Train of four monitoring device

Anastasia Karapanagou, Nicholas R. Bergstrom, Christopher Beauregard, Kyler B. Dillon, Jeanine L.M. Skorinko, Ahmet Can Sabuncu, Eric B. Rosero

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Assessment of neuromuscular blockade during anesthesia is achieved using the Train of Four (TOF) monitoring technique. However, current devices are limited to conditions in which the hand can move freely during operation. The goal of this project was to design, prototype, and test a device which extends the TOF technique to conditions where movement is restricted. Interviews were conducted with stakeholders to better understand the need for this device and to get feedback on preliminary designs. The resulting device consists of a thumb-mounted balloon, which converts the force due to thumb twitches into pressure, which then acts as the physical analog to muscle response. This pressure is transduced and analyzed to produce a TOF count and TOF ratio. A prototype was constructed and tested on human subjects with different hand geometries.

Original languageEnglish (US)
Title of host publicationFrontiers in Biomedical Devices, BIOMED - 2020 Design of Medical Devices Conference, DMD 2020
PublisherAmerican Society of Mechanical Engineers (ASME)
ISBN (Electronic)9780791883549
StatePublished - 2020
Externally publishedYes
Event2020 Design of Medical Devices Conference, DMD 2020 - Minneapolis, United States
Duration: Apr 6 2020Apr 9 2020

Publication series

NameFrontiers in Biomedical Devices, BIOMED - 2020 Design of Medical Devices Conference, DMD 2020


Conference2020 Design of Medical Devices Conference, DMD 2020
Country/TerritoryUnited States


  • Medical device
  • Monitoring
  • Neuromuscular blockade
  • Train of Four

ASJC Scopus subject areas

  • Biomedical Engineering


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