度を低下させる前処置が施されている。 By the way, when the insertion portion of the endoscope is inserted into the nasal cavity, this insertion portion acts as a foreign substance and stimulates the sensitive nasal mucosa, causing pain to the subject. Therefore, before the insertion portion is inserted, the insertion path in the nasal cavity, particularly the narrowest part of the insertion path, that is, the gap between the lower edge of the middle turbinate and the upper edge of the lower turbinate (hereinafter referred to as “the middle nasal passage”). ) Or by supplying an anesthetic in advance to the path to the posterior nostril via the gap between the lower edge of the lower turbinate and the bottom of the nasal cavity (hereinafter abbreviated as “the lower nasal passage”). A pretreatment is performed to reduce the sensitivity.
この鼻腔内麻酔薬塗布処置（以下「麻酔薬塗布装置」と略記する）の一例として、非特許文献１には、単回使用の内視鏡用の麻酔薬塗布装置が開示されている。 As an example of this intranasal anesthetic application treatment (hereinafter abbreviated as “anesthetic application device”), Non-Patent Document 1 discloses an anesthetic application device for a single-use endoscope.
経鼻内視鏡検査において、鼻腔内を内視鏡の挿入経路として使用するために、この経路で必要な箇所、つまり内視鏡が挿入されることにより被検者にとって刺激を受ける箇所に限定して、麻酔薬を塗布する。この場合、必要な箇所は、中鼻道（または下鼻道）を経て後鼻孔に至る経路である。それ以外の箇所、つまり手前側の鼻前庭や、後鼻孔より先の部位にはできるだけ麻酔薬が及ばないようにする。したがって、必要な箇所には確実に麻酔薬を塗布することができ、かつ必要以外の箇所に麻酔薬が及ぶことを抑制したいという要望がある。 In transnasal endoscopy, in order to use the inside of the nasal cavity as the insertion path of the endoscope, it is limited to the place necessary for this path, that is, the place where the subject is stimulated by inserting the endoscope Then apply anesthetic. In this case, the necessary part is a route from the middle nasal passage (or lower nasal passage) to the posterior nostril. Other areas, that is, the nasal vestibule on the near side and the area beyond the rear nostril should be kept as little as possible. Therefore, there is a desire to be able to reliably apply an anesthetic to a necessary location and to suppress the anesthetic from reaching a location other than necessary.
本発明は上記実情に鑑みてなされたものであり、経鼻内視鏡検査において、麻酔薬を必要な箇所に必要量供給する鼻腔内麻酔薬塗装置を提供することを目的とする。 The present invention has been made in view of the above circumstances, and an object of the present invention is to provide an intranasal anesthetic coating apparatus that supplies a necessary amount of an anesthetic to a necessary location in transnasal endoscopy.
前述した目的を達成するために、本発明に係る鼻腔内麻酔薬塗布装置は、外鼻孔から後鼻孔に至る距離以上の長さを有する棒状の本体部と、この本体部の先端近傍の外周面に所定の長さにわたって凹部形成された麻酔薬付着部と、前記本体部の基端部に設けられた把持部とを備えることを特徴とする。 In order to achieve the above-described object, an intranasal anesthetic application device according to the present invention includes a rod-shaped main body having a length equal to or longer than the distance from the outer nostril to the rear nostril, and an outer peripheral surface near the tip of the main body. And an anesthetic attachment part formed with a recess over a predetermined length, and a grip part provided at a base end part of the main body part.
本体部の外面、より詳しくは凹部形成された麻酔薬付着部に一時的に麻酔薬を貯留して、鼻腔内壁の所望の部位に麻酔薬を塗布する。このために、麻酔薬付着部は本体部の先端近傍に設け、麻酔薬を限定した領域に塗布する。この際、本体部の軸線方向にも所定の長さ分、具体的には本体部の先端部から把持部側方向に１乃至２ｃｍにある第一基点を基準とし、それよりも更に前記把持部方向に３乃至５ｃｍ近い位置にある第二基点までの範囲に設けられることが好ましい。更に、全周にわたって凹部を形成することが望ましい。これによって、必要な箇所には確実に麻酔薬を塗布することができ、かつ必要以外の箇所に麻酔薬が及ぶことを抑制することができる。 An anesthetic is temporarily stored on the outer surface of the main body, more specifically, an anesthetic attachment portion formed with a recess, and the anesthetic is applied to a desired site on the inner wall of the nasal cavity. For this purpose, the anesthetic agent attaching portion is provided in the vicinity of the tip of the main body portion, and the anesthetic agent is applied to a limited area. At this time, with respect to the axial direction of the main body portion, a predetermined length, specifically, a first base point that is 1 to 2 cm from the distal end portion of the main body portion to the grip portion side direction is used as a reference. It is preferable to be provided in the range up to the second base point at a position close to 3 to 5 cm in the direction. Furthermore, it is desirable to form a recess over the entire circumference. Thereby, an anesthetic can be reliably applied to a necessary location, and the anesthetic can be prevented from reaching other locations.
鼻腔の内部は狭く、しかもかなりの長さを有する経路であって、その経路は粘膜で覆われている。麻酔薬を塗布するための装置であるから、その本体部は内視鏡の挿入部より細径のものを用いることができる。また、内視鏡の挿入部が通過する経路の広さには個人差があり、経路の個人差に対応できるように麻酔薬塗布装置の本体部の太さ（外周径）はサイズの異なる径、例えば外径６ｍｍ、５ｍｍ、４ｍｍ、３ｍｍ等を用いることができる。従って、本体部は狭窄な部位を有する鼻腔内の経路に容易に挿入することができる。 The inside of the nasal cavity is narrow and has a considerable length, which is covered with mucous membranes. Since it is a device for applying an anesthetic, the main body can be smaller in diameter than the insertion portion of the endoscope. In addition, the width of the path through which the insertion part of the endoscope passes varies from person to person, and the thickness (outer diameter) of the body part of the anesthetic application device is different in size so that it can accommodate individual differences in the path. For example, an outer diameter of 6 mm, 5 mm, 4 mm, 3 mm or the like can be used. Therefore, the main body can be easily inserted into a route in the nasal cavity having a narrowed portion.
さらに、麻酔薬塗布装置を滅菌処理に対する耐性を備えた材質、例えばシリコンゴムやフッ素ゴム等といった耐薬品性及び耐オートクレーブ性に優れた材質のもので形成すれば、使用後における滅菌が可能となり、繰り返し使用することができる。また、繰り返し使用できることで、麻酔薬塗布装置の単価が単回使用のものと比べて若干高くなったとしても、複数使用することで結果的に医療機関の収益性の向上が期待できる。従って、単回使用の麻酔薬塗布装置に対してより複雑な加工を施して製造原価が向上することがあっても許容しやすくなり、使い勝手をより向上させた麻酔薬塗布装置を提供することができる。 Furthermore, if the anesthetic agent application device is made of a material having resistance to sterilization, for example, a material excellent in chemical resistance and autoclave resistance such as silicon rubber and fluorine rubber, sterilization after use becomes possible. Can be used repeatedly. Moreover, even if the unit price of the anesthetic agent applicator becomes slightly higher than that of a single-use device because it can be used repeatedly, the use of multiple devices can be expected to improve the profitability of the medical institution as a result. Accordingly, it is easy to tolerate even if the manufacturing cost is increased by applying more complicated processing to a single-use anesthetic agent application device, and an anesthetic agent application device with improved usability can be provided. it can.
また、麻酔薬塗布装置の本体部の先端部は、エッジのない凸曲面形状、例えば凸球面形状となし、かつ好ましくは、本体部はその軸方向に対して可撓性を有する。これにより、鼻腔の内部に挿入する際に、本体部の先端が鼻腔の粘膜を圧迫してダメージを与えることを抑止できる。 Moreover, the front-end | tip part of the main-body part of an anesthetic application apparatus is made into the convex curved surface shape without an edge, for example, convex spherical shape, for example, Preferably, a main-body part has flexibility with respect to the axial direction. Thereby, when inserting in the inside of a nasal cavity, it can suppress that the front-end | tip of a main-body part presses the mucous membrane of a nasal cavity, and gives a damage.
また、麻酔薬付着部は、本体部の外周面のうち、鼻腔内壁に内視鏡が接触することが予想される部位と対向する位置に備えられた複数の凹部として形成されることが望ましい。 In addition, the anesthetic agent attaching portion is preferably formed as a plurality of concave portions provided at positions facing the site where the endoscope is expected to contact the inner wall of the nasal cavity on the outer peripheral surface of the main body portion.
麻酔薬としてゼリー状または液状の局所麻酔薬（例えばキシロカインビスカス、キシロカインポンプスプレー等）が好適に用いられる。この麻酔薬を鼻腔内壁において特に内視鏡の挿入時に鼻痛を感じやすい部位に塗布するために、麻酔薬付着部は、本体部の先端部近傍に、望ましくは中鼻道（または下鼻道）から後鼻孔までの長さ分とほぼ一致する部分に凹部を複数設けて形成する。これによって、本体部を所定の長さ分だけ挿入して、本体部を僅かに捩じるように操作するだけで、必要な箇所に限定して、必要量の麻酔薬を塗布することができる。 As the anesthetic, a jelly-like or liquid local anesthetic (for example, xylocaine biscus, xylocaine pump spray, etc.) is preferably used. In order to apply this anesthetic on the inner wall of the nasal cavity, particularly in a region where nasal pain is easily felt during insertion of an endoscope, the anesthetic agent-attached portion is located near the distal end of the main body, preferably the middle nasal passage (or the lower nasal passage). ) To the rear nostril, and a plurality of recesses are formed in a portion that substantially coincides with the length. Accordingly, the necessary amount of anesthetic can be applied only to the necessary place by inserting the main body portion by a predetermined length and operating the main body portion slightly. .
凹部の形状は、一時的に麻酔薬を貯留できる形状であればその種類は問わない。従って、楕円形状、長円形状でもよいし、複数のひだ状に形成してもよい。ひだ状に形成する場合は、隣接するひだの間が凹部として機能する。更に、本体部の軸方向を回転軸とし、外周面に設けたらせん状溝により形成されてもよい。 The shape of the recess is not limited as long as it can temporarily store an anesthetic. Therefore, an elliptical shape, an oval shape, or a plurality of pleats may be formed. In the case of forming pleats, the space between adjacent pleats functions as a recess. Furthermore, it may be formed by a spiral groove provided on the outer peripheral surface with the axial direction of the main body portion as the rotation axis.
更に、前記本体部を前記被検者の鼻腔内に挿入した状態を維持するために、前記被検者の顔面に一時的に固定する固定体を含む脱落防止部を更に備えてもよい。一例として、脱不落防止部は、本体部を被検者の鼻腔内に挿入した状態で、被検者の上***の白唇部に接触する固定体、及び当該固定体と前記把持部とを連結する連結部を含んで形成してもよい。 Furthermore, in order to maintain the state where the main body portion is inserted into the nasal cavity of the subject, a drop-off preventing portion including a fixing body that is temporarily fixed to the face of the subject may be further provided. As an example, the drop-off prevention unit includes a fixed body that is in contact with the white lip portion of the subject's upper lip with the main body portion inserted into the subject's nasal cavity, and the fixed body and the gripping portion. You may form including the connection part which connects.
鼻腔内に麻酔薬を塗布する際には、麻酔薬が十分に鼻腔粘膜に浸潤するまでの時間、鼻腔内に本体部を留めておく必要がある。そこで、本体部の脱落を防ぐために固定体を鼻腔外、例えば被検者の上***の白唇部に固定体をテーピングすることで、本体部の脱落を防止することができる。 When applying an anesthetic within the nasal cavity, it is necessary to keep the main body in the nasal cavity for a time until the anesthetic sufficiently infiltrates the nasal mucosa. Therefore, in order to prevent the main body from falling off, the main body can be prevented from falling off by taping the fixed body outside the nasal cavity, for example, on the white lip of the upper lip of the subject.
本発明によれば、経鼻内視鏡検査において、麻酔薬を必要な箇所に必要量供給する鼻腔内麻酔薬塗装置を提供することができる。上記した以外の課題、構成及び効果は、以下の実施形態の説明により明らかにされる。 ADVANTAGE OF THE INVENTION According to this invention, in a nasal endoscopy, the intranasal anesthetic coating apparatus which supplies a required quantity of an anesthetic to a required location can be provided. Problems, configurations, and effects other than those described above will be clarified by the following description of embodiments.
以下、本発明の実施の形態を図面に基づいて詳細に説明する。なお、実施の形態を説明するための全図において、同一の機能を有する部材には同一または関連する符号を付し、その繰り返しの説明は省略する。また、以下の実施の形態では、特に必要なとき以外は同一または同様な部分の説明を原則として繰り返さない。 Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. Note that components having the same function are denoted by the same or related reference symbols throughout the drawings for describing the embodiments, and the repetitive description thereof is omitted. In the following embodiments, the description of the same or similar parts will not be repeated in principle unless particularly necessary.
図１において、１は内視鏡であって、内視鏡１は体腔内に挿入される挿入部２の基端部に本体操作部３を連結して設け、本体操作部３から光源装置やプロセッサに接続されるユニバーサルコード４を延在させる構成としたものである。挿入部２は、例えば食道，胃，十二指腸等といった上部消化管内に挿入されて、所望の検査や治療等を行うために用いられるものである。ここで、挿入部２は、被検者の口腔ではなく、鼻腔を介して体内に挿入されるようになっている。つまり、鼻道の入口である外鼻孔から中鼻道や下鼻道を含む鼻腔を通り、後鼻孔から咽頭部を経て食道に至る経路を取るようにしている。 In FIG. 1, reference numeral 1 denotes an endoscope. The endoscope 1 is provided with a main body operation unit 3 connected to a proximal end portion of an insertion unit 2 to be inserted into a body cavity. The universal cord 4 connected to the processor is extended. The insertion portion 2 is inserted into the upper digestive tract such as the esophagus, stomach, duodenum, etc., and is used for performing a desired examination or treatment. Here, the insertion part 2 is inserted into the body not through the oral cavity of the subject but through the nasal cavity. That is, a route is taken from the outer nostril, which is the entrance of the nasal passage, through the nasal cavity including the middle nasal passage and the lower nasal passage, and from the rear nostril through the pharynx to the esophagus.
内視鏡１の挿入部２を鼻腔内に挿入する前の段階で、麻酔薬を塗布する。この麻酔薬の塗布は、麻酔薬塗布装置を外鼻孔から挿入し、中鼻道や下鼻道から後鼻孔に至る鼻腔内経路に対して均一に、しかも必要な量だけ塗布する。このために用いられる麻酔薬塗布装置の一例が、図２乃至図４に示されている。 An anesthetic is applied at a stage before the insertion portion 2 of the endoscope 1 is inserted into the nasal cavity. The anesthetic is applied by inserting an anesthetic application device from the outer nostril and applying it uniformly and in a necessary amount to the intranasal route from the middle nasal passage and the lower nasal passage to the posterior nostril. An example of an anesthetic application device used for this purpose is shown in FIGS.
図２の麻酔薬塗布装置１０は、鼻腔内に挿入するスティック形状（棒状）の本体部２０と、本体部２０の軸方向の基端部側に連続して設けられ、本体部２０を鼻腔内に挿入する際にユーザが把持する把持部３０と、本体部２０を鼻腔内に挿入した状態を維持する、換言すると鼻腔内に挿入された本体部２０が鼻腔外に脱落することを防止する脱落防止部４０とを有する（図２（ａ）（ｂ）参照）。 An anesthetic application device 10 in FIG. 2 is provided continuously on a stick-shaped (rod-like) main body 20 to be inserted into the nasal cavity and an axially proximal end side of the main body 20, and the main body 20 is placed in the nasal cavity. The gripper 30 that the user grips when inserting into the nasal cavity and the main body part 20 are maintained in a state where they are inserted into the nasal cavity, in other words, the main body part 20 inserted into the nasal cavity is prevented from falling out of the nasal cavity. And a prevention unit 40 (see FIGS. 2A and 2B).
本体部２０は少なくとも外鼻孔から後鼻孔に至る長さ、具体的には６ｃｍ〜９ｃｍ程度の長さを有するものであり、太さ（外周径）は内視鏡１の挿入部２と同等若しくはそれ以下である。 The main body portion 20 has at least a length from the outer nostril to the rear nostril, specifically about 6 cm to 9 cm, and the thickness (outer diameter) is equal to that of the insertion portion 2 of the endoscope 1 or Less than that.
本体部２０は中実の棒状に形成されるが（図２（ｃ）参照）、中空のチューブ状に形成されてもよい。本体部２０の先端部２１は挿入性を向上させるために凸半球面または回転楕円面等といった凸球面形状となっており、エッジやコーナ部等は存在しない。 The main body 20 is formed in a solid rod shape (see FIG. 2C), but may be formed in a hollow tube shape. The tip portion 21 of the main body portion 20 has a convex spherical shape such as a convex hemispherical surface or a spheroid surface in order to improve insertability, and there is no edge or corner portion.
本体部２０の外周には、塗布あるいは噴射された麻酔薬を一時的に貯留する麻酔薬付着部２２が形成される。麻酔薬付着部２２は、本体部２０の外周面の内、本体部２０を被検者の鼻腔に挿入した状態で、被検者の鼻腔内壁のうち経鼻内視鏡を挿入した際に内視鏡が接触して鼻痛を生じさせる部位に対向する外周面に設けられる。図３に示すように、経鼻内視鏡の挿入ルートは３態様があるが、そのいずれの挿入ルートであっても麻酔処置を行いたい部位に麻酔薬付着部２２が配置されることが望ましい。 On the outer periphery of the main body portion 20, an anesthetic agent attaching portion 22 for temporarily storing the applied or sprayed anesthetic agent is formed. The anesthetic agent attaching portion 22 is formed when the transnasal endoscope is inserted into the inner wall of the subject's nasal cavity with the main body portion 20 being inserted into the subject's nasal cavity in the outer peripheral surface of the main body portion 20. It is provided on the outer peripheral surface facing the site where the endoscope contacts and causes nose pain. As shown in FIG. 3, there are three types of insertion routes of the nasal endoscope, and it is desirable that the anesthetic agent attaching portion 22 be arranged at a site where anesthesia treatment is to be performed in any of the insertion routes. .
そこで図２の例では、麻酔薬付着部２２を本体部２０の先端部２１から基端部側（把持部３０側）方向に１〜２ｃｍにある第一基点２２ａを基準とし、それよりも更に把持部３０方向に３〜５ｃｍ近い位置にある第二基点２２ｂまでの範囲に、複数の円形または楕円状の凹部２５が全周面に亘って複数形成される。 Therefore, in the example of FIG. 2, the anesthetic attachment portion 22 is based on the first base point 22 a that is 1 to 2 cm from the distal end portion 21 of the main body portion 20 to the proximal end portion side (gripping portion 30 side). A plurality of circular or elliptical concave portions 25 are formed over the entire circumferential surface in the range up to the second base point 22b located at a position close to 3 to 5 cm in the direction of the grip portion 30.
麻酔薬塗布装置１０の挿入前に麻酔薬付着部２２に麻酔薬を塗布あるいは噴霧すると、凹部２５に麻酔薬が一時的に貯留され、麻酔薬付着部２２外に漏出しにくくなる。そのため、本体部２０を鼻腔内に挿入する作業をしている間も麻酔薬を貯留し続けることができ、鼻腔内壁の所望の部位に対して麻酔薬を塗布できる。 When an anesthetic is applied to or sprayed on the anesthetic agent attaching part 22 before the anesthetic agent applying apparatus 10 is inserted, the anesthetic is temporarily stored in the recess 25 and is difficult to leak out of the anesthetic agent attaching part 22. Therefore, the anesthetic can be continuously stored even during the operation of inserting the main body portion 20 into the nasal cavity, and the anesthetic can be applied to a desired site on the inner wall of the nasal cavity.
麻酔薬付着部２２の形状の他例として、図３の麻酔薬塗布装置１０ａのように、長円状の凹部２６を複数配列してもよい。 As another example of the shape of the anesthetic agent attaching portion 22, a plurality of oval concave portions 26 may be arranged as in the anesthetic agent applying device 10a of FIG.
また図４の麻酔薬塗布装置１０ｂのように、本体部２０の周方向に沿って複数配置された複数のひだ部２７により、麻酔薬付着部２２を形成してもよい。この場合、隣接するひだ部２７の間に麻酔薬が貯留されるとともに、スティック状の本体部に比べてひだ部２７の方が表面積は広くなるので、麻酔薬がより付着しやすくなる。 Moreover, you may form the anesthetic agent adhesion part 22 by the some pleat part 27 arrange | positioned along the circumferential direction of the main-body part 20 like the anesthetic application | coating apparatus 10b of FIG. In this case, the anesthetic is stored between the adjacent pleat portions 27, and the surface area of the pleat portion 27 is larger than that of the stick-shaped main body portion, so that the anesthetic agent is more easily attached.
本体部２０及び把持部３０の間には本体部２０よりも太いフランジ部３１を備える。フランジ部３１は、被検者の外鼻孔よりも太く形成される。これにより、本体部２０を被検者の鼻腔に挿入した際に、フランジ部３１が外鼻孔に接触した位置で本体部２０の挿入が止まり、本体部２０を挿入し過ぎることを抑止できる。 A flange 31 that is thicker than the main body 20 is provided between the main body 20 and the grip 30. The flange portion 31 is formed thicker than the outer nostril of the subject. Thereby, when the main body portion 20 is inserted into the nasal cavity of the subject, the insertion of the main body portion 20 is stopped at the position where the flange portion 31 is in contact with the outer nostril, and it is possible to suppress the excessive insertion of the main body portion 20.
本体部２０、フランジ部３１、及び把持部３０は、同一軸線Ｌを有して形成される。一方、脱落防止部４０は、一端部が把持部３０に連結され、他端部は把持部３０から離隔した突出片（固定翼部）として形成される。図２（ｂ）の例では、脱落防止部４０は、フランジ部３１に連結する連結部４１、及び連結部４１よりも面積が広い板状部材からな固定体４２を含んで形成される。脱落防止部４０は、軸線Ｌに対して傾斜角θを有して形成される（図２（ａ）参照）。この傾斜角θは、鼻腔内に本体部２０を挿入した状態で、被検者の上***の白唇部に沿う形状となすことが望ましい。これにより図５に示すように、本体部２０を鼻腔内に挿入した状態で固定体４２を被検者の上唇の上側に粘着テープで一時的に固定することができる。その結果、麻酔塗布装置１０を鼻腔内に挿入し、麻酔薬が鼻腔粘膜に浸潤するまでの時間本体部２０を留置させる際にも、本体部２０の脱落を抑止することができる。 The main body portion 20, the flange portion 31, and the grip portion 30 are formed having the same axis L. On the other hand, the drop-off prevention part 40 is formed as a protruding piece (fixed wing part) having one end connected to the grip part 30 and the other end separated from the grip part 30. In the example of FIG. 2B, the drop-off prevention part 40 is formed including a connection part 41 connected to the flange part 31 and a fixed body 42 made of a plate-like member having a larger area than the connection part 41. The drop-off prevention unit 40 is formed with an inclination angle θ with respect to the axis L (see FIG. 2A). It is desirable that the inclination angle θ has a shape along the white lip portion of the upper lip of the subject in a state where the main body portion 20 is inserted into the nasal cavity. As a result, as shown in FIG. 5, the fixing body 42 can be temporarily fixed to the upper side of the upper lip of the subject with the adhesive tape in a state where the main body portion 20 is inserted into the nasal cavity. As a result, even when the anesthetic application device 10 is inserted into the nasal cavity and the body part 20 is left for a period of time until the anesthetic infiltrates into the nasal mucosa, the body part 20 can be prevented from falling off.
以上のように構成される麻酔薬塗布装置１０は、耐オートクレープ性を有する材質を用いて形成されることが好ましい。これにより、使い捨て（単回使用）ではなく、滅菌・殺菌処理後の再利用が可能となる。また、本体部２０は、更に曲げ方向に対する可撓性が要求される。そこで、例えばシリコンを用いて本体部２０を形成してもよい。このように、再利用性を確保することで、麻酔薬塗布装置１０の製造単価が使い捨て装置に比べて高くなることが許容されやすくなる。そのため、麻酔薬付着部２２のような複雑な形状加工技術や、脱落防止部４０を備えることによる製造原価の上昇に対しても、経済的な耐性を有することができる。特に、現行の診療報酬体制下では検査毎に診療報酬額が定まっており、検査器具のコストが上昇しても医療機関は診療報酬額に上乗せして回収することができず、経営圧迫要因となりかねない。従って、麻酔薬塗布装置の再利用性を確保することで、医療機関の収益性向上に資することができる。 The anesthetic application device 10 configured as described above is preferably formed using a material having autoclave resistance. This makes it possible to reuse after sterilization and sterilization treatment, not disposable (single use). Further, the main body 20 is further required to be flexible in the bending direction. Therefore, the main body 20 may be formed using, for example, silicon. Thus, by ensuring reusability, it becomes easy to accept that the manufacturing unit price of the anesthetic application device 10 is higher than that of the disposable device. For this reason, it is possible to have economical resistance against a complicated shape processing technique such as the anesthetic agent attaching portion 22 and an increase in manufacturing cost due to the provision of the dropout preventing portion 40. In particular, under the current medical fee system, the medical fee amount is fixed for each examination, and even if the cost of the inspection equipment rises, the medical institution cannot add to the medical fee amount and collect it, which causes management pressure. It might be. Therefore, ensuring the reusability of the anesthetic application device can contribute to improving the profitability of the medical institution.
麻酔薬塗布装置１０の使用方法について説明する。まず、麻酔薬付着部２２に麻酔薬を噴霧又は塗布し、凹部２５、２６、またはひだ部２７に麻酔薬を一時的に貯留させる。そして、本体部２０の先端部２１を被検者の外鼻孔の内部に挿入する。本体部２０の先端部２１は凸曲面形状となっているので、狭い通路である鼻腔内に粘膜を圧迫したり、ダメージを与えたりすることなく、円滑に挿入でき、被検者に与える苦痛は最小限に抑制される。 A method of using the anesthetic drug application device 10 will be described. First, an anesthetic is sprayed or applied to the anesthetic attachment portion 22, and the anesthetic is temporarily stored in the recesses 25, 26 or the folds 27. And the front-end | tip part 21 of the main-body part 20 is inserted in a test subject's outer nostril. Since the distal end portion 21 of the main body portion 20 has a convex curved shape, it can be smoothly inserted into the nasal cavity, which is a narrow passage, without compressing or damaging the mucous membrane. Minimized.
本体部２０の鼻腔内への進行に伴って、麻酔薬付着部２２も進行し、鼻腔内面に麻酔薬が塗布されることになる。麻酔薬付着部２２には、その全周にわたって凹部２５、２６またはひだ部２７が形成されているので、麻酔薬は鼻腔における内視鏡１の挿入部２が通過する中鼻道（または下鼻道）の粘膜のほぼ全周にわたって塗布される。また鼻腔内に本体部２０が進行する際に接触する鼻腔内壁に対して、凹部２５、２６またはひだ部２７に貯留された麻酔薬が塗布されるので、塗布むらを最小限に抑制できる。 As the main body portion 20 advances into the nasal cavity, the anesthetic agent attaching portion 22 also advances, and the anesthetic agent is applied to the inner surface of the nasal cavity. Since the concave portion 25, 26 or the pleat portion 27 is formed in the anesthetic agent attaching portion 22 over the entire circumference thereof, the anesthetic agent passes through the middle nasal passage (or lower nose) through which the insertion portion 2 of the endoscope 1 in the nasal cavity passes. It is applied almost all around the mucous membrane of the road. In addition, since the anesthetic stored in the recesses 25 and 26 or the pleats 27 is applied to the inner wall of the nasal cavity that comes into contact with the main body 20 when it moves into the nasal cavity, uneven application can be minimized.
そして、麻酔薬を行き渡らせるために、本体部２０を所定の時間だけ鼻腔内に留置する場合もある。その際、脱落防止部４０の固定体４２を上***の白唇部にテーピングすることで、把持部３０から手を離しても本体部２０が脱落することを防ぐ。これにより、ユーザが麻酔薬塗布装置１０を把持し続けなくてもよくなり、麻酔薬塗布装置１０が使いやすくなる。このように脱落防止部４０は本体部２０の留置時における脱落防止機能を発揮するが、さらにフランジ部３１と相まって、本体部２０が鼻腔内に完全に埋入してしまうのを防止するストッパとしての機能を発揮する。 And in order to distribute an anesthetic, the main-body part 20 may be detained in a nasal cavity only for predetermined time. At that time, by tapering the fixed body 42 of the drop-off prevention part 40 to the white lip part of the upper lip, the main body part 20 is prevented from falling off even if the hand is released from the grip part 30. This eliminates the need for the user to continue to hold the anesthetic drug application device 10 and makes it easier to use the anesthetic drug application device 10. In this way, the drop-off prevention part 40 exhibits a drop-off prevention function when the main body part 20 is placed, but further, as a stopper that prevents the main body part 20 from being completely embedded in the nasal cavity, coupled with the flange part 31. Demonstrate the function.
麻酔薬が十分作用するまでの間本体部２０を留置した後、本体部２０を鼻腔外に引き出す。そして、内視鏡１の挿入部２を鼻腔内に挿入して、この挿入部２の先端部を検査すべき位置にまで進行させて、この挿入部２を適宜操作することにより内視鏡検査が行われる。そして、必要に応じて処置具挿通チャンネルを介して鉗子等の処置具を体腔内に挿入することによって、所定の治療を施すこともできる。 After the main body part 20 is left until the anesthetic agent sufficiently acts, the main body part 20 is pulled out of the nasal cavity. Then, the insertion portion 2 of the endoscope 1 is inserted into the nasal cavity, the distal end portion of the insertion portion 2 is advanced to a position to be examined, and the insertion portion 2 is appropriately operated to perform endoscopy. Is done. Then, if necessary, a predetermined treatment can be performed by inserting a treatment tool such as forceps into the body cavity via the treatment tool insertion channel.
麻酔薬塗布装置１０の使用後は、アルコール処理やオートクレープによる熱処理により、殺菌、滅菌処理を行う。これにより、再利用を行うことができる。 After use of the anesthetic agent application apparatus 10, sterilization and sterilization are performed by alcohol treatment or heat treatment by autoclave. Thereby, reuse can be performed.
上記実施形態は本発明の一態様の例示にすぎず、本発明を限定する趣旨ではない。本発明の趣旨を逸脱しない範囲での様々な変更態様は本発明に含まれるものである。例えば、脱落防止部４０は、連結部及び固定体を共に一つの板状部材として形成してもよいし、連結部はフランジ部ではなく把持部３０に連結してもよい。また固定体は板状部材ではなく棒状部材でもよい。さらに固定体は被検者の上***の白唇部に固定できる位置に設けたが、例えば図２（ａ）の軸線Ｌに対して仰角に、かつ本体部２０方向に突出する突出片として形成し、被検者の鼻上にテーピングできるように形成してもよい。 The above embodiment is merely an example of one aspect of the present invention and is not intended to limit the present invention. Various modifications within the scope of the present invention are included in the present invention. For example, the drop-off prevention unit 40 may form both the connection part and the fixed body as one plate-like member, or the connection part may be connected to the grip part 30 instead of the flange part. The fixed body may be a rod-shaped member instead of a plate-shaped member. Further, the fixed body is provided at a position where it can be fixed to the white lip portion of the upper lip of the subject. For example, the fixed body is formed as a protruding piece protruding at an elevation angle with respect to the axis L in FIG. In addition, it may be formed so that it can be taped on the subject's nose.
１：内視鏡、２：挿入部、３：本体操作部、４：ユニバーサルコード、１０：麻酔薬塗布装置、２０：本体部、２１：先端部、２２：麻酔薬付着部、３０：把持部、４０：脱落防止部 DESCRIPTION OF SYMBOLS 1: Endoscope, 2: Insertion part, 3: Main body operation part, 4: Universal cord, 10: Anesthetic agent application apparatus, 20: Main body part, 21: Tip part, 22: Anesthetic agent adhesion part, 30: Gripping part , 40: drop-off prevention part
前述した目的を達成するために、本発明に係る鼻腔内麻酔薬塗布装置は、被検者の外鼻孔から後鼻孔に至る距離以上の長さを有する中実の棒状部材からなる本体部と、前記棒状部材の先端近傍の外周面に所定の長さにわたって形成された凹部からなる麻酔薬付着部と、前記本体部の基端部に設けられた把持部と、を備える、ことを特徴とする。 In order to achieve the above-described object, an intranasal anesthetic application device according to the present invention includes a main body portion formed of a solid rod-like member having a length equal to or longer than a distance from an outer nostril of a subject to a rear nostril, It is provided with an anesthetic agent adhesion part which consists of a crevice formed in the outer peripheral surface near the tip of the rod-like member over predetermined length , and a grasping part provided in the base end part of the main part. .
Claims (2)
前記本体部の先端近傍の外周面に所定の長さにわたって凹部形成された麻酔薬付着部と、
前記本体部の基端部に設けられた把持部と、を備える、
ことを特徴とする鼻腔内麻酔薬塗布装置。 A rod-shaped main body having a length equal to or longer than the distance from the outer nostril of the subject to the rear nostril;
An anesthetic agent attaching part formed with a recess over a predetermined length on the outer peripheral surface near the tip of the main body part,
A grip portion provided at a base end portion of the main body portion,
An intranasal anesthetic application device.
前記麻酔薬付着部は、前記本体部の先端部から前記把持部側方向に１乃至２ｃｍにある第一基点を基準とし、それよりも更に前記把持部方向に３乃至５ｃｍ近い位置にある第二基点までの範囲に設けられる、
ことを特徴とする鼻腔内麻酔薬塗布装置。 The intranasal anesthetic application device according to claim 1,
The anesthetic agent attaching portion is based on a first base point that is 1 to 2 cm in the gripping portion side direction from the distal end portion of the main body portion, and is further closer to the gripping portion direction by 3 to 5 cm. Provided in the range to the base point,
An intranasal anesthetic application device.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2019148320A JP6731530B2 (en) | 2019-08-13 | 2019-08-13 | Intranasal anesthetic applicator |
Applications Claiming Priority (1)
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113397456A (en) * | 2021-07-20 | 2021-09-17 | 侯铁柱 | Throat protection device with antacid and secretion inhibiting functions |
| CN114602046A (en) * | 2022-05-10 | 2022-06-10 | 纳索菲德(上海)制药技术有限公司 | Device for delivering liquid medicine to nasal cavity olfactory region and using method thereof |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2006326064A (en) * | 2005-05-27 | 2006-12-07 | Nobuyuki Ohara | Intranasal anesthetic coater |
| JP2007000156A (en) * | 2005-05-27 | 2007-01-11 | Nobuyuki Ohara | Trial insertion device for endoscope |
| JP2015073639A (en) * | 2013-10-07 | 2015-04-20 | 株式会社トップ | Pretreatment instrument for transnasal endoscope |
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Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2006326064A (en) * | 2005-05-27 | 2006-12-07 | Nobuyuki Ohara | Intranasal anesthetic coater |
| JP2007000156A (en) * | 2005-05-27 | 2007-01-11 | Nobuyuki Ohara | Trial insertion device for endoscope |
| JP2015073639A (en) * | 2013-10-07 | 2015-04-20 | 株式会社トップ | Pretreatment instrument for transnasal endoscope |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113397456A (en) * | 2021-07-20 | 2021-09-17 | 侯铁柱 | Throat protection device with antacid and secretion inhibiting functions |
| CN113397456B (en) * | 2021-07-20 | 2024-04-30 | 侯铁柱 | Throat protection device with antiacid secretion inhibition function |
| CN114602046A (en) * | 2022-05-10 | 2022-06-10 | 纳索菲德(上海)制药技术有限公司 | Device for delivering liquid medicine to nasal cavity olfactory region and using method thereof |
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| JP6731530B2 (en) | 2020-07-29 |
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