Neuromuscular monitoring, the monitoring of muscle relaxation, is as essential as controlling blood pressure or heart rate during surgery. A patient who is extubated when still partially relaxed is at great risk of respirator y complications. Also, a patient incompletely relaxed during surgery can endanger the success of surgery. Since muscle relaxants are the single most important cost factor in anesthetic drug selection, neuromuscular monitoring should help to titrate the exact dosing of muscle relaxants during surgery. Further application of neuromuscular monitoring are in intensive care whe re peripheral neuropathies with impaired muscle function play an essential role in morbidity of long term ventilation and repetitive and objective neuromuscular monitoring could help to control and monitor this problem. Unfortunately, despite these facts, knowledge about the action of muscl e relaxants is still quite limited and the tools to measure their function in daily routine are even more limited. In the ideal world, (a) we would be able to easily monitor neuromuscular function for all physiologically important muscles in a non-invasive and reliable way, (b) we would have a neuromuscular method and easy-to-use monitoring device giving precise and reliable information about the state of neuromuscular transmission at any given time during surgery, and finally (c) we would have established reliabl e data for any given muscle relaxant of onset, offset and peak effect for different muscles. Phonomyographic method and device for neuromuscular monitoring have been developed in view of reaching these objectives.
NEUROMUSCULAR MONITORING USING PHONOMYOGRAPHY