Insertion And Placement Of The Electrodes - Synapse NeuRx Handbuch

excursion. The mapping instrument has a suction port that allows it to temporarily
attach to the diaphragm and deliver an electrical stimulus. Stimulation is applied
in either a twitch or burst mode from the clinical station. Mapping allows qualitative
and quantitative data to be obtained. Quantitatively, changes in abdominal
pressures are measured. Qualitatively, observation of the diaphragm contraction
is performed. The stronger the stimulated contraction the closer to the motor point
of the phrenic nerve. During mapping the entire diaphragm is assessed in grid
pattern to be sure the point of maximal contraction is not missed.
These locations are recorded on transparency that is overlaid on the laparoscopic
video display. The magnitude of the abdominal pressure change, to the applied
stimuli, is recorded for each location. The primary electrode site is identified at the
location of maximal pressure change in each hemi-diaphragm. A secondary
electrode site is identified as either a backup to the primary site or at a location in
each hemi-diaphragm that recruits another region (e.g. anterior, lateral, or
posterior) of the diaphragm at a similar magnitude. The two locations are marked
using a marker.

16.0 INSERTION AND PLACEMENT OF THE ELECTRODES

16.1 Loading Electrodes into the Electrode Delivery Instrument (Both
instruments, Reusable or Disposable are loaded with the following technique)
Preparation of the Disposable Electrode Delivery Tools:
®
The scrub staff should load one Permaloc Electrode into one of the Disposable
Electrode Delivery Tools.
A bowl of sterile water or saline may be used to lubricate the electrodes prior to
inserting into the Disposable Electrode Delivery Tool. Use a syringe filled with
saline to lubricate the Disposable Electrode Delivery Tool to aid in electrode
insertion. The Disposable Electrode Delivery Tool can be loaded with the needle
locked at 90̊ or 180̊ .
· Option #1: Loading electrode with needle at 180̊ :
1. Squeeze handle to the second locking position and lock the needle position
by pushing the slide button.
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