The Trend That Changed the Game

The TwitchView® Train of Four Monitor is the only quantitative monitor clinically proven to eliminate residual paralysis4

More Power. More Precision.

Delivering 80 mA for stronger signals and superior data quality— stimulation competitors simply can’t match.  

Active Noise Canceling.

Noise is eliminated at the source by hardware, ensuring even the tiniest twitches are accurately captured — something software alone cannot achieve. 

Gold-Standard Accuracy.

Validated in multiple top tier journals as equivalent to gold standard mechanomyography6,7
Blink DC 2

Engineered for the OR.

Meticulously designed with robust cables, durable screens, rugged design— all backed by a market-leading warranty.

Truly Integrated.

TwitchView works with virtually any EHR and mounts anywhere with our TwitchArm positioning system.
Blink DC 5

Engineered for the OR.

Meticulously designed with robust cables, durable screens, rugged design— all backed in the U.S. by a market-leading warranty. 

Truly Integrated.

TwitchView works with virtually any electronic health record and mounts anywhere using the TwitchArmTM positioning system.

First in the Industry: Automatic Cycling Between Train of Four and Post-Tetanic Count
TwitchView’s Auto-PTCTM allows continuous, hands-free monitoring through all depths of neuromuscular block8. Often imitated. Never matched. 

One Button Startup.

Press the Start button, and TwitchView handles the rest.

One Button Startup
Press the Start button, and TwitchView handles the rest.

Everything That Matters—At a Glance

While other monitors scatter data across multiple screens, TwitchView puts real-time measurements, the raw EMG, and trended data on one screen front and center. 

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Designed for infants, children, and adults.

The TwitchView® Train of Four Monitor is the only monitor that automatically detects the size of the connected electrode array, adjusts stimulation parameters, and tunes the EMG algorithm for precise monitoring at every age. 
Blink DC 9

Patented Dual Muscle Monitoring

Unique electrode design9 covers both ASA-recommended monitoring sites5, the adductor pollicis and the first dorsal interosseous—automatically selecting the strongest signal for reliable, accurate neuromuscular monitoring.

Engineered with precision, validated with data, and built to withstand the toughest OR demands. Let performance speak for itself - see why we set the standard.

Real Case Examples

The TwitchView Train of Four Monitor tracks neuromuscular blockade in real time, displaying data on an interactive trend plot so clinicians can tailor dosing and often reduce overall drug use. TwitchView can also confirm smaller reversal doses or spontaneous recovery without pharmacologic intervention. The following real-case examples illustrate how this works in a typical OR setting.

General-1

Case Type: Gastrectomy
Case Duration: 4 hours 
Patient Age: 35 years
Patient Weight: 148kg
---
Electrode Size: Large
Intubation Dose: 100mg Succinylcholine
Maintenance Dose: 30mg Rocuronium 
Reversal: Spontaneous Recovery

TwitchView Train of Four Monitor confirms complete spontaneous recovery to a TOF Ratio ≥90%—no pharmacological reversal needed!

Suggamadex 15m-10

Case Type: Cholecystectomy
Case Duration: 2 hours
Patient Age: 87 years
Patient Weight: 87kg
---
Electrode Size: Large
Intubation Dose: 50mg Rocuronium
Maintenance Dose: 10mg Rocuronium
Reversal Dose: 200mg Sugammadex

After sugammadex administration, it took six minutes to start taking effect and 10 minutes to achieve adequate recovery (TOFR ≥90%). Two minutes after sugammadex was administered, the provider noted four twitches on the face, whereas TwitchView measured a TOF Count (TOFC) 1.

TwitchView Train of Four Monitor accurately informed the provider, preventing this at-risk elderly patient from being extubated at a TOFC 1.

TwitchView2 Cath Lab Case Highlight

Case Type: Cardiac Catheterization
Case Duration: 2 hours
Patient Age: 12 years
Patient Weight:  34kg
---
Electrode Size: Medium
Intubation Dose: 34mg Rocuronium
Maintenance Doses: 2x 10mg Rocuronium
Reversal: Spontaneous Recovery

Continuous data and the trend plot inform providers of the rapid clearance of rocuronium guiding more frequent dosing. When the case is complete, TwitchView Train of Four Monitor confirms spontaneous recovery was achieved, and no reversal was administered.

TwitchView2 TOF Monitor Trend Plot - Cardiac Case

Case Type: Congenital Heart Defect Correction
Case Duration: 7 hours 
Patient Age: 5 years
Patient Weight: 16.6kg
---
Electrode Size: Medium
Intubation Dose: 2mg/kg Rocuronium (Roc)
1st Maintenance Doses: 4x 0.6mg/kg Roc
2nd Maintenance Dose: 1mg/kg Roc
Reversal Doses: 2x 4mg/kg Sugammadex

Before bypass, TwitchView Train of Four Monitor guided 0.6 mg/kg redoses every 40 minutes to maintain necessary surgical conditions. After 4 mg/kg sugammadex was administered at a PTC of 5, TwitchView indicated recovery had stalled and a second reversal dose was administered.

TwitchView2 TOF Monitor Trend Plot - Plastics Case

Case Type: Cleft Palate Repair
Case Duration: 4 hours 
Patient Age: 7 months
Patient Weight: 6.7kg
---
Electrode Size: Small
Intubation Dose: 1mg/kg Rocuronium (Roc)
Maintenance Dose: None
Reversal: Spontaneous Recovery

TwitchView Train of Four Monitor indicated that the induction dose of rocuronium provided sufficient surgical conditions in a 4.5-hour case and confirmed spontaneous recovery—no reversal administered.

TwitchView2 TOF Monitor Trend Plot - Urology Case

Case Type: Pyeloplasty
Case Duration: 2 hours 
Patient Age: 2 months
Patient Weight: 6kg
---
Electrode Size: Small
Intubation Dose: 1.2mg/kg Rocuronium (Roc)
Maintenance Dose: None
1st Reversal Dose: 4mg/kg
2nd Reversal Dose: 2mg/kg in PACU

4mg/kg reversal dose of sugammadex stalled at a TOFR 42%, but patient passed subjective assessment was extubated and brought to PACU. Recovery did not progress and baby was inconsolable. An additional 2 mg/kg sugammadex was administered in the PACU and baby recovered to TOFR 91%, calmed and accepted a bottle.

Residual Paralysis Stops Here.

 See the TwitchView® TOF Monitor in action at your institution.

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