Method and apparatus for rectal anaesthesia

Abstract

A system and method for delivering a medicament to a target tissue site in a patient over a period of time. A catheter is configured for implantation in different target tissue sites and extends from a proximal end to a distal end and has a sidewall which defines an internal lumen. The distal end has one or more apertures either in the sidewall or at a distal end for the release of the medicament into the target tissue site; the system also comprises a medicament reservoir fluidly communicable with the internal lumen of each catheter, an adhesive member configured to adhere to the skin of the patient around the exit wound and having an opening therein to allow the catheters to pass through the adhesive member and a retaining member configured to be overlaid on the adhesive member and comprising a guide surface configured to receive a length of the two or more catheters and a plurality of retaining portions to retain the catheters against the guide surface.

1 . A system for delivering a medicament to a target tissue site in a patient over a period of time, the system comprising:
 a catheter configured for implantation in a target tissue site, the catheter extending from a proximal end to a distal end and having a sidewall which defines an internal lumen, said distal end having one or more apertures in the sidewall for the release of the medicament into the target tissue site;   a medicament reservoir fluidly communicable with the internal lumen of the catheter;   an adhesive member configured to adhere to the skin of the patient around the exit wound and having an opening therein to allow the catheter to pass through the adhesive member; and   a retaining member configured to be overlaid on the adhesive member and comprising a guide surface configured to receive a length of the catheter and a plurality of retaining portions to retain the catheters against the guide surface.   
     
     
         2 . The system of  claim 1  wherein the catheter comprises two or more catheters. 
     
     
         3 . The system of  claim 2 , wherein the two or more catheters have a trocar receiving opening in the sidewall at the distal end, the proximal end or both the distal and proximal ends. 
     
     
         4 . The system of  claim 1 , further comprising a trocar, said trocar having an elongate solid body which extends from a proximal end to a distal end, the trocar having a hook feature at or adjacent to either the proximal or distal end. 
     
     
         5 . The system of  claim 3 , further comprising a nerve stimulating trocar. 
     
     
         6 . The system of  claim 5 , wherein the nerve stimulating trocar comprises an elongate body having a proximal region, a distal region having a distal tip and an intermediate region between the proximal and distal regions. 
     
     
         7 . The system of  claim 6 , wherein the nerve stimulating trocar comprises one or more electrodes. 
     
     
         8 . The system of  claim 7 , wherein the one or more electrodes are at the distal tip of the nerve stimulating trocar. 
     
     
         9 . The system of  claim 6 , wherein the intermediate region of the nerve stimulating trocar forms a bend such that a main axis of the proximal region is offset and substantially parallel to a main axis of the distal region. 
     
     
         10 . The system of  claim 9 , wherein the proximal region of the nerve stimulating catheter is configured to extend along an outer surface of the two or more catheters and the intermediate region passes through the trocar receiving opening such that the distal region is housed within the internal lumen of the two or more catheters and the distal tip extends from the distal end of the two or more catheters. 
     
     
         11 . The system of  claim 1 , wherein the retaining member is a partially circular structure having a relatively planar base surface and wherein the guide surface is opposed to the planar base and is a curved surface which terminates in an outer rim. 
     
     
         12 . The system of  claim 11 , wherein the retaining member includes one or more clips to retain the catheter against the guide surface. 
     
     
         13 . The system of  claim 12 , wherein the clips comprise a pair of opposed jaw members which together form a tunnel therethrough. 
     
     
         14 . The system of  claim 13 , wherein the jaw members are made from a resiliently flexible material and are biased in a closed configuration such as to form the tunnel therethrough. 
     
     
         15 . The system of  claim 1 , further comprising a retainer housing comprising a substantially circular base having an outer facing surface and a substantially flat inner surface and an outer rim which extends peripherally from circular base and terminates in a lip. 
     
     
         16 . The system of  claim 15 , wherein the retainer housing further comprises a plurality of arms which extend centrally from an inner edge of the circular base and which terminate in a central body. 
     
     
         17 . The system of  claim 1 , wherein the catheter includes a balloon having an internal passage to thread over an end of the catheter such that the balloon slides over the catheter to a desired location. 
     
     
         18 . The system of  claim 1 , further comprising a pump, wherein the pump comprises two separate pumping members each connected to the medicament reservoir and to respective catheters. 
     
     
         19 . The system of  claim 18 , further comprising a power source to power the pump and a control unit to control the rate of flow of the medicament from the medicament reservoir to the two or more catheters. 
     
     
         20 . The system of  claim 19 , wherein the control unit is pre-programmed to deliver a pre-determined regimen of medicament over a period of time. 
     
     
         21 . The system of  claim 20 , wherein the pre-determined regimen includes different pre-programmed intervals. 
     
     
         22 . The system of  claim 21  including a bolus interval wherein during the bolus interval, an increased amount of medicament is delivered to the patient compared to one or more of the other pre-programmed intervals. 
     
     
         23 - 34 . (canceled) 
     
     
         35 . A surgical kit comprising:
 two or more catheters configured for implantation in a target tissue site of a patient, each catheter extending from a proximal end to a distal end and having a sidewall which defines an internal lumen, said distal end having one or more apertures in the sidewall;   an adhesive member configured to adhere to the skin of the patient around the exit wound and having an aperture therein to allow the catheters to pass through the adhesive member;   an open ring-shaped retaining member configured to be overlaid on the adhesive member and comprising a substantially flat base, a guide surface configured to receive a length of the two or more catheters and a plurality of retaining portions to retain the catheters against the guide surface;   a tunnelling trocar configured for attachment to the proximal ends of the catheters;   a stimulator trocar comprising an elongate body which is made from a material having a greater rigidity than the two or more catheters, the stimulator trocar comprising a nerve stimulator configured to stimulate nerves in a target tissue site;   a pump and a medicament reservoir;   a sheet for application to the patient's skin around the surgical site, the sheet having an adhesive surface for adhering to the skin of the patient and a series of frangible regions for removal of parts of the sheet.