Neuromuscular Stimulation
Operating Room Troubleshooting
Force 2 User’s Guide 5-5
filters for use in the monitor leads. These filters reduce interference
while the generator is activated. RF filters minimize the potential for
an electrosurgical burn at the site of the monitor electrode.
4. Check that the ground wires in the operating room are electrically
consistent. All ground wires should go to the same grounded metal
with wires that are as short as possible.
5. If the above steps do not remedy the situation, the generator should be
checked by qualified service personnel.
Neuromuscular Stimulation
1. Stop the surgery.
2. Check all connections to the generator, patient return electrode, and
active electrodes to look for a possible metal-to-metal spark.
3. Lowering the power setting or using a lower voltage (low voltage coag
or cut) may alleviate the problem. Neuromuscular stimulation is more
likely to occur in the coag mode when fulgurating than when cutting,
and is unlikely when desiccating.
4. If no problems are found, the generator should be checked by qualified
service personnel for abnormal 50-60 Hz AC leakage currents.
Pacemaker Interference
1. Check all connections of both active and patient return electrode cords
to ensure that there is no intermittent or metal-to-metal sparking.
2. Use bipolar instruments if possible.
3. If monopolar instruments must be used, place the patient return
electrode as close as possible to the site of surgery and make sure that
the current path from the site of surgery to the patient return electrode
does not pass through the vicinity of the heart.
4. Always monitor pacemaker patients during surgery.
5. Always keep a defibrillator available during electrosurgery on patients
with pacemakers.
6. Consult the pacemaker manufacturer for specific recommendations.
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