Neuromuscular monitoring

In anesthesia, a branch of medicine, Neuromuscular monitoring is a technique used during recovery from the application of general anesthesia to objectively determine how well a patient's muscles are able to function. It involves the application of electrical stimulation to nerves and recording of muscle response using, for example, an acceleromyograph. Neuromuscular monitoring is typically used when neuromuscular-blocking drugs have been part of the general anesthesia and the doctor wishes to avoid postoperative residual curarization (PORC) in the patient, that is, the residual paralysis of muscles stemming from these drugs. Before the patient is fully awake, voluntary muscle testing is not possible and indirect clinical tests, such as apparent muscle tone and pulmonary compliance, can be affected by factors other than PORC. Direct neuromuscular monitoring avoids these problems and allows the doctor to remedy PORC before it becomes a source of patient distress.^{[1][2][3][4][5]}

Nerve stimulator

Nerve stimulator

Modifizied mechanomyography. Electrodes on n. ulnaris

References

Further reading

• Hemmerling TM, Le N. (Jan 1960). "Brief review: Neuromuscular monitoring: an update for the clinician". Can J Anaesth. 54 (1): 58–72. doi:10.1007/BF03021901. PMID 17197470.