2025 Year in Review: Quantitative Train-of-Four Monitoring Comes of Age

Over the past 15 years, in roles spanning OR Nurse, clinical specialist, sales representative, and now regional business director, I have witnessed significant changes in healthcare and the adoption of cutting-edge technologies that meaningfully improve workflow and patient care.

This year, I saw a growing focus on implementing innovative quantitative train-of-four (TOF) monitoring into anesthesia practice.  In this blog, I will share my perspective on how this year has been. 

My goal has always been to work for a company that supports disruptive and innovative technology that can make a difference in clinical practice and empower clinicians to improve patient care.  I hit the motherlode with Senzime.  The work is purposeful, engaging and at times grueling—but knowing that we are supporting a shift in clinical practice that helps reduce or eliminate residual neuromuscular block (rNMB) keeps me motivated now and moving forward into 2026 and beyond.

This has been an interesting year; the shift in momentum around the use of quantitative TOF monitoring in anesthesia is exciting. The conversations are different, the questions are thoughtful, and the adoption rates are on the rise. In early 2024, a common question was, “What is quantitative monitoring, and why do I need it in my practice?” Fast forward to mid-2025, the question from anesthesia providers is often, “How can I adopt this quantitative neuromuscular monitoring technology into my practice to reduce the risk of residual paralysis while remaining compliant with ASA (American Society of Anesthesiologists) guidelines?”

Looking back at 2025, the interest around quantitative neuromuscular monitoring is quickly shifting from “recommended” to “expected” in modern anesthesia practice.  

The past year brought stronger guidelines, better technology, and growing recognition that rNMB remains a preventable threat. The electromyography-based (EMG) Next-Generation TetraGraph® provides accurate, objective monitoring—offering a clear alternative to subjective clinical assessments and peripheral nerve stimulators (PNS), which are devices rather than true monitors and rely on user interpretation.

Clinicians from across the country have shared that quantitative monitoring has helped them identify and confirm cases of pseudocholinesterase deficiency—raising the question of whether this condition is less rare than traditionally believed and continues to be underrecognized. 

Implementation barriers remain—cost, training, and workflow adaptation—and we can be a partner at every level of adoption through education, training and future innovations.

These shifts toward quantitative TOF monitoring adoption echo the evolution of pulse oximetry—from innovation to standard for better and safer outcomes.  Evidence continues to show fewer airway issues and smoother recovery when monitoring guides management.

Quantitative neuromuscular monitoring is increasingly viewed as the baseline for safer anesthesia. 

With EMG technology maturing, this is no longer a “nice-to-have”—it’s the new normal. Senzime is here to help.