Understanding Anesthesiology - The Global Regional Anesthesia ...

Monitoring
The purpose of monitoring during anesthesia is to ensure
the maintenance of homeostasis. The best single
monitor is a vigilant anesthesiologist. The practice of
anesthesia involves the use of some key monitors that
are not commonly seen in other health care settings. Examples
include the pulse oximeter, the capnograph
and the peripheral nerve stimulator. The Canadian Anesthesia
Society guidelines for intra-operative monitoring
are listed in Table 8.
In some settings, depending on the patient status or the
nature of the procedure, monitoring beyond the routine
measures listed above may be deemed necessary. There
are methods of invasively monitoring the cardiovascular,
renal and central nervous systems in the perioperative
period. Examples include arterial catheter,
pulmonary artery catheter, transesophageal echocardiography,
Foley catheter and 16-channel EEG monitoring.
Table 8 The Canadian Anesthesia Society guidelines
for intra-operative monitoring
Monitors which must be continuously used:
• pulse oximeter
• apparatus to measure blood pressure
• electrocardiography
• capnograph when an endotracheal tube or
laryngeal mask is in use
• agent-specific anesthetic gas monitor when inhaled
anesthetic agents are used
Monitors which must be exclusively available:
• apparatus to measure temperature
• peripheral nerve stimulator (when neuromuscular
blockers are used)
• stethoscope (precordial or esophageal)
• visualization of exposed portion of patient with
adequate lighting
Monitors which must be immediately available:
• spirometer for measurement of tidal volume
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