How It Works:

  • A battery-powered stimulator delivers a small electric current to a superficial nerve, usually the ulnar nerve
  • Activity stimulated by the four consecutive impulses is assessed by watching or feeling for associated muscle movement
  • The muscle movement (“twitch”) observed is used to estimate the level of blockade (see the chart below)

Things to Keep in Mind:

  • Adequate muscle relaxation exists when 2 of 4 twitches are present
  • Good intubating conditions exist when 1 of 4 twitches remains
  • It is important to take the patient off the NMB periodically to determine if it is still needed
Train-of-Four Responses
NIMBEX 200 mg/20 mL bottle

© 2022 AbbVie. All rights reserved.
ULTANE® and its design are registered trademarks of AbbVie Inc.
NIMBEX® and its design are trademarks of GlaxoSmithKline LLC, used under license by AbbVie Inc.
US-NIMB-220002 November 2022

AbbVie logo