Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609, USA.
Worcester Polytechnic Institute, 2808 Matsu Ln, Opelika, AL 36804, USA.
Med Eng Phys. 2024 Mar;125:104127. doi: 10.1016/j.medengphy.2024.104127. Epub 2024 Feb 19.
The monitoring of the neuromuscular blockade is critical for patient's safety during and after surgery. The monitoring of neuromuscular blockade often requires the use of Train of Four (TOF) technique. During a TOF test two electrodes are attached to the ulnar nerve, and a series of four electric pulses are applied. The electrical stimulation causes the thumb to twitch, and the amount of twitch varies depending on the amount of neuromuscular blockade in patient's system. Current medical devices used to assist anesthesiologists to perform TOF monitoring often require free hand movement and do not provide accurate or reliable results. The goal of this work is to design, prototype and test a new medical device that provides reliable TOF results when thumb movement is restricted. A medical device that uses a pressurized catheter balloon to detect the response thumb twitch of the TOF test is created. An analytical model, numerical study, and mechanical finger testing were employed to create an optimum design. The design is tested through a pilot human subjects study. No significant correlation is reported with subjects' properties, including hand size.
神经肌肉阻滞的监测对手术期间和手术后患者的安全至关重要。神经肌肉阻滞的监测通常需要使用四串刺激(TOF)技术。在 TOF 测试中,两个电极被连接到尺神经,并且施加一系列四个电脉冲。电刺激会导致拇指抽搐,抽搐的程度取决于患者体内神经肌肉阻滞的程度。目前用于协助麻醉师进行 TOF 监测的医疗设备通常需要自由手部运动,并且不能提供准确或可靠的结果。本工作的目的是设计、原型制作和测试一种新的医疗设备,该设备在限制拇指运动时提供可靠的 TOF 结果。创建了一种使用加压导管球囊来检测 TOF 测试中拇指抽搐反应的医疗设备。创建了一个分析模型、数值研究和机械手指测试来创建最佳设计。该设计通过初步的人体受试者研究进行了测试。没有报告与受试者的特征(包括手的大小)有显著相关性。