TOF (Train-of-Four) monitoring

Train-of-Four (TOF) monitoring is a technique used in anesthesia to assess the level of muscle relaxation caused by neuromuscular blocking agents. It involves delivering four small electrical impulses to a nerve near a muscle (usually the wrist) and observing the muscle's response. The results help clinicians determine how much paralysis is achieved, ensuring patients are adequately relaxed for surgery but not overly paralyzed. The key measure is the ratio of the strength of the last twitch compared to the first, guiding precise dosing of muscle relaxants to optimize anesthesia safety and effectiveness.