The TetraGraph system utilizes the golden standard method of measuring train-of-four (TOF) by means of electromyography (EMG). The easy-to-use, compact and portable battery operated monitoring device helps the clinician to adequately quantify the depth of a patient’s neuromuscular block in real-time.
The advances in computer technology and electronic miniaturization have recently allowed us to design and develop a miniaturized, portable LED-screen monitor that can deliver stimulations to a nerve and record, measure, analyze and report muscle electrical activity (compound muscle action potentials, cMAPs) to determine muscle function. All of these monitoring functions are performed in real-time; the system requires less than 30 seconds for set-up and calibration; and monitoring involves techniques that are non-invasive: the TetraGraph System is connected to the patient by single-use skin electrodes, minimizing cross-contamination between patients (vertical bacterial transmission).
The unique applications of the TetraGraph System are varied, and they solve the limitations of other existing monitoring technologies: both acceleromyography (AMG) and kinetomyography (KMG) require that the stimulated muscle be free to move. However, in a majority of surgeries (laparoscopic, bariatric, robotic, neurosurgical, orthopedic, and thoracic), unencumbered access to the patient’s hand for monitoring neuromuscular function is unavailable, as the patient’s arms are tucked under the surgical drapes. In such surgeries, neuromuscular monitoring is simply not practical. In contrast, EMG monitoring with the TetraGraph is possible, since the technology records electrical activity, not muscle movement.