TOF WATCH
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Eyes that never miss a twitch objective neuromuscular transmission monitor

The TOF-Watch—more effective than subjective monitoring at detecting residual blockade Patients monitored objectively with a TOF-Watch experienced a signicantly lower incidence of residual blockade (train-of-four [TOF] ≤0.9) when compared with patients monitored subjectively 1,2 by clinical exam alone or with a peripheral nerve stimulator lacking an objective display. Incidence of residual blockade in PACU*1 40 4.5% monitored with the TOF-Watch monitored with a peripheral nerve stimulator * Postanesthesia care unit. The limitations of subjective monitoring Research has also shown that...

Acceleromyography—the most accurate and reliable method of objectively measuring neuromuscular blockade 4 Acceleromyography (AMG) is a technique used by the TOF-Watch for recording evoked muscle responses. The TOF-Watch performs AMG by using a small piezoelectric transducer to convert measured acceleration into electrical signals, which are then processed and presented as clear and accurate measures 4,5 of neuromuscular transmission. The advantages of the TOF-Watch for performing AMG include4,6: Accuracy Simplicity Suitability for routine use during surgery and in the PACU A versatile...

What can your TOF-Watch do for you? The TOF-Watch series consists of 3 monitors: TOF-Watch, TOF-Watch® S, and TOF-Watch® SX. All 3 monitors accurately measure the depth of neuromuscular blockade to help assess1,8: Onset time of neuromuscular blocking agents (NMBAs) The need for the administration of maintenance doses of NMBAs When to administer a reversal agent When to safely extubate While all 3 monitors work to help ensure your patient maintains the appropriate level of blockade during surgery and reaches a TOF ratio ≥0.9 postsurgery, each TOF-Watch model differs in the total features...

TOF-Watch SX The most sophisticated instrument in the TOF-Watch series, the TOF-Watch SX incorporates all the features offered by the TOF-Watch and TOF-Watch S along with added features such as a surface sensor for measuring skin temperature and the ability to connect with Philips Monitors. ® TOF-Watch SX Monitor Software The TOF-Watch SX is also compatible with monitor software that can be purchased separately and downloaded to a desktop or laptop computer. This software can be used to easily add comments to a patient’s measured data recordings. These comments can later be edited, with...

Key features of the TOF-Watch TOF-Watch Stimulation patterns Train-of-four (TOF) Posttetanic count (PTC) Single twitch (ST) 1 or 0.1 Hz Double-burst stimulation (DBS) 3.3 or 3.2 Tetanus (TET) 50 or 100 Hz Slow TOF (TOFs) programmable from 1 to 60 min Stimulation current (0-60 mA at impedance ≤5 kOhm) Stimulation pulse width monophasic 200 µs Stimulation pulse width monophasic 300 µs Calibration with user-set current Calibration with automatically set supramaximal current Manual transducer sensitivity setting User-programmable upper and lower TOF/TOFs alarms (OFF, count, or % TOF) Automatic...

TOF ratio ≥0.9—the gold standard Clinical studies are frequently dening recovery from neuromuscular blockade as a TOF ratio ≥0.9, due to an increased recognition of the risks associated with a TOF ratio <0.9.10-14 Hypoxemia A study using pancuronium showed that 60% of patients with a TOF ratio <0.7 experienced hypoxemia versus 10% of patients with a TOF ratio ≥0.710 A separate study showed that patients with a TOF ratio <0.9 were signicantly more likely to develop postoperative hypoxemia than those with a TOF ratio >0.9 (24 of 39 vs 7 of 30, P=0.003)11 Pharyngeal dysfunction In a study...

Never miss a twitch with the TOF-Watch The TOF-Watch series offers an accurate and reliable method of objective acceleromyographic monitoring of neuromuscular blockade that overcomes the limitations of subjective monitoring.4 Reliable detection of residual blockade 4.5% incidence in the PACU for patients monitored with the TOF-Watch, versus 30% incidence for patients monitored subjectively 1,2 Avoids the risks associated with a TOF <0.9 Recovery to a TOF <0.9 has been associated with a wide range of side effects10-14 The TOF-Watch helps ensure patients are recovered to a TOF >0.9 before...