Peripheral Nerve Stimulator Flashcards Preview

Summer Pharm (2016) ** COPY > Peripheral Nerve Stimulator > Flashcards

Flashcards in Peripheral Nerve Stimulator Deck (15)
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1
Q

What are the phases of monitoring?

A
  1. Baseline
    • Check functioning of neuromuscular monitor
    • choose the appropriate nerve/muscle to be monitored
  2. Intubation
  3. Maintenance
    • redosing
    • observation and interpretation of evoked response
  4. Emergence
    • reversal
    • observation and interpretation of evoked response
2
Q

When should you check your baseline?

A

Before the neuromuscular blocker is administered but after induction of anesthesia

3
Q

How do you place the electrodes?

A
4
Q

Order the muscles from most resistant to non depolarizing muscle relaxants to most sensitive

A
  • Most resistant
    • vocal cord
    • diaphragm
    • orbicularis oculi
    • abdominal rectus
    • adductor pollicis
    • masseter
    • pharyneal
    • extraocular
  • Most sensitive
5
Q

Chart of TOF responses

How do you calculate the TOF ratio?

What is the difference between the TOF ratio for a Non-depolarizing block and the TOF ratio for a depolarizing block?

A
  • B/A = TOF ratio (on this pic it is the 4th line/1st line=TOF)
  • Depolarizing block has no fade so the TOF ratio is 1
6
Q

What percent of block remains with 3 responses abolished?

What percent of block remains with 2 responses abolished?

1?

All responses equal?

A
7
Q

Onset time definition

A

time from injection to peak effect

8
Q

Types of NMB doses that can be given

A
  • intubating dose- max dose
  • relaxant dose- lower dose for maintenance
    • 20% of intubating dose
  • defasiculating dose-
    • 10% of intubating dose
9
Q

what is the goal of maintaining a block?

What twitch suppression do you need for abdominal surgery?

A
  • Maintain the minimum depth of block that is required for the surgery
  • 80% twitch depression
    • correlates with 1 or 2 twitches present from train of 4
10
Q

What is the preffered site for monitoring recovery from block?

A

adductor pollicis

11
Q
A
12
Q

When do you use the post tetanic count?

A

Used in profound block when there is no response to TOF

13
Q

What is tetanic stimulation?

A

Rapid 50-200 Hz delivery of stimulus given for every 5 seconds

14
Q

When would you see a sustained response to a Tetanic stimulation?

A

normal neuromuscular transmission and depolarizing block

15
Q

When would a Tetanic stimulation not be sustained?

A

during a non-depolarizing and phase 2 depolarizing block