The Stimcur: Monitoring of Neuromuscular Blockade
The STIMCUR nerve stimulator, developed by Luxomed, is a medical device designed for anesthesiologists and intensivists. Its innovative design and advanced features make it a vital tool for monitoring neuromuscular blockade during surgical procedures. Neuromuscular blockade, which involves the use of muscle relaxants, is a common practice that facilitates intubation and ensures greater safety during anesthetic procedures. However, assessing the depth of this blockade based solely on clinical criteria can be challenging and sometimes misleading.
The use of a nerve stimulator like the STIMCUR is crucial for providing objective data regarding a patient’s level of neuromuscular blockade. Indeed, respiratory movements or a normal tidal volume can create a false sense of security, leading to potential postoperative complications. The necessity for such equipment is established by decree No. 94-1050 of December 5, 1994, which emphasizes the importance of monitoring neuromuscular blockade in the post-operative care unit.
With the STIMCUR, the anesthesiologist can:
- Determine the optimal time for intubation.
- Rationally adjust the use of muscle relaxants during the operation, maintaining the desired level of blockade.
- Detect any residual blockade that could contribute to postoperative respiratory depression.
- Safely administer antagonists of neuromuscular blockade.
The STIMCUR is equipped with several stimulation modes, each serving a specific role in monitoring neuromuscular blockade:
- TWITCH: This mode delivers repeated stimulation at 1 Hz, allowing for the assessment of baseline muscle response. It is essential for initial evaluations.
- T4 20 (or TOF - Train Of Four): This mode provides a train of four impulses at a frequency of 2 Hz, performed every 20 seconds. This test is fundamental for evaluating the degree of blockade and recovery.
- PTC (Post Tetanic Count): Used during deep blockades, this mode includes a tetanic stimulation at 50 Hz for 5 seconds, followed by 10 twitches. This allows for quantification of muscle response after tetany.
- DBS (Double Burst Stimulation): This mode is particularly effective for detecting residual blockade. It uses two brief stimulations at 50 Hz, separated by an interval of 750 ms, and is an excellent indicator of muscle fatigue.
One of the major advantages of the STIMCUR is its ease of use. It requires no adjustment of current intensity, making it straightforward to use in emergency situations. The stimulator activates automatically as soon as the user presses the button corresponding to the selected function. To turn off the device, simply press the same button again. An indicator light shows when the device is powered on, while an audible signal confirms the delivery of impulses.
The STIMCUR's casing is made of ABS, making it particularly shock-resistant. Its compact design allows healthcare professionals to carry it easily, ensuring it is always within reach during procedures.
To guarantee the safe and effective use of the STIMCUR, it is imperative that medical personnel have received appropriate training. Adherence to best practices and safety procedures is essential to avoid errors that could compromise patient safety.
The STIMCUR nerve stimulator from Luxomed is an indispensable medical device for anesthesiologists and intensivists. Its ability to provide objective assessments of neuromuscular blockade, combined with its ease of use and robustness, makes it an essential tool in modern anesthetic care. With its multiple features, it ensures secure and effective patient management, contributing to optimal surgical outcomes.
