The German manufacturer, MIPM – Mammendorfer Institut für Physik und Medizin GmbH has announced that effective June 30, 2016 the TOF Watch, TOF Watch S and TOF Watch SX neuromuscular monitors will no longer be manufactured. The official announcement of the discontinuance of the TOF Watch is below:
TOF-Watch – objective neuromuscular monitoring
Product cancelation Note
We wish to inform you that the TOF Watch monitors are not produced and sold any more effective July 1st 2016.
Their USA distributor Blue Star Enterprises will continue selling the TOF Watch while supplies last. They will also offer the replacement alternative from Bell Medical and Xavant called the Stimpod NMS 450. The only accelerometer based neuromuscular monitor now available is the Stimpod NMS 450 from Xavant distributed in the USA and Canada by Bell Medical Inc. The Stimpod NMS 450 is a neuromuscular monitor that offers Quantitative TOF Monitoring as endorsed by the Anesthesia Patient Safety Foundation or APSF.
Stimpod NMS 450 Nerve Stimulator and TOF Monitor
Stimpod NMS 450 Nerve Stimulator and TOF Monitor includes a Tri-axial accelerometer which provides real time feedback of the strength of contraction of the affected limb (Train Of Four, Double Burst and Post Tetanic Count modes). The strength of each measured contraction is displayed graphically and the relevant ratios are calculated and also displayed.
The fine movement differences that can be detected by utilizing accelerometry offer major advantages over gauging contraction strength visually or tactilely.
Tri-axial accelerometry calculates the movement vector of the contraction in three dimensions. This negates the need for calibration as is the case with one-dimensional accelerometers, and reduces the setup time of the procedure.
Combined Nerve Mapping and Nerve Location
Auto sensing technology provides a solution for simultaneous nerve mapping and nerve location. The Stimpod monitors whether the mapping probe or needle touches the patient and adjusts the current range accordingly, ensuring quick and precise nerve location.
The Stimpod Nerve Mapping Probe was designed to enable transcutaneous nerve mapping at higher currents (to a maximum of 20mA), whilst the tip offers a contact surface small enough to ensure effective discrimination.
| Current Range | Load Impedance | Stimulating Modes |
| Nerve Locating: 0.0 – 5.0mA Nerve Mapping: 0 – 20mA NMBA Monitoring: 0 – 80mA | Nerve Locating: 0 – 20kΩ (100V) Nerve Mapping: 0 – 20kΩ (400V) NMBA Monitoring: 0 -5kΩ (400V) | Train-of-Four (TOF) Double Burst (DB) Post-Tetanic-Count (PTC) Tetanus (TET) Twitch (1Hz, 2Hz, 5Hz) |
Kit includes:
- STIMPOD NMS450
- NMBA Monitoring Cable
- Nerve Locating Cable
- Nerve Mapping/Locating Cable
- Carrying Case
Stimpod NMS 450 Comparison Study
| TOF Watch (discontinued) | STIMPOD NMS450 | |
| NMBA Monitoring (Objective) | Yes – 1 Dimensional Accelerometer | Yes – 3 Dimensional Accelerometer, enhanced accuracy |
| Calibration Before TOF Monitoring | Yes | No, easier setup and operation |
| Nerve Mapping | No | Yes – Integrated StimPen results in superior nerve blocks |
| Nerve Block Application | Yes | Yes |
| Pulse Width Selections | 0.04ms, 0.2ms | 0.05ms, 0.1ms, 0.3ms, 0.5ms, 1ms |
| Current Range | Nerve Locating 0.0 – 6.0 mA Nerve Mapping None NMBA Monitoring 0 – 60 mA | Nerve Locating 0.0 – 5.0 mA Nerve Mapping 0 – 20 mA NMBA Monitoring 0 – 80 mA |
| Adjustable Timers | Yes | Yes |
| Auto Sensing Technology | Yes | Yes – Combination Cable Auto Sensing |
| Warranty | Limited One Year Warranty | Two Year Warranty |
| TOF Bar Graph Display | No | Yes |
| Lead Wire Construction | 18 Gauge OD, thin and fragile | 12 Gauge OD, thick and heavy duty, easy thumb application, 6 month cable warranty |
| Lead Wire & Accelerometer Cable Replacement Cost | $296 | $260, 12% savings |
| Device Attachment | IV Pole Attachment | Drape clip or IV pole option |