Neuromuscular Monitoring Equipment, Neuromuscular Monitoring Sites, Practical Neuromuscular Monitoring

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  • KITAJIMA Osamu
    Department of Anesthesiology, Nihon University School of Medicine

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  • 筋弛緩モニタリングの機器，モニタリング部位，モニタリングの実際

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Abstract

Neuromuscular blocking drugs act on the neuromuscular junction, but there is no way to directly measure their effects on the neuromuscular junction, so neuromuscular function is monitored by evaluating the muscular response to stimulation of a peripheral motor nerve. Neuromuscular monitoring equipment : Mostly TOF-Watch® is clinical used. Neuromuscular monitoring sites : The adductor pollicis muscle response to ulnar nerve stimulation is the most popular site. The other monitoring sites are facial nerve stimulation and observation of the corrugator supercilii muscle, flexor hallucis brevis muscle and posterior tibial nerve, and masseter muscle and masseteric nerve. Neuromuscular monitoring : The black electrode should be placed at the distal position, the white electrode at the proximal position, and the acceleration transducer attached so as to be perpendicular to the motion. Finally, calibration should be done.

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