The Design and Development of a Novel Train of Four Monitoring Device

Guo, Shu

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The Design and Development of a Novel Train of Four Monitoring Device

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The monitoring of quantity the neuromuscular blockade is critical for a patient’s safety during and after surgery. The monitoring of neuromuscular blockade often requires the use of Train of Four (TOF) monitoring technique. During TOF test two electrodes are attached to the ulnar nerve on a patent’s forearm, a series of four electric shock at half second interval is then applied to the ulnar nerve. Electrical stimulation will cause the thumb to twitch, and the amount of twitch will vary 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 purpose of this project is to design, prototype and test a new medical device that provides reliable TOF results and can be used when thumb movement is restricted. A medical device that uses a pressurized catheter balloon to detect the response thumb twitch of the TOF test was created during this project. An analytical model and COMSOL simulation were created to study how pressurized balloons will behave under parallel compression. A compression bench test was used to verify the result from the analytical model and COMSOL simulation. A finger simulator was used to study the performance of different balloons to determine which radius and material is best for the medical device. A pilot study was also conducted to study the effect of different body features on the performance of the medical device.

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