Device and method for nerve block by local cooling to room temperature
Provided herein are methods of nerve blockage, for example for treatment of obesity, heart failure, cardiovascular disease, muscle spasms, chronic pain, or urinary retention in a patient. The method comprises first heating a nerve above physiological temperature (e.g., 37° C. in a human), such as from 43° C. to 54° C. for a duration that leads to reversible nerve blockage as opposed to nerve damage. Second, reversible nerve blockage is produced by cooling the nerve below physiological temperature to a temperature in which reversible nerve blockage is achieved, for example from 15° C. to 30° C.
1 . A method of reversibly blocking a sensory nerve in a patient, comprising:
placing a temperature controller in proximity to the sensory nerve to heat and cool the sensory nerve, the temperature controller comprising a heating element, a cooling element, and a temperature sensor;
first heating, with the heating element, the sensory nerve to a temperature ranging from 42° to 54° C. for a time period sufficient to increase the threshold temperature for producing a cold conduction block within the nerve and below a temperature and time duration at which an irreversible nerve block is produced; and
then cooling, with the cooling element, the sensory nerve to a temperature ranging from 15° C. to 30° C. to produce a reversible nerve block at a higher temperature than would be required without the heating step.
2 . The method of claim 1 , wherein the temperature controller is optionally connected to a controller for controlling heating of the heating element, cooling of the cooling element, and monitoring temperature at the sensory nerve by the temperature sensor.
3 . The method of claim 1 , wherein the heating element is a fluidic tube, a resistor, a thin film semiconductor, a Peltier heater, a microwave radiator, or an infrared heater, the cooling element is a fluidic tube or a Peltier cooler, and the temperature sensor is a thermocouple or a thermistor.
4 . The method of claim 1 , wherein the patient is experiencing pain and wherein reversibly blocking the nerve treats the patient's pain.
5 . The method of claim 4 , wherein the pain is chronic pain.
6 . The method of claim 4 , wherein the pain is peripheral pain.
7 . The method of claim 1 , wherein the sensory nerve is heated for 60 minutes or less.
8 . A system for reversibly blocking a nerve, comprising:
a device configured to heat and cool the nerve;
a temperature sensor configured to be placed in proximity to the nerve;
a power source to provide power to the device;
a processor in communication with the temperature sensor; and
memory having stored thereon programming instructions that, when executed by the processor, cause the processor to control the device to:
first heat the nerve to a temperature ranging from 42° C. to 54° C. for a time period sufficient to increase the threshold temperature for producing a cold conduction block within the nerve and below a temperature and time duration at which an irreversible nerve block is produced; and
then cool the nerve to a temperature ranging from 15° C. to 30° C. to produce a reversible nerve block at a higher temperature than would be required without the heating step.
9 . The system of claim 8 , wherein the programming instructions, when executed by the processor, further cause the processor to receive temperature information from the temperature sensor and, based on the temperature information, modify control of the device.
10 . The system of claim 8 , wherein the temperature sensor is a thermistor or a thermocouple.
11 . The system of claim 8 , wherein the device comprises a heating element and a cooling element, and wherein the heating element is a fluidic tube, a resistor, a thin film semiconductor, a Peltier heater, a microwave radiator, or an infrared heater, and the cooling element is a fluidic tube, a coolant tube or a Peltier cooler.
12 . The system of claim 8 , wherein the device is implantable.
13 . The system of claim 8 , wherein the processor is in wireless communication with the device.
14 . The system of claim 8 , wherein the device comprises a controller.
15 . The system of claim 14 , wherein the controller is in communication with the temperature sensor and the processor.
16 . A method of reversibly blocking a sensory nerve in a patient experiencing pain, comprising:
placing a temperature controller in proximity to the sensory nerve to heat and cool the sensory nerve, the temperature controller comprising a heating element, a cooling element, and a temperature sensor;
first heating, with the heating element, the nerve to a temperature above 37° C. for a time period sufficient to increase the threshold temperature for producing a cold conduction block within the nerve and below a temperature and time duration at which an irreversible nerve block is produced; and
then cooling, with the cooling element, the nerve to a temperature below 37° C. and above a temperature at which an irreversible nerve block is produced, thereby reversibly blocking the sensory nerve at a higher temperature than would be required without the heating step and treating the pain.
17 . The method of claim 16 , wherein the pain is chronic pain.
18 . The method of claim 16 , wherein the pain is peripheral pain.
19 . The method of claim 16 , wherein the sensory nerve is heated for 60 minutes or less.
20 . The method of claim 16 , wherein the nerve is heated and cooled with an implantable device.