Electrodes

APS™ electrode

<p>APS™ (automatic periodic stimulation) electrodes are used to enable early detection of a change in nerve function in neuromonitoring procedures.</p>

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Indications, Safety, and WarningsIndicationsThe APS™ (automatic periodic stimulation) electrode is an accessory intended for providing automatic periodic stimulation to nerves when used with the Medtronic nerve monitoring systems.ContraindictionsThe use of paralyzing anesthetic agents will significantly reduce, if not completely eliminate, electromyography (EMG) responses to direct or passive neural stimulation.Warnings

Be careful not to damage vascular structures when preparing the nerve for the installation of the APS™ electrode.

EMG amplitude may be affected by anesthesia regimen used. Consult an anesthesiologist if EMG changes are observed.

Remove APS™ electrode from patient prior to using external defibrillator to prevent thermal injury to patient at APS™ electrode site.

Safe stimulus levels are dependent on various conditions including, but not limited to, type of excitable tissue, charge per pulse, and charge per unit area.

Waveform morphology, repetition rate, and stimulator effective surface area must be considered. It is also important to ensure proper contact of the stimulating electrode and recording electrode before increasing stimulus settings.

When exceeding recommended APS™ stimulation settings special operator attention is required. Raising current above recommended parameters may result in charge density high enough to cause nerve damage.

Schneider R, Randolph GW, Sekulla C, et al. Continuous intraoperative vagus nerve stimulation for identification of imminent recurrent laryngeal nerve injury. Head Neck. 2012;35(11):1591–1598.
Van Slycke S, Gillardin JP, Brusselaers N, Vermeersch H. Initial experience with S-shaped electrode for continuous vagal nerve stimulation in thyroid surgery. Langenbecks Arch Surg. 2013;398(5):717–722.

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APS™ electrode

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