Quantitative neuromuscular monitoring: a crucial contributor to enhanced postoperative recovery

Enhanced Recovery After Surgery (ERAS) protocols were developed to optimize healing and accelerate postoperative recovery for surgical patients. These evidence-based guidelines are designed to improve surgical outcomes, reduce complications, and shorten hospital stays. 

When considering all the elements necessary to ensure the success of ERAS protocols, it is important to assess the implementation of quantitative neuromuscular monitoring during the intraoperative stage.

Utilizing quantitative train-of-four (TOF) monitoring provides clinicians with objective data that ultimately: 

• Allows clinicians to visualize level of neuromuscular block in real time 
• Enables patient-specific dosing of neuromuscular blocking agents (NMBAs)
• Ensures complete reversal of NMBAs before extubation, improving patient safety 
• Reduces the risk of residual neuromuscular block (rNMB)-related complications such as reintubation, hypoventilation and aspiration 
• Supports early ambulation and faster patient recovery 
• Allows spot-checks in the PACU when complications arise—providing numerical data to confirm or rule out rNMB 

Technologies like Senzime’s next-generation TetraGraph® EMG-based monitor exemplify the value of quantitative TOF monitoring in optimizing outcomes. The next-generation TetraGraph helps clinicians:

• Integrate sensor placement as part of the preoperative workflow to facilitate ease of use
• Build rapport and boost patient confidence by discussing monitoring during pre-op education 
• Establish quantifiable baseline (signal strength) with pre-paralytic sensor placement 
• Monitor patient response with multiple display modes—TetraGraph Level-of-Block Gauge™, bar graphs, EMG waveforms, and three different trend screens
• Guide NMBA redosing based on individual patient need, case dynamics and surgical preference 
• Reinforce clinical judgment with objective, quantifiable data, enhancing clinician confidence and consistency 

Real-time, patient-specific data is key to safe, timely recovery. Quantitative neuromuscular monitoring is not just a nice-to-have, it’s a vital pillar of intraoperative care within ERAS.

In the world of surgical care, trust isn’t built on experience alone—it’s forged through consistency, safety, and outcomes. When clinicians trust the data, patients can trust their clinicians—to recover faster, breathe easier, and return home sooner.