Neuromuscular monitoring is described that uses a novel lead assembly and a monitor that can select the appropriate electrodes on the lead assembly and calibrate the stimulation signals applied to the patient through the lead assembly. The monitoring can also set a noise floor value to reduce the likelihood of an erroneous train of four calculations. The present system can automatically sense train of four response of a patient and reduce the likelihood of false train of four indications.

The present invention involves systems and related methods for performing percutaneous pedicle integrity assessments involving the use of neurophysiology.

A catheter system for controlled sympathectomy procedures is disclosed. A catheter system for controlled micro ablation procedures is disclosed. Methods for performing a controlled surgical procedure are disclosed. A system for performing controlled surgical procedures in a minimally invasive manner is disclosed.

The present disclosure relates to various methods for determining a neuromuscular blockade status and systems suitable for performing such methods. The present disclosure further relates to electro-stimulation electrodes for stimulating a muscle of a patient, optionally in the context of at least some of the mentioned methods. The present disclosure still further relates to hybrid air-signal connectors for use in an electro-stimulation cuff which can be used in the context of at least some of the cited methods. The present disclosure also relates to electro-stimulation circuits comprising an electrode portion and a track portion suitable for pressure cuffs for electro-stimulation, and to pressure cuffs configured to be arranged around a limb of a patient and comprising an active electro-stimulation electrode and a passive electro-stimulation electrode. These electro-stimulation circuits and pressure cuffs may also be used in the context of at least some of the mentioned methods.

A method of assessing nerve conduction of a trigeminal nerve in a subject in response to an oral cavity treatment by an oral composition helps improve/design oral care compositions, especially those having a sensate.

A paralysis monitoring system can be utilized during various medical procedures. Generally, the system is used during procedures involving anesthesia, when general paralysis is necessary, e.g., during surgery that requires cutting through or mobilizing muscle tissue. The paralysis monitoring system stimulates a nerve with low voltage signals and can provide for continuous monitoring and recording of the evoked muscle activity throughout and after a procedure. By monitoring a quantitative response of the muscle activity to nerve stimulation, an anesthesiologist may adjust subsequent doses of a paralytic agent to achieve a desired level of paralysis.

One aspect of the present disclosure relates to a system for monitoring a diaphragmatic twitch response. The diaphragmatic twitch response can be used to determine a depth of neuromuscular blockade. The system includes a neural stimulation device to stimulate a phrenic nerve of a subject, which has the effect of stimulating the subject's diaphragm. The system also includes a monitor to detect the diaphragm's response to the stimulation. For example, the monitor can include a nasogastric tube with two distally positioned inflatable balloons. Each of the inflatable balloons is coupled to a sensor to measure a corresponding pressure (e.g., an esophageal pressure and a gastric pressure). The pressure differential between the esophagus above the diaphragm and the stomach below the diaphragm (also referred to as the transdiaphragmatic pressure) can be used as a measure of the diaphragmatic twitch response.

Method and systems are provided for monitoring neuromuscular blockade in patients during surgical procedures. The system and method utilizes a stimulator to provide stimulation to a nerve of the patient, such as train-of-four (TOF). Following such stimulation, the system and method monitors for muscle twitch reaction and, based upon the monitored muscle twitches, the system and method creates a neuromuscular blocking trend curve. The neuromuscular blocking trend curve provides an estimated time of recovery for the patient and provides the estimated recovery time to a clinician. The estimated recovery time allows the clinician to modify treatment of the patient to accelerate recovery if required.

A neural monitoring system for detecting an artificially-induced mechanical muscle response to an electrical stimulus at a stimulation frequency includes a mechanical sensor and a processor in communication with the mechanical sensor. The mechanical sensor is configured to be placed in mechanical communication with the muscle and to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle. The processor is configured to receive the mechanomyography output signal from the mechanical sensor and determine a frequency component of the mechanomyography output signal that has a peak magnitude and to detect the occurrence of an artificially-induced mechanical muscle response therefrom.

A neural monitoring system for detecting an artificially-induced mechanical muscle response to a stimulus provided within an intracorporeal treatment area includes a mechanical sensor and a processor in communication with the mechanical sensor. The mechanical sensor is configured to be placed in mechanical communication with the muscle and to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle. The processor is configured to receive the mechanomyography output signal from the mechanical sensor and determine a frequency component of the mechanomyography output signal that has a peak magnitude and to detect the occurrence of an artificially-induced mechanical muscle response therefrom.