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

A microsurgical tool is configured for monitoring, evaluating, mapping, and/or modulating electrophysiological activity in the vicinity of a lumen within a body. The microsurgical tool may be part of a system used in evaluating the sympathetic tone of a subject and/or neuromodulating an anatomical site in the vicinity of a lumen within a body. Such systems include a catheter system for controlled sympathectomy procedures and/or controlled micro ablation procedures. Such systems may be used in methods for performing a controlled surgical procedure, including performing controlled surgical procedures in a minimally invasive manner.

A system for nerve stimulation is provided; it comprises a nerve stimulation device configured to execute a set of nerve stimulation instructions for generating electrical pulses for nerve stimulation of a patient. A user electronic device is configured to generate the set of nerve stimulation instructions; and send the set of nerve stimulation instructions wirelessly to the nerve stimulation device.

A method of monitoring depth of muscle relaxation of a patient includes applying a series of stimulations to a nerve of a patient and measuring muscle responses thereto. A maximal stimulus current, a supramaximal stimulus current, and/or a submaximal stimulus current are determined based on the muscle responses, wherein the maximal stimulus current is a current at which a maximal muscle response is produced from stimulating the nerve, the supramaximal stimulus current is greater than or equal to the maximal stimulus current, and the submaximal stimulus current is less than the maximal stimulus current. A first set of stimulations are applied to the nerve of the patient. Either the supramaximal stimulus current or the submaximal stimulus current are then selected for a subsequent series of stimulations based on the measured muscle responses to the first series of stimulations, and the subsequent series of stimulations are performed accordingly to monitor the patient's depth of muscle relation.

A paralysis monitoring system including a nerve stimulation device configured to deliver a series of low current electrical impulses to a nerve to produce only sub-visible muscle responses; and a recording device configured to record electrical activity associated with an evoked muscle response caused by the series of low current electrical impulses. The low current electrical impulses that the nerve stimulation device is configured to deliver are between 0.2 mA-4 mA.

A computer-implemented method for quantitatively determining a person's neuro-muscular blockade (NMB) level in real-time using at least one sensor attached to the person is provided. The method includes receiving a first input signal from the sensor, wherein the first input signal includes a measurement of a first muscular response, the first muscular response resulting from a baseline stimulus current delivered to the person before administration of NMB agents to the person, and establishing a baseline chronaxie based on the first input signal. The method also includes delivering one or more stimulus currents to the person after the administration of NMB agents to the person, receiving a second input signal from the sensor, wherein the second input signal includes a measurement of one or more muscular responses resulting from the one or more stimulus currents, and determining the person's NMB level based on the second input signal.

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.

An automated system, method, apparatus, device and/or computer program product for detecting positioning effect is set forth, the apparatus according to an exemplary embodiment may include an output operable to couple to one or more stimulating electrodes to stimulate one or more peripheral nerves of the patient, an input operable to couple to one or more recording electrodes to record resultant electrical waveforms generated by a nervous system of a patient in response to the stimulating module, and one or more processors operable to identify the positioning effect based on the resultant electrical waveforms.

Sensors are provided for monitoring neuromuscular blockade in patients. In one embodiment, a sensor includes a first flexible substrate including a sensing element for measuring patient response to a stimulus, a second flexible substrate for providing the stimulus, the second flexible substrate including at least two electrodes, the first flexible substrate not connected to the second flexible substrate, and a common connector coupled to both the first flexible substrate and the second flexible substrate, the connector configured to couple to an NMT monitoring device.

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.