Philips Intellivue NMT module: variability of initial measurements

Excerpt

When administering neuromuscular blocking agents (NMBA) during general anesthesia, it is recommended to monitor the neuromuscular transmission (NMT) quantitatively to manage the intraoperative depth of blockade and to rule out any residual paralysis before awakening the patient [1, 2]. Acceleromyography (AMG) has been demonstrated to be a valuable measurement tool in clinical practice [3]. Recently, Philips (Amsterdam, The Netherlands) has launched a new device that uses this principle: the Philips Intellivue NMT module. This is a well-manufactured monitor that is integrated with the anesthesia Intellivue monitor. The software allows the anesthetist to configure the nerve stimulation patterns and display the current results and their trends. The peripheral cables, the grabbers, and the piezoelectric sensor are robust and easy to set on the patient. The device may be used with standard cutaneous ECG electrodes. Unfortunately, the authors encountered difficulties in the daily use of this new device, and technical artifacts impaired the clinical management. Particularly, the first measurements carried out before inducing the neuromuscular block presented a surprising variability that could make reliance on the results difficult. Calibration of the initial stimulation is recommended to improve this issue [4]. We designed a prospective study in 200 consenting patients to determine and compare the initial baseline provided by the new device with or without calibration. …