The updated 2025 anesthesia monitoring guidelines from JSA now state that neuromuscular blockade must be quantitatively assessed, and that before extubation, a Train-of-Four (TOF) ratio exceeding 0.9 must be confirmed using hand muscle responses. This represents a significant step up from the 2019 edition, which included more general recommendations on monitoring neuromuscular function.

“These new guidelines should accelerate adoption of neuromuscular monitoring and unlock further potential for us in the Japanese market. They are the result of comprehensive clinical evidence and reflect the global trend toward stricter and clearer recommendations for quantitative neuromuscular monitoring in the operating room. With TetraGraph already installed in hundreds of Japanese hospitals, this opens the door for higher monitor utilization and improved patient outcomes”, said Philip Siberg, CEO of Senzime.

The updated Japanese guidelines follow similar recommendations issued by leading anesthesia societies in many other countries. Historically, surveys suggest that Japanese physicians adhere closely to national guidelines – particularly in specialties where there is strong consensus and organizational oversight.

Since 2016, Senzime has a long-standing partnership with Fukuda Denshi in Japan, which is responsible for commercializing the TetraGraph system and the Fukuda HN-100 integrated NMT module based on TetraGraph technology. The Japanese market consists of approximately 15,000 operating rooms, with nearly 3 million major surgical procedures performed annually, representing a substantial potential for the TetraGraph system.