Method and device for applying transcutaneous electrostimulation mainly in dentistry

FIELD: medicine; medical engineering.

SUBSTANCE: method involves placing negative and positive electrode on skin surface in the innervation area of the second and the third trigeminus branch. An additional negative electrode is applied in the innervation area of auriculotemporal trigeminus branch. The electrodes are fed with pulsating electric current in predefined sequence. Current intensity is controlled in stimulation process in a way that patient feels intensive sensation with no pain. Device has DC supply source connected to unit for generating pulsating electric current having three outlet leads for connecting electrodes, modulator having regulator unit, transformer, switch and microprocessor.

EFFECT: enhanced effectiveness of anesthesia in treating teeth.

15 cl, 7 dwg

 

The invention relates to medicine, namely to methods of transcutaneous electroneurostimulation for pain relief, relief of pain and the data demonstrate that differently modulated tissues of patients, mainly in dental practice.

Improving the efficiency and quality of patient care is inextricably linked with the improvement of the means and methods of dealing with pain. In recent years there has been a growing interest in non-pharmacological methods of pain relief and relief of pain.

The applicant considers it necessary at this point in the description to note the features of each of these concepts.

PAIN is a psychological and physical condition of the person, resulting from the impact of super-strong or damaging stimuli, causing organic or functional disorders in the body [1]. Receptors (nociceptors) perceive such stimuli activate neurons, afferent processes which nociceptive information in the form of action potentials reaches the cortex of the brain, where the sensation of pain. Thus pain is a subjective sensation that arises in the human mind when you activate nociceptive (pain) system, providing reception, transmission and processing of information in the sensory area of the cerebral cortex. All of these processes are under the control of antinociceptive (and the gene analgesic) system, which, with the participation of many neurotransmitters and neuromodulators, reduces the excitability of the nociceptive system and reduces the severity of pain.

Antinociceptive system includes endogenous system simulation and control of pain, which is localized in the brain stem, medium, oblong, as well as in the spinal cord and is represented by two mechanisms: opiate and neopytnym.

For a better understanding of the mechanism of action of the proposed method it is necessary to dwell on the most effective mechanism of endogenous regulation of pain sensitivity - opiate.

The basis of the opiate type antinociceptive system is binding ability of narcotic analgesics and endogenous opioids produced by the body, with specialized opioid receptors on the membranes of neurons in the nociceptive system. The greatest number of these receptors found in the field periaqueductal grey matter in the brain stem sensory nuclei of the thalamus, hypothalamus, and other structures of the nervous system.

Endogenous opioids have a neuropeptide structure, synthesized in specialized neurons of the Central nervous system and their counterparts in chromaffine cells of the cerebral layer of the adrenal cortex, carotid bodies, aortic PA is ganglia. They accumulate in the microvesicles and transported in their composition to the free end of the sensitive nerve fibers. Opioid neuropeptides are released from microphysical in the synaptic gap and binds with opioid receptors on sensory neurons, reduce the intensity of nociceptive (pain) activity.

In the transmission of nociceptive (pain) signals a significant function of endogenous algogennah substances: the prostaglandins, the neuropeptide substance P, kinny and several others, which are produced in the tissues as a result of inflammation or injury reducing activity antinociceptive systems, call their sensitization and hyperly.

Excitation of antinociceptive systems is accompanied by a reduction in the activity of nociceptive neurons and increased pain threshold, i.e. desensitization, hypoalgesia, until analgesia.

Thus, the sensation of pain, which occurs in the human mind when damage or threatened damage to the tissue is subjective. Thus the organism is not only the intensity of the flow of nociceptive information, but also performed and emotional assessment of its threat to the life, formed the necessary vegetative and motor protection from damaging factor.

Thus, painful reaction and EET objective in nature and consists of: touch, emotional, autonomic and motor components.

The term “analgesia” means, in General, the process of early struggle with the expected pain arising directly during dental treatment, for example the preparation of dental hard tissues in the treatment of dental caries, tooth extraction.

The term “sedation” means, in General, struggle with the already existing pain arising from traumatic injuries and/or associated with inflammatory processes in the oral and maxillofacial region. In some cases there is a need of relief of pain syndromes that occur after dental interventions, particularly after operations in the maxillofacial region that also applies to the sedation.

Relief of the pain and the relief of pain, used at the present time, a variety of.

Currently known methods of analgesia:

1) General anesthesia (narcosis):

- inhalation anaesthesia;

- pengallery anesthesia.

2) local anesthesia (local anesthesia):

- application anesthesia;

- infiltration anesthesia;

- regional anesthesia.

3) the combined anesthesia:

- neuroleptanalgesia;

- sedation in combination with inhalation of Gazenergoset the tion of a mixture of oxygen and nitrous oxide - analgesia;

- sedation in combination with intravenous subarcticus doses of calypsol - balanced anaesthesia;

- sedation combined with local anesthesia in the treatment area.

4) neurotological anesthesia:

- electroanalgesia;

- hypnosis.

Consider the features of each.

General anesthesia (narcosis), affects all components of the pain response and allows you to maximize their oppression.

However, for outpatient dental surgery, anaesthesia has limited application and is not more than 1% of all types of anesthesia. The risk of General anesthesia outweigh the risks of intervention. The resulting disordered breathing and ventilation, negative effects on the contractile function of the heart, changes of Central hemodynamics, and the suppression of the normal flow of vegetative reactions - all this creates an excessive burden on compensatory processes in the body of the patient who is in the dental chair. Thus, the depressing effect on the autonomic and muscular components of the pain response is a disadvantage of this method in outpatient dental practice. The relative disadvantage is the impact on the emotional component of the pain response, so is it in violation of verbal contact with the patient during the intervention.

Given the above, it is necessary to adhere strictly to the medical indications for the dental procedures under General anesthesia in the dental clinic.

Local anesthesia involves tissue anesthesia of the surgical field without turning off the consciousness of the patient when the exposure is carried out on peripheral mechanisms of pain information through blockade of sensory nerve fibers. Thus, local anesthesia mainly affects the sensory component of the pain response. Due to the relative simplicity of the performed manipulations and high efficiency, it is the leading method of anaesthesia in dentistry. Divided into infiltration, conduction and regional.

Recently there have been important changes in the means and methods of providing local anesthesia. This affected almost all the components and dosage forms and methods of preparation of local anaesthetic solutions; designs syringes and techniques of working with them; designs, sizes of needles and their packaging, as well as ensuring the sterility of the used solutions and tools. Update occurred throughout the techniques of local anesthesia in dentistry, including the emergence of new and improvement of the previously known methods of anesthesia that is not tol is to created additional facilities, but increased security and simplified requirements for the sterility of the operating conditions of a dentist. If the former approach allows for local anesthesia only in a sterile surgical wards, modern technology provides the ability to apply it in their jobs doctors any dental specialties [3, 4].

However, local anesthesia is not without flaws, as limiting the indications for use, and efficiency.

The main drawback is the presence of allergic reactions to mestnoanesteziruyuschie solutions and intolerance of the individual components included in ready-made forms for injection. Another disadvantage of local anesthetic solutions is their low efficiency in conditions of inflammation, i.e. in terms of sensitization tissue. Another drawback is the effect on the vegetative component of painful reaction components ready-made forms for injection, such as vasoconstrictors (epinephrine, norepinephrine). In addition, local anesthesia does not reduce psychological stress of patients, occurring before dental procedure, and sometimes increases, for example, is important discomfort from vcol needle and the point of introduction of the local anesthetic drug in the tissue, and myorelaxation aneste the dummy tissues, which also adversely affects the effectiveness of pain relief and comfort of holding a dental intervention. In addition, after the intervention for a long time still feeling numb of the soft tissues of the maxillofacial area, which not only causes discomfort, but also can lead to injury.

One of the problems outpatient dentistry remains the treatment of patients at risk, as required a special approach for successful implementation. In cases of failure of patients from “presence” when performing the treatment, when difficult or impossible to contact due to the nature of their psyche successful treatment can be carried out under combined anesthesia.

Combined anesthesia includes the positive side of local and General anesthesia: effects on sensory component of the pain response, optimal impact on emotional and autonomic components of the pain response and negligible effect on the motor component of the pain response. All this allows to achieve adequate pain relief, but saving some disadvantages of local anesthesia does not allow you to use it everywhere.

For more of my shortcomings when conducting combined anesthesia is the need to maintain adequate aisle the value of the upper respiratory tract, what is the main problem faced by the anesthesiologist.

However, as you can see, the above methods cannot solve all the problems of anesthesia in the outpatient dental practice [5].

As noted above, before the doctors is also the problem of the relief of pain, there is relief of pain syndromes that occur after a dental procedure. To date for this purpose are widely used analgesics (aspirin, analgin, paracetamol, Ketorolac etc). However, they have some contraindications. Therefore it is not recommended for use in patients suffering from gastritis, gastric ulcer, etc. as in the recent increase in cases of allergic reactions to these drugs. Low duration of their effect the relief of pain and a long waiting the effects that these drugs make the patient often to take them in large quantities, which exacerbates their side effects.

All this has prompted researchers to search for optimal and safe methods of pain relief and relief of pain.

The purpose of the blockade of pain impulses to dental surgeries since the 50-ies of XX century began to apply various methods of electric shocks for pain and Boleto is to be placed.

We can distinguish the following three areas of application of electrical current:

1. Topical application, in which a constant electric current is fed directly to the teeth and alveolar bone during treatment [6], [7].

This method was used for anesthesia of hard tissues of teeth during their preparation. The disadvantage is that you must have special dental equipment, since the current is supplied directly through the handpiece and in the mouth it is impossible to create a completely dry environment. The presence of conducting electric current moisture in the oral cavity leads to the fact that electric current flows through the moist mucous membrane into the surrounding tissue and not to the tooth, in which area the conduct impact. In the result, the strength of the electric current on the tooth is reduced. For this reason, this method has not found wide application.

2. The overall effect on the Central nervous system [8], [9].

Under this method refers to electronicos, electrosleep. The effect of these methods is directly related to the influence of electric current on the thalamus and midbrain. Along with low efficiency (as a result of their use does not occur, a sufficient effect of anesthesia), they have other drawbacks inherent to the stroke methods of treatment of the patient, namely, unpleasant sensations in the field of electrodes, a slight convulsive twitching of various muscles, tingling and numbness in the fingertips of the hands and feet. In addition, these methods are associated with effects on the Central nervous system, require special attention to safety and, as a consequence, expensive special equipment and qualified personnel. In the end, the broad application of electronicos and electrosleep not currently received.

3. Reflex effect. Of these methods, the most effective was this method.

It includes the following methods: electroacupuncture [10], electropuncture [11] and transcutaneous electrical nerve stimulation (hereinafter - enss)[12].

Electroacupuncture [10] it is used for pain and is exposed to constant or pulsed electric current through the needle, put into acupuncture points. Its disadvantages are the inability or difficulty of the use of needles in certain acupuncture points in connection with an involuntary patient in the dental chair, violation of the integrity of skin and tissue, skin burns, abscesses, sores, etc. in Addition, to perform the method requires a specially trained doctor-re is exoteric.

Given the drawbacks, it was proposed a method of electrical stimulation of acupuncture points through cutaneous electrodes. This is the method of electropuncture [11]. It is based on the effects of electric shock on acupuncture points in their projections on the skin of the patient. However, this method also has several disadvantages. In particular, the application of the electrodes in some acupuncture points in connection with an emergency in the same way as in the previous method required a special doctor-reflexologist, and low efficiency of the relief of pain, the inability or difficulty of the position of the patient in the dental chair, the need for trained medical personnel to perform the techniques of reflexology.

Advances in neurophysiology have led to the emergence and development of a new way of dealing with pain using tens [13].

For the first time since positions neuroscientists this method was justified in 1965, when it was created R.Melzach and R.Wall “gate” theory. According to this theory the pain signal included in certain areas of the spinal cord (gelatin substance posterior horns of the spinal cord), is not passed on to the Central nervous system if both of the input do not pain signals from another place, closing the entrance to pain impulses [14]. This theory is Oli and analgesia suggests, the input control exists not only in the spinal cord, but in the higher parts of the Central nervous system. In particular, the cells of the gray matter of the brain have significant receptor area and complex projection. Intense stimulation of these zones leads to the perception of pain in the Central nervous system, at the same time stimulates inhibitory fibers in the brain stem, which block pain impulses from other sites.

The second more modern theory of the effect, which is based CHENS is to activate the above opiate type antinociceptive system.

Thus, the effect of the method CHENS is due to the fact that the afferent flow, i.e. moving towards the brain, the action potentials caused tens, activates the production of endogenous opioids, that is, substances that reduce the excitability of nociceptive structures, the duration of which considerably exceeds the time electroneurostimulation. These substances bind to opiate receptors stem and limbic structures of the brain, which leads to an effective modulation of afferent streams of sensory information and is expressed in volutrauma, gopalratnam up to the analgesic actions.

After the description of theory underlying the actions of tens, we believe the need is passed to disclose further entity known accepted as a prototype method transcutaneous electroneurostimulation, mostly, dental practice [15].

Adopted as a prototype method transcutaneous electroneurostimulation used mainly for pain relief, the data demonstrate that differently modulated and the relief of pain in patients in the dental practice and is that define the area of the proposed intervention and the occurrence of pain or an area of existing pain, impose negative and positive electrodes on the surface of the skin in the areas that represent the projection on the skin of sensitive nerve, Innervate this region, in places it as close to the skin surface. Meanwhile, the negative electrode sets on the skin, as close as possible to the place of intervention, or the projection of the exit site on the skin of the specified nerve-side intervention, and the positive electrode during this nerve serves on the electrodes pulsed electric current, and in the process of implementing a way to regulate the current strength in the direction of its increase, so that the patient always felt an intense nabolese feelings.

The applicant considers it necessary to clarify at this point in the description of the need to regulate the current in the direction of its increase, so that the patient always felt the intensity of the positive nabolese feelings. This is caused by the following circumstances related to the physiology of the human nervous system. The thing is that if you have an impact on the human body at a constant rate, in particular, electrical shock, the body adapts to this effect over time and the intensity of the sensation is reduced down to extinction. In this regard, cease to be allocated endogenous opioids, which leads to reduction or lack of effect of reduction in pain from their influence. Thus, while the organism perceives stimulation electric current, that is, feels it, he highlights the endogenous opioids in peripheral nerve endings in the brain that modulate the passage of pain impulses.

As soon as the patient stops or decreases the thrill transcutaneous electroneurostimulation, it ceases to distinguish endogenous opioids and pain flow information flows freely into the appropriate parts of the Central nervous system, where a painful reaction. Therefore, to prevent adaptation, tens necessarily made on the “background” continuous maintenance of the patient's perception of electric current, as intense mebolevich sensations. This is achieved in various ways, in particular, periodic increase in current, passing the century between the electrodes during the entire procedure transcutaneous electroneurostimulation.

The way transcutaneous electroneurostimulation used mainly for pain relief and relief of pain patients in dental practice, described in the source [15]adopted as a prototype of the claimed method and device, because it is the closest to him in terms of total essential features and the achieved result.

Compared with the above described methods, the method according to the prototype provides a more adequate analgesia and sedation with greater ease of use and learning, and most importantly more secure, non-invasive and minimal development side, and a complete lack peredozirovki reactions, as at the time of application method, and in the long term.

However, this method is inefficient because it does not provide effective pain relief for all categories of patients, that is, if it is applied in a high percentage of patients that did not receive analgesia. In addition, the known method does not solve the problems associated with sensitizatio tissues. Thus, according to Raguraman and other [16], the main obstacle to widespread implementation of the method reflex anesthesia in anesthetic practice is its lack of effectiveness. The analysis of numerous clinical data, conduct the config specified by the authors, shows that approximately 10% of cases pain sensitivity is not reduced, and in 50% the degree of pain caused by reflex action, is insufficient for holding dental intervention. As evidenced by the results of research, it is not associated with gender or age or ethnicity of the patient, and is likely to be due to inadequate development of the method. This fact hinders its application.

Thus, the known method has a very narrow application in anesthesia and does not allow to obtain good results across the breadth of dental care.

The purpose of the claimed inventions is the intention to find a technical solution, characterized by an increase in the effectiveness of pain relief using tens, extension of indications CHENS not only for the relief of pain, but also for pain and the data demonstrate that differently modulated.

The first object of our invention is a method of transcutaneous electroneurostimulation, mainly in dental practice, which define the area of the proposed intervention or area of existing pain, impose negative and positive electrodes on the surface of the skin in the areas that represent the projection on the skin sensitive nerve is, Innervate the area, in places it as close to the skin surface. Meanwhile, the negative electrode sets on the skin, as close as possible to the place of intervention, or the projection of the exit site on the skin of the specified nerve-side intervention, and the positive electrode during, served on the electrodes pulsed electric current, and in the process of implementing a way to regulate the current strength in the direction of its increase, so that the patient always felt an intense nabolese feelings, and at the same time, according to the invention, previously conducted stimulation of the Central analgesic structures of the nervous system by imposing before intervention additional negative electrode on the surface of the skin in the area of innervation of USNO-temporal branch the trigeminal nerve with subsequent supply a pulse of electric current between it and the positive electrode with a frequency of 0.5-3 Hz, pulse duration 50-2500 μs within 20-50 minutes, and after disabling additional negative electrode includes a main negative electrode feed him pulse current with a frequency between 6 and 15 Hz, pulse duration of 20 to 60 μs, followed by the intervention.

This technical solution has the following advantages : the STV compared with prototype:

1. The use of technical solutions for prototype for pain allows you to achieve positive results in a limited number of cases, namely, it is possible to achieve a positive result: preparation of hard tooth tissues about the surface caries and in more rare cases, secondary, and preparation of hard tooth tissues under orthopedic design that does not require removal of a large number of tissues. The inventive method provides adequate analgesia in addition to the above cases, and also in many other cases, in particular when preparing teeth for prosthetic requiring significant removal of tooth structure, and for small non-traumatic surgical interventions.

2. The prototype can not be used for data demonstrate that differently modulated before the intervention, so as to ensure that mostly only local mechanisms for the relief of pain (“gate” theory). The claimed invention has extended the boundaries and indications in addition to pain relief and relief of pain it can be used also for data demonstrate that differently modulated. That is, the claimed method can be used in combination with local anesthesia for pain relief prior to the intervention in terms of sensitization tissues in the result is inflammation or injury, as well as to improve the effectiveness of local anesthesia when performing highly traumatic surgical interventions. In this case the claimed method is used to traditional medicinal pain relief. This increases the comfort for the patient carried out the intervention, especially in conditions of acute inflammation, as well as in conditions of emotional arousal, as well as prolonged action of local anesthesia, which is important for long-term interventions.

At this point in the description of the applicant considers necessary to pay attention to the following essential features of the claimed invention. The essence of the invention lies in the fact that in order to achieve effective pain relief you need in a strict sequence to carry out the transcutaneous electrical nerve stimulation of the Central and local mechanisms of antinociceptive system to ensure the effective interaction of their results, and not one of these mechanisms separately.

The first step according to the method of systematic desensitization, that is, the decrease in pain threshold until analgesia. And at the second stage, on the background of a significant reduction in pain threshold, make use of local mechanisms of the antinociceptive system. As a result, achieved higher the nd synergies, to achieve high results in analgesia and sedation in the early postoperative period.

One of the key points of the proposed method are the placements of the electrodes, for transcutaneous electroneurostimulation that are bound to fields of the passage of the branches of the trigeminal nerve and areas of innervation, as well as the use of the current, specially designed for conditions of stimulation in these areas, which allows you to refuse the use of reflex zones for holding tens and greatly simplifies the use of the method as it does not require special knowledge in the field of acupuncture and extends the range of persons able to apply the claimed method.

The above-mentioned characteristics fundamentally distinguishes the claimed method from analogues, including from other methods reflex analgesia.

Furthermore, with respect to method, we believe it is necessary to highlight the following development and/or refinement of the aggregate of its total essential features relating to individual cases, performance or use.

1. Overlay before intervention additional negative electrode on the surface of the skin in the area of innervation of USNO-temporal branch of the trigeminal nerve may be made at various points, for example on the skin pok is ove the ear or on the ear lobe, using in the latter case the clip. But more efficient and convenient is the extra negative electrode anterior to the tragus of the ear, because you can use the standard electrodes, which are easy to place and secure.

2. The distance between the electrodes should be at least 2.5 to see If a shorter distance is possible an electrical circuit not through the nerve, and through the surface of the skin. Not to mention the fact that when too close maybe short circuit with the direct contact of the electrodes with each other.

3. When using the inventive method there are various options for placement of the electrodes.

When anesthesia or sedation in the area of the front teeth and premolars of the lower jaw of the positive and negative electrodes are preferably placed on both sides of the projection of the chin holes of the lower jaw.

When anesthesia or sedation in the area of the front teeth and premolars of the upper jaw of the positive and negative electrodes are preferably positioned on two sides of the projection area intraorbitally holes of the upper jaw.

When anesthesia or sedation lower molars negative and positive electrodes, it is advisable to install the projection of the chin on the werste and at the roots of the second molars on the appropriate side.

When anesthesia or sedation of the upper molars negative and positive electrodes are preferably mounted on the appropriate side in the area of projection infraorbitale holes of the upper jaw and the root apex of the second upper molar.

- In addition to the above examples of suitable electrode potential and numerous other ways, for example, the negative electrode may be located as close as possible to preparereport tooth.

4. It is desirable to stimulate the Central analgesic structures of the nervous system (low-frequency stimulation of 0.5-3 Hz) with overlay additional negative electrode for 20-50 minutes before the intervention. This is because during this period of time, the body has time to allocate a sufficient number macromolecular endogenous opioids provide effective and long lasting analgesic and analgesic effect. This is confirmed by clinical trials. With less duration transcutaneous electroneurostimulation may appear painful sensations in the beginning of the intervention due to an insufficient number of released endogenous opioides, and generally can not come the effect of analgesia. More time transcutaneous electroneurostimulation neeleswaram is because does not increase analgesia.

5. As noted above, the implementation of the method it is necessary to adjust the strength of the current in the direction of its increase, so that the patient always felt intense, but nabolese sensations throughout medical procedures. While it is possible to achieve the maximum current values until the end of the treatments, which is a consequence of adaptation of the organism to the influence of electric current or in this case the development of analgesia.

6. Sometimes it is appropriate combined use of tens, which is that first there is a desensitization of the body, and after it carried out the traditional methods of analgesia, for example, using local anesthesia. In this case, increasing the efficiency of local anesthesia in conditions of inflammation, tissue hypoxia.

On the other hand, the invention relates to a device transcutaneous electroneurostimulation mainly in dental practice, including a source of direct electric current, connected to a node generating a pulse of electrical current to the output terminals of which are connected the negative and positive electrodes, and, according to the invention, the device has an additional negative electrode, and the GE site is aerovane pulsed electric current contains connected to the source of direct electric current supplied by the regulator voltage Converter, the output of which is connected with the controller module, which is connected to a primary winding of a pulse transformer, one of the outputs of the secondary winding of which is connected to the positive electrode, and the other with the switch, has a pair of output terminals, one of which is installed with the possibility of connecting to the negative electrode, and the other more negative electrode.

With this design of the device more efficient pain relief using tens, expansion of indications for the use of tens, covering not only the pain and the relief of pain, but the desensitization. In addition, the device compared to the prototype more clearly and easy to use.

With regard to the device, we believe it is necessary to highlight the following development and/or refinement of the totality of its essential features relating to individual cases, performance or use:

1. It is advisable that the device additionally contains connected to the source of direct electric current microprocessor, includes push-button control of the microprocessor and associated with the control node of the regulator, voltage Converter and to the control node of the modulator, switch, display, and beep.

2. To control condition the electrical circuit, preferably connected to the positive electrode output of the secondary winding of pulse transformer would be connected with the unit microprocessor control circuit of the electrodes.

3. For clarity, control circuits, it is advisable to block the microprocessor for the control circuit of the electrodes would be connected to the display and the site, including audio signal.

There are numerous additional nodes in the microprocessor, which increases the usability of the device.

Also available various designs of DC electric current. However, it is advisable that the source of direct electric current would include a switch node of a boost DC voltage, the input of which is connected to the battery, one of the outputs from the microprocessor, and the other with a voltage Converter.

An important advantage of the invention is that the method of treatment does not require special tools or devices except devices required to implement the method and the device can be manufactured by the manufacturing equipment already used in the industry. The invention is illustrated in the drawing.

1 shows a General block diagram of the claimed device that implements the claimed method;

figure 2 - a detailed block diagram of the claimed device that implements the claimed method;

figure 3 - timing diagram of the operation of the modulator, characterizing the parameters of the electric current at its output;

figure 4 - timing diagram of the operation of the pulse transformer, characterizing the parameters of the electric current at the output (at the output of the secondary winding);

figure 5 - the claimed device, a front view in plan;

figure 6 - layout of electrodes on the person's face, full face;

7 - this is the same view at the same time front and side. The claimed method is illustrated on the example of the device, it implements.

The device 1 transcutaneous electroneurostimulation, mainly in dental practice (hereinafter - the device 1)includes source 2 constant electric current connected to the node 3 generate a pulsed electric current with output three output terminals 4, 5 and 6 (figure 1). The output terminal 4 is designed to connect the positive electrode 7, which for this purpose has a connecting wire 8 with the connecting plug 9 at the end of the wire, for connection to terminal 4. The output terminal 5 is designed to connect the negative electrode 10, which for this purpose has a connecting wire 11 with a connecting plug 12 at the end of the wire, for connection with the terminal 5. The output terminal 6 is rednaznachena to connect additional negative electrode 13, this is the connecting wire 14 with the connecting plug 15 at the end of the wire, for connection to terminal 6. The electrodes and their placement on the face and fixation on the skin will be explained in detail below.

In addition, the claimed device may contain the node 16 automation control device 1 transcutaneous electroneurostimulation mainly in dental practice.

Consider the structure of each block of the claimed device separately.

Source 2 constant electric current can have a different design. In the inventive device it includes a battery 17 constant electric current (figure 2). It can represent, for example, a block of two batteries at 1.5 volts each, generating the output DC voltage to 3 volts. The battery 17 direct current output connected to node 18 increasing DC voltage, output 19 which is connected to the microprocessor 20 node 16 automation control device 1. The output 21 of the node 18 of the increase of DC voltage is connected with the voltage Converter 22 site 3 generate a pulsed electric current. The voltage at the output terminals of the voltage Converter 22 can be changed manually or by the microprocessor 20 node 16 automation control device 1 in the interval from 0 in which LT to 24 volts. Node 18 increase the DC voltage is controlled by a switch 23, which has two positions: “on” and “OFF”. If the switch 23 is in the “on”position, electrical current voltage of 5 volts is input to the microprocessor 20, and the electric current voltage of 24 volts on the input of the voltage Converter 22. If the switch 23 is in the “OFF”position, the device is powered down and does not work.

Node 3 generate a pulsed electric current contains the above-mentioned voltage Converter 22, the output of which is connected to the modulator 24, connected to the primary winding 25 of the pulse transformer 26 (figure 2). The output 27 of the secondary winding 28 of the pulse transformer 26 is connected to the switch 29, equipped with the above-mentioned output terminals 5 and 6. The output 30 of the secondary winding 28 of the pulse transformer 26 is connected to the aforementioned output terminal 4.

The modulator 24 is designed to convert DC electrical current in a pulsed electric current with an average component of the DC electric current. At the output of the modulator 24 generates pulses of electric current is rectangular in shape (figure 3). Their parameters can be changed, namely, the amplitude (A), duration (τ) and frequency (period or squareknot T) signals (pulses). The company is and, they can be set by the microprocessor 20 (see below). The pulse repetition frequency, and duration of each individual pulse can also be set by the microprocessor 20 (see below).

Pulse transformer 26 necessary to transform the system of electric pulses of rectangular shape in a pulsed electric current (figure 4), as well as to increase the amplitude of the signal and to eliminate the DC component of the signal available at the output of the modulator 24.

Node 16 automation control device 1 includes the above-mentioned microprocessor 20, equipped with a control unit of the microprocessor and connected through a control circuit 31 to the control node of the regulator voltage Converter 22. In addition, the microprocessor 20 is connected to the control circuit 32 to the control node of the modulator 24, the control circuit 33 with the switch 29, the control circuit 34 with a display 35, the control circuit 36 - unit sound signal 37. It should be noted that connected with the positive electrode 7, the output 30 of the secondary winding 28 of the pulse transformer 26 is connected by an electric circuit 38 with a block of the microprocessor control circuit of the electrodes. The microprocessor 20 is equipped with a memory unit, a control unit display and control unit of the audio signal. In addition to the above, the microprocessor 20 contains BL is to control the microprocessor, coupled with the control buttons 39 and 40 of the microprocessor 20.

The applicant considers necessary initially to illustrate the claimed invention in the following example.

First, you need to make preparatory Assembly of the device. This connector plugs 9, 12 and 15 are inserted into the corresponding terminals 4, 5 and 6. As a result of these actions get the device to which through wires connected to three electrodes.

After that, depending on the localization of the target (planned) intervention or the source of the pain is placed and fixed on the face of the patient the positive electrode 7, the negative electrode 8 and the additional negative electrode 13.

Suppose you want to make preparation of teeth in the side area of the lower jaw under fixed prosthetic design. In this case, it is known that the pain occurs during exposure of tissues to the tooth of a rotating tool, such as boron.

To use the invention in this case, place and fix the positive electrode 7 on the skin of the face in the area of projection of the roots of the second painters of the lower jaw of the corresponding side (see figure 1). This area on the face indicated by the position 41 figure 7. The negative electrode 10 is placed and fixed on the surface of the skin in the area of projection mentalnog the holes. This area on the face indicated by the numeral 42 figure 7. Additional negative electrode 13 is placed and fixed on the surface of the skin in the area anterior to the tragus of the ear. This area on the face indicated by the position 43 figure 7. In this example, you specify the location of electrodes for pain premolars and molars of the lower jaw.

After that include the device switch 23, turning it into the “on”position. As a result, the processor 20 and the voltage Converter 22 is supplied a constant voltage, respectively, at 5 volts and 24 volts.

On the display 35 of the microprocessor 20 will display the number of the last used program.

Further, for clarity, the applicant considers it necessary to make a slight digression and report incorporated in the device programs transcutaneous electroneurostimulation. Four of them:

Program 1 (on the display it is portrayed by the characters “P1”),

- Program 2 (on the display it is portrayed by the characters “P2”),

- Program 3 (on the display it is portrayed by the characters “P3”),

Program 4 (on the display it is portrayed by the characters “P4”).

Program selection button 39 by successively clicking on it.

Each program contains an algorithm of operation of the device. Program 1 is designed primarily for pain relief and is characterized by following the respective parameters:

stage 1 stimulation: supply a pulse of electric current between the positive and more negative electrodes with a pulse frequency in the range of 0.5-3 Hz and a duration in the range of 50-2500 ISS during the time interval of 20-50 minutes.

stage 2 stimulation: supply a pulse of electric current between the positive and negative electrodes with a pulse frequency in the range of 6-15 Hz and a duration in the range of 20-60 ISS during the intervention during the time required for its execution.

Program 2 is designed primarily for data demonstrate that differently modulated characterized by the following parameters:

supply a pulse of electric current between the positive and more negative electrodes with a pulse frequency in the range of 0.5-3 Hz and a duration in the range of 50-2500 ISS during the time required for data demonstrate that differently modulated.

Program 3 is intended primarily for the relief of pain and is characterized by the following parameters:

supply a pulse of electric current between the positive and negative electrodes with a pulse frequency in the range of 6-15 Hz and a duration in the range of 20-60 ISS during the time required for the relief of pain.

In addition, the device can be incorporated Program 4, by means of which the doctor may ask the individual (for konkretnogo patient) parameters of the pulsed electric current for holding tens, for example: with a pulse frequency in the range of 0.5-15 Hz and a duration in the range of 20-2500 msec.

The applicant considers it necessary to note that the parameters of each program, the user can change depending on the specific situation.

Based on the above, it follows that after application of the electrodes and turn on the device you want to select and activate the desired program. It is, as noted above, by successively pressing the control button 39 and 40 (figure 2, figure 5). Each press of the button 39 on the display 35 occurs image number: P1, P2, P3, P4. After appearing on the display screen of the image required by the user is pressing the button 40. When the button 40 is the inclusion of the selected program.

For the considered example, the anesthesia must include the Program 1. As explained above, Program 1 is designed primarily for pain and consists of two stages:

stage 1: submission of a pulse of electric current between the positive and more negative electrodes with a pulse frequency in the range of 0.5-3 Hz and a duration in the range of 50-2500 ISS during the time interval of 20-30 minutes.

stage 2: submission of a pulse of electric current between the positive and negative electrode is mi with a pulse frequency in the range of 6-15 Hz and a duration in the range of 20-60 ISS over the course of time, necessary for its implementation.

When a Program is enabled 1 on the display 35 is lit the inscription “I=0”. This means that at the moment, the microprocessor 20 via the controlling circuit 31 gives a command to the transmitter 22, which results in the connection of the device 1 according to the stage of the Program 1, the result is the following:

first, the switch 29 is in the position closing the following circuit: the output 28 of the secondary winding 27 of the pulse transformer 26, the output terminal 6 additional negative electrode 13, the negative electrode 13, the positive electrode 7, the output terminal 4 and the output 30 of the secondary winding 28 of the pulse transformer 26;

secondly, the zero voltage at the output of the voltage Converter 22. Display 35 “I=0” just means that the current output of the voltage Converter 22 is equal to zero, the current at the output of the modulator 24 is equal to zero, and the current between the electrodes 13 and 7 is also zero.

According to the invention, the patient to obtain the effect electroneurostimulation must experience intense nabolese sensations from the action of electric current. For this purpose he should gradually increase the amperage in an electrical circuit. He performs with the button 39 processor 20 by successively clicking on it (figure 2, figure 5).

easneye: after entry into the Program 1 function button 39 is changed. She now intends to gradually increase the magnitude of the current tapping on it. However, on the display 35 shows not the true current value in mA, increasing from each hit, and some conventional units, gradually, from pressing to pressing changing from “0” to “99”, although in reality, the strength of the electric current in the above circuit is changed, for example, from 0 mA to 60 mA. The use of conventional units on the display screen 35 is caused by the fact that the patient is not necessary to know the actual value of the electric current, and it is necessary to maintain tolerant of his feeling. In addition, the display 35 is displayed gradually increasing the time of the whole procedure in minutes, total time 1 and 2 phases 1.

Because when a Program is enabled 1 patient does not feel any sensations he begins to press the button 39. Each press of the button 39, the microprocessor 20 via the controlling circuit 31 gives a command to the output of the voltage Converter 22 appeared more constant voltage, which, after passing through the modulator 24, is converted in the control of the microprocessor 20 into electrical impulses 44 of rectangular shape at the output of the modulator 24 (figure 3). These electrical impulses 44 rectangular shape pass through the primary winding 25 of impulse the th transformer 26. In the secondary winding 28 of the pulse transformer 26 generates a pulse electric current, the form of which is shown in Fig 4. Pulsed electric current has a positive 45 and negative 46 half. During this negative half-wave 46 can reach 150 volts and above. The higher individual resistance of electric current, the higher the surge voltage. During the negative half-wave 46 is a positive half-wave 45, having a small amplitude and decays smoothly. Square negative and positive half-waves of the same. Crucial has a pulse duration of τobecause it has a feel of pain, the impact on the patient and it is calculated pulse duration at the output of the modulator 24. Figs.4 τoindicated by the position 47. The above-described pulsed electric current in the form of sequences of positive 45 and negative 46 half-wave passes between the additional negative electrode 13 and the positive electrode 7. If the patient does not feel this electric current, it increases by clicking on the button 39. Each press of the amplitude of the negative half 46 is increased. If in the process of increasing experiencing sharp pain, then the patient can reduce the effect by clicking on kN is PKU management 40, function which has changed after logging in Program 1, as well as the control buttons 39 (figure 2, figure 5).

At stage 1 of Program 1, the microprocessor 20 provides a pulse frequency of the pulsed electric current between the electrodes 13 and 7 in the range of 0.5-3 Hz, and a duration in the range of 50-2500 ISS during the time interval of 20-30 minutes, for example, the pulse frequency is 2 Hz, the duration is 800 μs during the time interval of 25 minutes.

During this period of time, the body has time to allocate a sufficient number of endogenous opioids provide effective reduction of pain at the initial period of treatment manipulations.

After 25 minutes, begins phase 2 of Program 1. The microprocessor 20 is automatically submits a command to transition to phase 2, which means the following:

first, the microprocessor 20 instructs to reduce the voltage in the output circuit of the voltage Converter 22 to “0”, which means a decrease to “0” pulse of electric current in the secondary winding 28 of the pulse transformer 26;

secondly, the microprocessor 20 moves the switch 29 in the position closing the following circuit: the output 28 of the secondary winding 27 of the pulse transformer 26, the output terminal 5 of the negative electrode 10, the negative electrode 10, the positive electrode 7, the output terminal 4 and the output 30 in arachnoi winding 28 of the pulse transformer 26;

thirdly, the microprocessor 20 rebuilds the parameters of the modulator 24 so that were feeding a pulse of electric current between the positive electrode 7 and the negative electrode 10 with a pulse frequency in the range of 6-15 Hz and a duration in the range of 20-60 ISS within the required for an intervention period of time, for example, pulse frequency 10 Hz, pulse duration of 20 μs.

In the upper part of the display 35 at the start of the phase 2 Program 1 there is an additional inscription on the beginning of the phase 2 Program 1, which can be arbitrary, for example, in the form of symbols “DF”. This is necessary so that the user can always determine the beginning and during phase 2.

With the inclusion of the phase 2 Program 1 on the display 35 is again ignited the inscription “I=0”. This means that the strength of the electric current between the electrodes 7 and 10 is equal to “0” and the patient again it should be elevated to the occurrence of intense mebolevich sensations by sequential pressing the control button 39. From the moment when the patient will feel more intense nabolese feelings, your doctor may start intervention, in our example, the process of preparation of hard tooth tissues. With the passage of electrical impulses above parameters between the electrodes 7 and 10 is locked painful impul the owls from prepareimage tooth in the peripheral Department antinociceptive system. If intensive nabolese sensation reduced, then the patient by pressing the control button 39 increases the amplitude of the electric current. If the thrill of electric current between the electrodes 7 and 10 became unbearable, the patient can reduce the intensity of the stimulation by pressing the control button 40.

After the procedure is first de-energized device, and then disconnect the electrodes.

This is the use of the invention for pain on the example of preparation of teeth in the side area of the lower jaw under fixed prosthetic design. As can be seen, in this case, the Program 1.

Consider other programs that are embodied in the claimed device.

Program 2 is designed primarily for holding data demonstrate that differently modulated tissue before surgical intervention in acute inflammation, chronic or acute. The application of this program due to the fact that in the period of acute or acute inflammatory diseases in the maxillofacial region is observed sensitizatio tissues. This is due to the excretion and accumulation in the tissues of toxins, resulting in inflammation and hypoxia, resulting from hemodynamic in inflammation. This leads to reduced effective the particular local anesthesia because of a significant decrease in pain threshold.

Thus, in this situation, Program 2 is used for data demonstrate that differently modulated, that is, to increase the threshold of pain sensitivity to normal with the aim of increasing the effectiveness of local drug pain relief.

When using the Program 2 should be applied only to the two electrode: positive electrode 7 and the additional negative electrode 13 (instead of the more negative electrode 13 it is possible to use a negative electrode 10). The electrodes 13 and 7 are located on the side of the face, where it will be surgery.

After termination of anesthesia on the side of intervention for the relief of pain it is better to use the Program 3.

Program 3 is intended primarily for the relief of pain. When using the Program 3 must be applied only two electrode: positive electrode 7 and the negative electrode 10.

The use of this program in the postoperative period due to the fact that included its mechanisms of relief of pain block the passage in the Central nervous system pain impulse, thereby achieving effective relief of pain. Program 3 is also effective in the relief of chronic pain syndromes of different etiology.

Program 4 is a program by which the physician may ask the individual (for specific cases) the parameters of the electric current for holding tens. The parameters of this program are determined by the capabilities of the device, for example:

The frequency of the pulse electric current of 0.5-60 Hz;

The pulse duration 20-2500 msec.

It also can be used with all three electrodes in various combinations include.

Although this device thanks to the microprocessor 20 all the work is done automatically; however, the claimed method can be implemented without a microprocessor 20 when manually configuring, reconfiguring, and control of the treating physician.

Using the microprocessor 20 can be achieved a number of advantages.

With it you can control open circuit, i.e. disconnecting the cable or removing the electrodes from the skin surface. This coupled with the positive electrode 7, the output 30 of the secondary winding 28 of the pulse transformer 26 is connected by an electric circuit 38 with a block of the microprocessor 20 for controlling the circuit of the electrodes. Does this system as follows. If the electrical circuit connected to the secondary winding 28 of the pulse transformer 26, no gap, the voltage is removed from resistor 48 and through the electric circuit 38 is transmitted to the microprocessor unit 20 for controlling the circuit of the electrodes (figures not shown). If there is a gap of a specified electrical circuit, the voltage across the resistor 48 hundred is ulitsa equal to zero, what is recorded by the microprocessor unit 20 for controlling the circuit of the electrodes. After this, the unit sends a signal about the gap on the display 35 and the block 37 of the audio signal. In the end starts ringing call and you receive a warning message on the display screen 35.

When using the inventive method there are various options for placement of the electrodes. They are depicted in Fig.6 and Fig.7.

When anesthesia or sedation in the area of the front teeth and premolars of the lower jaw negative 10 positive and 7, the electrodes are preferably placed on both sides of the projection of the chin holes of the lower jaw. The area of the projection of the chin holes on the right and left marked positions 42 figure 6. In this case, the main negative electrode 10 is placed on the side of the alleged interference or source of pain. For example, if the intervention is expected to be implemented in the field 49 (6), the negative electrode 10 is disposed on the same side, and the positive electrode 7, on the other.

When anesthesia or sedation in the area of the front teeth and premolars of the upper jaw negative 10 and the positive electrodes 7 are preferably positioned on two sides of the projection area of the infraorbital holes 50, as shown in Fig.6 and Fig.7. The principle location relative to VM the intervention were the same, as explained above.

When anesthesia or sedation lower molars negative 10 and the positive electrodes 7, it is advisable to install the chin holes 42 and at the roots of the second molar teeth 41 on the appropriate side, as shown figure 7 and explained in detail on the example of the application of the device.

When anesthesia or sedation of the upper molars negative 10 and the positive electrodes 7 are preferably mounted on the appropriate side in the area of the projections of the infraorbital holes 50 and under the zygomatic bone at the root apex of the second upper molar 51.

In addition to the above examples of suitable electrode potential and numerous other ways, for example, a negative electrode can be located as close as possible to the tooth, which are therapeutic manipulation.

The invention is illustrated by clinical examples.

Example 1. Patient W., 27 years old, medical history, No. 30418, diagnosis: 17 tooth - deep caries, class 2 according to black. The patient has a slight fear of dental intervention. Blood pressure 120/70 mm rst; heart rate: 86 beats per minute; respiratory rate 23 of breathing per minute. When psychological testing revealed average reactive anxiety (psychological test Eysenck). On t the STU SAN (psychological test: “Feeling. Activity. Mood”) values close to normal. According to these data it was decided to use tens as an independent method of pain relief according to the present invention. This placed the positive electrode on the surface of the skin under the zygomatic bone in the area of the projections of the second upper molar on the right, a negative electrode on the skin in the area of projection of the infraorbital foramen, and the additional negative electrode on the skin anterior to the tragus of the ear. Select a Program 1. After 20 minutes of starting the procedure was repeated measurements of the patient. Got the following results: blood pressure 110/68 mm rst; heart rate: 76 beats per minute; respiratory rate: 17 breaths per minute. According to psychological testing anxiety and vulnerability to stress has decreased. Improved mood. After 30 minutes from the start of the procedure transcutaneous electroneurostimulation started carious cavity preparation. Dissection was painless. Also any unpleasant feelings do not arise in the period of preparation for sealing and polishing and finishing seal. As a result of use of the claimed invention has been normalizing the General health of the patient and painless carrying out all the necessary medical measures is rd. The feeling of anesthesia facial tissues and discomfort disappeared simultaneously with the disabling of the device and removal of the electrodes.

The above observation illustrates the most typical example of the use of the claimed method and device for pain.

Example 2. Patient M., 44, a history No. 310603, appealed with complaints of pain and swelling in the area 24, 25 teeth, and pain in namasivaya on these teeth. After examination, the diagnosis: exacerbation of radicular cysts in region 24, 25 teeth. The patient has a slight fear of the upcoming intervention. Blood pressure 135/89 mm rst heart rate: 86 beats per minute. Respiratory rate 26 breaths per minute. When psychological testing revealed average reactive anxiety. According to these data it was decided to use tens in accordance with the claimed invention for data demonstrate that differently modulated before the upcoming intervention for the relief of pain in the postoperative period. For this posted for 35 minutes prior to the scheduled surgery the positive electrode on the surface of the skin under the zygomatic bone in the area of the projections of the second upper molar on the left and the more negative the electrode on the skin anterior to the tragus of the ear. Select the Program 2 incali procedure. After 20 minutes, it started re-measurement of parameters of the patient. Got the following results: blood pressure 121/76 mm rst; heart rate: 76 beats per minute; respiratory rate 18 breaths per minute. According to psychological testing anxiety and vulnerability to stress has decreased. After 35 minutes the device was turned off, the electrodes are removed. Then on the side of the interventions carried out with local anesthesia. It was further held surgical intervention, during which any painful or unpleasant sensations the patient had not experienced. After surgery and complete disappearance of anesthesia on the side of intervention continued electrical nerve stimulation for 40 minutes Program 3-side intervention using negative and positive electrodes fixed in the field infraorbitale holes and in the area of projection of the roots of the second molars, respectively. Further postoperative period was unremarkable. The patient felt no pain for 16 hours.

The occurrence of pain in the area of operations were re-imposed the electrode: positive electrode placed on the skin surface under the zygomatic bone in the area of the projections of the second upper molar on the left, a negative electrode on the skin in the region of the projection infraorbital holes on the left and used the Program 3, also within 40 minutes. In the later postoperative period, the procedure was carried out once again after 1 day and after that the need for it did not arise, as more pain syndrome was not observed. The entire postoperative period was without the use of anesthetic drugs. Postoperative swelling in the area of operation was expressed slightly.

As a result of use of the claimed invention has been normalizing the General health of the patient and painless implementation of any necessary remedial measures. The discomfort has disappeared simultaneously with the disabling of the device and removal of the electrodes.

The above observation illustrates the most typical example of the use of the claimed method and device to data demonstrate that differently modulated and the relief of pain during surgical interventions.

In total, the clinic was cured with the use of the claimed invention 38 people, including for pain - 26, and order data demonstrate that differently modulated and postoperative relief of pain - 12 people. All patients received adequate pain relief and relief of pain, and the treatment was conducted under conditions of complete emotional comfort of patients.

Using the proposed method improved the results chacteristics, and surgical treatment, and also to reduce the risk of complications, accelerate the rehabilitation of patients after ambulatory surgical procedures in the maxillofacial region.

The use of the claimed invention is especially effective in the treatment of analgesia hard tissues of the tooth preparation in the clinic therapeutic and orthopedic dentistry, as well as during surgical interventions in conditions of acute or without it.

Advantages of the claimed method of treatment and devices for implementing it, are as follows:

1. The increase in the number of patients who received adequate pain relief using tens, by increasing its efficiency due to the use of two mechanisms of pain suppression.

2. Expanding indications for the use of tens: the use of the method in addition to the data demonstrate that differently modulated.

3. Reducing the use of drugs for pain relief and relief of pain when performing some of the most common measures in dental practice.

4. The acceleration terms of tissue regeneration, as well as reducing the severity of post-operative edema by improving local blood flow in the area of operation in the maxillofacial region.

5. Improving comfort of the patient:

- in clinic terapeuticas the th dentistry for the preparation of hard tooth tissues and after endodontic treatment;

in the clinic of orthopedic dentistry, preparation of hard tooth tissues and in the treatment of patients with dysfunctional disorders of the temporomandibular joint;

in the clinic of operative dentistry as during surgery and the postoperative period, due to the action of endogenous opioids.

6. Simplifying the use of patient and physician method and device, reducing the time of the preparatory phase settings, eliminating the possibility of breaking the device settings during the procedure, ensuring the integrity of the electric circuit, to improve the comfort of using the device of the patient and the doctor through automation and the application of additional negative electrode.

Apart from the variants of the invention are possible and numerous other modifications. They are all covered by the following claims.

Sources of information

1. Pchanged. Essays on physiology of functional systems, M., 1975, p.34.

2. Africaeu, Suyunov, AVIELEN, Saubenova. Anesthesia in the dental clinics, M., necr MOH, 2002, p.19-22.

3. Spherical. Anesthesia in dentistry, Meters, Medical information Agency, 1998, p.7-64.

4. Africaeu, Suyunov, AVIELEN, Saubenova Pain in conditions the place the tological clinics, M, necr MOH, 2002, p.29.

5. Iaspire. Selected lectures, M., 2003, p.8-96.

6. Chasechase. The application of an anesthetic machine IPL-1 in dental practice, the Main dental diseases, Tashkent, 1977, p.70-71.

7. Gverment. Anesthesia DC when the teeth preparation, Collection of scientific works of students and residents. The Moscow medical stomatological Institute, M., 1971, p.23-25.

8. Africaeu and other Electronegative preparation of patients for outpatient dental surgeries. The main dental diseases, M., 1981, s-118.

9. Onevidence. The rationale for the use of some types of elektroobessolivaniya in dental practice, author's abstract on competition of a scientific degree of candidate of medical Sciences. M., 1977, s.

10. Iggerance and other electro-acupuncture analgesia in the preparation of the teeth, Dentistry, 1982, No. 2, p.57-59.

11. Inn. The use of electroacupuncture in the preparation of teeth. Dentistry, 1984, No. 3, pp.69-71.

12. Inn and other Clinical and experimental analysis of the application of the pacemaker anagement for dental anesthesia, Dentistry, 1991, No. 3, s.43-45.

13. Iaspire the Use of transcutaneous electroneurostimulation to improve the efficiency of conduction anesthesia in dental practices is, Dentistry, 1988, No.1, p.41-43.

14. Genkigenki. General pathophysiology of the nervous system. Manual, M, Medicine, 1997, s-255.

15. USSR author's certificate No. 1079252, class a 61 N 1/36, publ. 1984 (the prototype for the method and the device).

16. Raguraman etc. To the question of optimizing the parameters of the instruments for reflex analgesia, Technology communications, M, 1980, No. 3, s-87.

1. The way transcutaneous electroneurostimulation mainly in dental practice, which define the area of the proposed intervention or area of existing pain and impose negative and positive electrodes on the surface of the skin in the areas that represent the projection on the skin of sensitive nerve, linking the pain receptors in the area of pain, the proposed surgery or pain to the Central nervous system, in places it closer to the skin surface, and the negative electrode mounted on the skin as close as possible to the place of intervention or the projection of the exit site on the skin of the specified nerve-side intervention, and the positive electrode during this nerve served on the electrodes pulsed electric current, and in the process of implementing a way to regulate the current strength in the direction of his povysheniya way the patient suffered from intense nabolese feelings, characterized in that the pre-conduct stimulation of the Central analgesic structures of the nervous system by imposing before intervention additional negative electrode on the surface of the skin in the area of innervation of USNO-temporal branch of the trigeminal nerve with subsequent supply a pulse of electric current between it and the positive electrode with a frequency of 0.5-3 Hz, pulse duration 50-2500 ISS within 20-50 minutes, and after disabling additional negative electrode includes a negative electrode feed him pulse current with a frequency between 6 and 15 Hz, pulse duration of 20 to 60 μs and produce interference.

2. The method according to claim 1, characterized in that the additional negative electrode mounted on the earlobe.

3. The method according to claim 2, characterized in that as an additional negative electrode using the clip.

4. The method according to claim 1, characterized in that the additional negative electrode installing anterior to the tragus of the ear.

5. The method according to claim 1, characterized in that the additional negative electrode is installed in the external auditory meatus.

6. The method according to claim 1, characterized in that the distance between the electrodes is not less than 2.5, see

7. The method according to claim 1, featuring the the action scene, when anesthesia or sedation in the area of the front teeth and premolars of the lower jaw of the positive and negative electrodes are placed on both sides of the projection of the chin holes of the lower jaw.

8. The method according to claim 1, characterized in that when the anesthesia or sedation in the area of the front teeth and premolars of the upper jaw of the positive and negative electrodes have two sides in the field of projection intraorbitally holes of the upper jaw.

9. The method according to claim 1, characterized in that when the anesthesia or sedation lower molars negative and positive electrodes are set at the chin of the hole and at the roots of the second molars on the appropriate side.

10. The method according to claim 1, characterized in that when the anesthesia or sedation of the upper molars negative and positive electrodes are set on the appropriate side in the area of projection infraorbitale holes of the upper jaw and the root apex of the second upper molar.

11. The device transcutaneous electroneurostimulation mainly in dental practice, including a source of direct electric current, connected to a node generating a pulse of electrical current to the output terminals of which are connected the negative and positive electrodes, otlichalis the same time, the device has an additional negative electrode, and the node generating the pulsed electric current contains connected to the source of direct electric current supplied by the regulator voltage Converter, the output of which is connected with the controller module, which is connected to a primary winding of a pulse transformer, one of the outputs of the secondary winding of which is connected to the positive electrode, and the other with the switch, has a pair of output terminals, one of which is installed with the possibility of connecting to the negative electrode, and the other to the additional negative electrode.

12. The device according to claim 11, characterized in that it additionally contains connected to the source of direct electric current microprocessor, includes push-button control of the microprocessor and associated with the control node of the regulator, voltage Converter and to the control node of the modulator, switch, display, and beep.

13. The device according to item 12, characterized in that connected to the positive electrode output secondary winding of the pulse transformer is connected with the microprocessor unit for controlling the circuit of the electrodes.

14. The device according to item 13, wherein the microprocessor unit to control the gap is a Bishop of the electrodes is connected with a display and a host of sound signal.

15. The device according to claim 11, wherein the source of direct electric current contains has a switch node of a boost DC voltage.



 

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4 dwg

FIELD: medicine; cosmetics; medical engineering.

SUBSTANCE: device has DC power supply source, unit for controlling and producing starting pulses, demultiplexor unit, two-sectioned, inductance coil of high figure of merit, key amplifiers and electrode unit having coaxial active and passive electrodes. The electrode unit has electric insulating casing and external passive electrode and internal active electrode coaxially mounted on end and/or lateral casing surface. The electrodes are connected to stimulator device output via outgoing wire leads. The casing is designed as hollow truncated tetrahedral pyramid. Contact surfaces of the electrodes have revolution body surface which radius is 3-10 or more times as large as maximum external electrode size. Method involves applying the stimulator device by smoothly moving or changing place of the electrode unit having coaxial active and passive electrodes along massage lines of face and/or neck. The electrodes are connected to the inductance coil of high figure of merit (greater than 100) periodically saturated with electromagnetic energy in connecting several coil loops to DC power supply source poles for given time of 0.5-500 mcs having 1.0-12.0 V voltage. Repeated connection is carried out not earlier than in twice the connection time duration. The first electric oscillation half-wave amplitude is equal to A=20-800 V and oscillation period T=0.1-200 mcs. Treatment with electric current is administered at least every second day during 21-25 days with total treatment time being 10-40 min per day.

EFFECT: enhanced effectiveness of treatment; high stability of contact to skin; accelerated treatment course.

21 cl, 11 dwg

FIELD: medicine.

SUBSTANCE: method involves using Stimul-1 apparatus. Movements applied in manual muscular testing are administered concurrently with current passed through. Initial postures are selected with injured muscle force, measured as a result of manual muscular test, taken into account. 4 points estimation being obtained, movement in articulation is carried out with gravitation force and weighting collar load of 500 g being overcome in standing sitting and lying position. 3 points high estimation being the case, movements are carried out without gravitation force being overcome in sitting position to train lower extremity articulations. 2 points high estimation being obtained, movements are carried out under easier conditions without gravitation force loading in lying initial position. 1 point being the estimation, patient strains muscle in isometric mode in lying initial position.

EFFECT: enhanced effectiveness of rehabilitation treatment; involving earlier idle muscle fibers in work.

FIELD: medicine.

SUBSTANCE: method involves setting electrode on epicardial surface of the right ventricle in making operation. Programmed right ventricle electrostimulation is carried out by means of the electrode. Superficial electrocardiogram is continuously recorded in process of stimulation. Ectopic ventricular activity being observed during electrostimulation, potential ventricular arrhythmia occurrence is predicted in postoperative period.

EFFECT: high reliability of prognosis with no arrhythmia indications in anamnesis.

3 dwg

FIELD: medicine.

SUBSTANCE: method involves exposing motor activity points of injured dorsal muscles to pulsating extremely high frequency noise radiation in bandwidth of 52-78 GHz, duration of 1 mcs, mean power flow intensity of 0.85 mcW/cm2. Their tonus is to be determined in advance. Tonus being initially high, the daily treatment session is 5-8 min long. Tonus being initially low, the daily treatment session is 2-4 min long. The total treatment course is 8-15 procedures long.

EFFECT: enhanced effectiveness of treatment; reduced pain feeling intensity; stable treatment effect.

1 dwg, 7 tbl

FIELD: medicine.

SUBSTANCE: method involves applying thermomagnetic self-excitation inductance treatment of 1.2-2 Tesla units in subcortical nuclei projection with effective frequencies detected from increased amplitude of somatosensory and motor invoked potential and dophamine level growth in blood or liquor, reduced basic rhythm disorganization on electroencephalogram before and after applying thermomagnetic self-excitation inductance treatment. Synchronized median nerve electrostimulation with rectangular pulses is concurrently carried out with current intensity equal to 12-18 A and pulse duration of 0.1-0.l3 ms in trains of 3-5 s duration and 6-10 s long pauses with pulse succession frequency equal to 50 Hz daily during 15-30 min. The total treatment course is 10-20 days long.

EFFECT: enhanced effectiveness of treatment.

Electrode device // 2252793

FIELD: medical equipment.

SUBSTANCE: device can be used in multichannel in electrical neuron-adaptive stimulators. Electrode device has joint for connecting multichannel neuron-adaptive stimulator and flat multiwired flexible cable. Each wire of cable is connected with corresponding contact of joint for switching stimulator in. Mounting shoes provided with fixing bushings are installed along the whole length of flexible cable. Electrodes are inserted into fixing bushings. Each contact of mounting shoe is connected with corresponding contact of joint via wire of flat multiwired flexible cable. Fixing metal bushing is connected contact of mounting shoe through conductor. Connection is made in such a way that number of contact corresponds to number of mounting shoe, to number of wire of multiwired flexible cable and to number of contact of joint.

EFFECT: improved efficiency of electro-therapeutic influence when treating prolonged pathological areas.

2 dwg

FIELD: medicine; medical engineering.

SUBSTANCE: method involves placing negative and positive electrode on skin surface in the innervation area of the second and the third trigeminus branch. An additional negative electrode is applied in the innervation area of auriculotemporal trigeminus branch. The electrodes are fed with pulsating electric current in predefined sequence. Current intensity is controlled in stimulation process in a way that patient feels intensive sensation with no pain. Device has DC supply source connected to unit for generating pulsating electric current having three outlet leads for connecting electrodes, modulator having regulator unit, transformer, switch and microprocessor.

EFFECT: enhanced effectiveness of anesthesia in treating teeth.

15 cl, 7 dwg

FIELD: medicine, therapy, cardiology.

SUBSTANCE: at hypertension I stage a patient should be prescribed several courses of transcranial electrostimulation at interval of 1-2 mo per 5-7 seanses , current power being 0.5-0.8 mA. At hypertension II and III stages one should prescribe transcranial eletrostimulation along medicinal therapy, and, also, several courses at interval of 2-3 mo and current power being 0.8-1.2 mA. The innovation enables to remove side effects, shorten the period of in-patient therapy and reduce the dosage of hypotensive preparation.

EFFECT: higher efficiency of therapy.

2 cl, 2 ex, 4 tbl

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