Monobody Sensors for Monitoring Neuromuscular Blockade

Abstract

Improved sensors and sensing methods for detection of Neuromuscular Blockade (NMB), for example to improve monitoring generally, as well as facilitate automated NMB drug administration. The methods, systems, devices, etc., herein can increase the quantity and quality of data available. The methods, etc., include translation between commonly available sensing types, use of partially saturated sensor measurements, use of a model of neurotransmitter storage and release and sophisticated use of more than one sensor simultaneously. These methods are aided by new sensors and methods of decreasing electrical noise. An implementation of the methods, systems, devices, etc., herein is automated drug delivery for NMB, whether through an advisor system or through with full computer control.

What is claimed is: 
     
         1 . A sensor for quantifying neuromuscular response, the sensor comprising:
 a) at least one stimulation mechanism,   b) at least one sensing mechanism, and   c) a body to connect with and support said stimulation and sensing mechanisms, and with conductors to carry electrical signals to and from the said stimulation and sensing mechanisms and a monitoring device.   
     
     
         2 . The sensor of  claim 1  where said body is flexible. 
     
     
         3 . The sensor of  claim 1  where said body is constructed with left or right handedness. 
     
     
         4 . The sensor of  claim 1  where said body is shaped such that said stimulation and sensing mechanisms align with the anatomy of the muscle being stimulated. 
     
     
         5 . The sensor of  claim 1  where said stimulation and sensing mechanisms have spacing proportional to anatomical locations for an intended muscle of stimulation and said spacing is based on statistical surveys and/or population averages. 
     
     
         6 . The sensor of  claim 1  where said body is shaped such that said stimulation and sensing mechanisms are spaced proportional to patient size or sex. 
     
     
         7 . The sensor of  claim 6  where the degree of spacing is based on statistical surveys and/or population averages. 
     
     
         8 . The sensor of  claim 1  where said stimulation mechanism comprises at least two electrodes. 
     
     
         9 . The sensor of  claim 8  where said body further comprises jogs and/or bridges to position the one or more of said electrodes. 
     
     
         10 . The sensor of  claim 1  where said sensing mechanism comprises an accelerometer. 
     
     
         11 . The sensor of  claim 1  where said sensing mechanism comprises at least two electrodes. 
     
     
         12 . The sensor of  claim 1  further comprising an adhesive applied at one or more locations on said body, stimulation mechanism and/or sensing mechanism and one or more liners applied at said locations. 
     
     
         13 . A method of application of a monobody sensor strip to a patient for monitoring response of a muscle, said monobody sensor strip comprising:
 a) at least one stimulation mechanism,   b) at least one sensing mechanism,   c) a body to connect with and support said stimulation and sensing mechanisms, and with conductors to carry electrical signals to and from the said stimulation and sensing mechanisms and a monitoring device,   d) an adhesive including a glue or a tape applied at one or more locations on said body, stimulation mechanism and/or sensing mechanism and   e) one or more liners applied over said adhesive at said locations where said adhesive is applied;   
       having the steps:
 a) remove said one or more liners enough to expose said adhesive at said stimulation mechanism, 
 b) apply said stimulation mechanism part to said patient, 
 c) provide stimulation through said stimulation mechanism to said patient, 
 d) observe muscle response to said stimulation, 
 e) further remove said one or more liners to expose the adhesive at said sensing mechanism, and 
 f) apply said sensing mechanism to said muscle at an observed location of response. 
 
     
     
         14 . The method of  claim 13  further comprising the step of adjusting the position of the stimulation mechanism should said stimulation mechanism elicit no response or an inadequate response.