If motor twitch cannot be evaluated, what should be done?

In the context of intraoperative monitoring, if motor twitch cannot be evaluated, the appropriate action is to increase the intensity until the maximum peripheral signal is observed. This is important because the ability to assess motor function relies on eliciting a clear and measurable response from the patient.

Increasing the stimulus intensity aims to optimize nerve stimulation and enhance the likelihood of observing a twitch. Understanding the physiological principles behind neuromuscular stimulation is essential; typically, a response may not be observed if the stimulus is too low to activate the motor fibers responsible for the twitch. By adjusting the intensity upward to find the threshold where a clear motor response can be elicited, the monitoring team can effectively evaluate the functional integrity of the motor pathways during surgery.

This approach adheres to the principle of ensuring adequate stimulation to confirm neuromuscular function, which is critical for patient safety and ensuring the success of the surgical intervention.