Author(s): Julia M. Danford, Elisa C. Walsh
The American Society of Anesthesiologists Standards for Basic Anesthetic Monitoring state that qualified anesthesia personnel should be present during all anesthetics (general, regional, monitored anesthesia care [MAC]), and that oxygenation, ventilation, circulation, and temperature should be continually evaluated.
Standard monitoring for general anesthesia
The minimal requirements for general anesthesia include an oxygen analyzer to confirm the administered Fio2, pulse oximetry, expired carbon dioxide monitoring, an alarm to detect disconnection of components of the breathing system, electrocardiogram (ECG), blood pressure measurement, and the ability to assess temperature. Capnography (Chapter 11: Administration of General Anesthesia and Chapter 13: Airway Evaluation and Management) is mandatory for general anesthesia and recommended for MAC and regional anesthesia.
Additional monitoring
The patient’s comorbidities and operative procedure may require additional monitors to measure invasive arterial and venous pressures, cardiac function (Chapter 3: Specific Considerations for Cardiac Disease and Chapter 29: Anesthesia for Cardiac Surgery), depth of sedation, neuromuscular blockade (Chapter 14: Neuromuscular Blockade), and central nervous system activity (Chapter 16: Monitoring Anesthetic Brain States and Chapter 23: Anesthesia for Neurosurgery).