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Chapter: Clinical Cases in Anesthesia : Monitoring the Neuromuscular Junction

What is the mechanomyograph (MMG)?

The MMG is the historical standard for neuromuscular monitoring.

What is the mechanomyograph (MMG)?

 

The MMG is the historical standard for neuromuscular monitoring. Peripheral nerves are stimulated with a suffi-cient current to depolarize all axons of a motor nerve. This current is usually on the order of 50–60 milliamps and is called a supramaximal stimulus. Increasing the stimulus beyond supramaximal does not further increase the response. The current applied to a nerve causes a wave of depolarization, which results in acetylcholine release from nerve terminals with subsequent endplate and motor depolarization and muscle contraction. Mechanical twitch tension can then be measured using a force transducer. The force vector must be properly aligned with a transducer, or the measurement will not be accurate. Furthermore, the muscle must be preloaded with a specific tension (100–300 g) to ensure optimal contractile force. Clearly, MMG monitors must be carefully applied to ensure accu-rate and consistent measurements. MMGs are designed for preselected sites, usually ulnar nerve stimulation and adductor pollicis brevis force measurements.

 

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Clinical Cases in Anesthesia : Monitoring the Neuromuscular Junction : What is the mechanomyograph (MMG)? |


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