Peripheral Nerve Stimulation

Peripheral Nerve Stimulation

Peripheral nerve stimulation assesses and monitors the depth of neuromuscular blockade in patients receiving neuromuscular-blocking drugs, which are administered to produce paralysis. Neuromuscular-blocking drugs may be given to help synchronize breathing and mechanical ventilation in patients with severe lung injury; assist with the treatment of severe muscle spasms in patients with seizures, tetanus, or drug overdose; and help in the management of increased intracranial pressure in patients with head injury.

A peripheral nerve stimulator (PNS) is used to evaluate the level of neuromuscular blockade and determine the lowest therapeutic dose of the neuromuscular-blocking drug needed to produce paralysis. The PNS works by stimulating a peripheral nerve with a series of brief electrical pulses to produce a muscle response or twitch.

The train of four (TOF) is the most commonly used method for monitoring neuromuscular blockade. Using this method, a series of four electrical impulses are delivered to a particular peripheral
nerve. If four twitches occur, then 75% or less of the receptors are blocked. Three twitches occur when 80% of the receptors are blocked. One or two twitches correspond to 85% to 90% neuromuscular blockade. After the neuromuscular blockade drug is administered, it’s titrated so that each set of four electrical impulses produces one or two muscle twitches.

Jul 21, 2016 | Posted by in NURSING | Comments Off on Peripheral Nerve Stimulation

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