How advanced noise-canceling technology in the TetraGraph system ensures accurate and reliable monitoring in the dynamic operating room

Modern operating rooms are complex environments, filled with various electrical surgical devices that can create significant background noise. This noise poses a challenge for accurate quantitative train-of-four (TOF) monitoring, but Senzime’s TetraGraph system has revolutionized the field with its patented, advanced noise-canceling technology.

Developed through over 40 years of research, TetraGraph ensures precise and reliable monitoring without the need for extra equipment or electrodes.

The TetraGraph system’s innovative approach to noise cancellation makes it one of the most user-friendly and accurate quantitative TOF monitors available. Unlike other EMG-based monitors that require additional electrodes or external equipment, the TetraGraph seamlessly integrates noise cancellation into its software. This not only simplifies setup but also enhances usability for clinicians.

Here’s how it works: The system generates a single stimulus signal to stimulate the motor nerve and simultaneously measures background noise during time intervals when no response signal is expected. Using these data, the TetraGraph creates a noise waveform that is subtracted from the patient’s response signal. The result? Clean, accurate, and repeatable data that allow clinicians to make confident decisions.

From a technical perspective, TetraGraph’s noise-canceling process involves several critical steps:

1. Stimulus Generation: A single electrical stimulus is sent to the motor nerve via the system’s skin adhesive sensors.
2. Noise Measurement: During periods when no response signal is expected (such as before or after the initial EMG response), the system measures background noise in the operating room. These measurements are typically taken during a 100 ms window, offering sample data for analysis.
3. Periodic Noise Estimation: The system analyzes the measured noise for periodic components (e.g., 50 Hz or 60 Hz) and generates a noise waveform.
4. Noise Subtraction: This noise waveform is mathematically subtracted from the recorded response signal, ensuring the final data (the EMG waveform) are free of interference.
5. Improved Signal Display: The cleaned signal is stored in the system’s memory and displayed in real-time, providing clinicians with reliable information to assess the patient’s neuromuscular function.

Unlike other systems that rely on additional electrodes or hardware to combat noise, the TetraGraph’s built-in noise-canceling software ensures accuracy without added complexity. This simplicity not only saves time during setup but also reduces the risk of errors, making the system highly practical for busy operating rooms.

Furthermore, the TetraGraph’s ability to measure noise during non-overlapping intervals with the response signal provides unparalleled sensitivity. By utilizing the entire measurement window effectively, the system ensures precise monitoring even in the presence of significant background noise.

The TetraGraph system includes a noise notification feature that alerts clinicians whenever electromagnetic interference is detected from nearby electronic devices. This interference may stem from electrocautery activity or adjacent equipment. Once the electrocautery interference ceases, monitoring will automatically resume.

To minimize potential interference, it is essential to ensure the patient cable is well separated from other electrical equipment and cables, further enhancing the reliability of quantitative TOF monitoring.

The TetraGraph system’s patented noise-canceling technology represents a significant leap forward in quantitative TOF monitoring. By seamlessly integrating noise reduction into its design, the system ensures clean, accurate, and reliable data without the need for additional equipment.

This innovation not only simplifies the monitoring process but also enhances patient safety, making the TetraGraph an invaluable tool in modern anesthesia practice.