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TOF - Watch

TOF - Watch. Subjective monitoring TOF vs. DBS (tactile observation). “Neuromuscular Monitoring by Jorgen Viby-Mogensen Based on a idea originating with N. Ueda, Kurume University, Japan. Objective Monitoring Acceleromyography (AMG). F = m x a ( 뉴튼의 제 2 법칙 )

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TOF - Watch

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  1. TOF - Watch

  2. Subjective monitoringTOF vs. DBS (tactile observation) “Neuromuscular Monitoring by Jorgen Viby-Mogensen Based on a idea originating with N. Ueda, Kurume University, Japan

  3. Objective Monitoring Acceleromyography (AMG) • F = m x a (뉴튼의 제 2 법칙) If mass is constant ,acceleration is directly related to force Characteristics:

  4. TOF-WatchFeatures • 간편한 사용법 ( PNS) • 객관적 모니터링 • All stimulation modes: • TOF : Train-Of-Four • PTC : Post-Tetanic-Count • ST : Single Twitch (0.1 - 1 Hz) • TET : Tetanic Stimulation • DBS : Double Burst Stimulation

  5. Objective Monitoring Acceleromyography (AMG) • 장점: • Simplicity • Robustness • Suitable for routine clinical practice • 단점: • Muscle must be able to move freely • Over estimation at recovery • Acceptability for scientific studies

  6. TOF-WatchFeatures Can be used as: • Objective monitoring • Peripheral Nerve Stimulator (PNS) • PNS for LA (nerve location)

  7. TOF Ratio Assessment TOF ratio and ability to maintain five-second head lift in 72 patients after anesthesia From Viby-Mogensen et al. Anesthesiology 1979;50:539-41

  8. TOF Ratio Assessment Onset and recovery of neuromuscular blockade after injection of vecuronium 0.07 mg/kg at four muscles. Donati F et al. Anesthesiology 1990;73:870-5

  9. Nervus Ulnaris

  10. Nervus Tibialus Posterior

  11. Nervus facialis

  12. During induction During operation in recovery Supramaximal Tracheal Intense Moderate room Thiopental Reversal stimulation Intubation blockade blockade Single 0.1 Hz 1.0 Hz Twitch TOF ?! PTC In case of tactile or visual evaluation DBS Optimal application of stimulation patterns for NMTM

  13. Plus Minus

  14. 2.5- 4 cm Ulnar nerve

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