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There are numerous mechanical and electronic devices available for the assessment of neuromuscular blockade, e.g. Myograph 2000 (Biometer International, Odense, Denmark) or TOFwatch (Schering-Plough, Kenilworth, USA). Although these devices are not available in all centres, a recent survey implies that it is usually not too hard to find an iPhone (Apple Inc, Cupertino, USA) in the operating theatres [1].

Other anaesthesia-related uses reported for the iPhone have included measurement of patient tilt in obstetric anaesthesia [2], a case logbook [3], a guide to resuscitation [4] and pharmacokinetic/dynamic modelling [5].

I would like to present yet another use of the iPhone for anaesthetists. The iPhone has an inbuilt accelerometer that can be used to monitor the effects of neuromuscular blocking agents (Fig. 5) through the use of a free ‘seismograph’ application (iSeismometer, Objectgraph LLC, NY, USA). This simple app can provide an objective, graphical representation of neuromuscular function, somewhat similar to commercially available devices. It is possible to illustrate ‘fade’ (Fig. 6) and then return of function (Fig. 7) following a ‘train of four’. In addition, this application allows easy demonstration of the recovery characteristics of neuromuscular blocking agents to our trainees.

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Figure 5.  Hand-held iPhone displaying movement during a train-of-four stimulus.

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Figure 6.  Partial paralysis with train-of-four stimulus fade of responses.

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Figure 7.  Train-of-four stimulus displaying return of normal function.

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