Monitoring During Anesthesia

Adel Mohamad Alansary, MD

Why?

• Alert for potential incidents and errors.

• Guide medical, fluid and blood

therapy.

• Replace patient homoeostatic system.

• Guide surgical therapy.

Who?

Anesthesiologist.

What?

• Oxygenation:

• Oxygen analyzer.

• Oximetry.

• Clinical observation.

What?

• Ventilation:

• Clinical observation.

• Stethoscope.

• EtCO2.

What?

• Circulation:

• ECG

•HR.

•Arrhythmia.

What?

•ST analysis.

• BP

•Non-Invasive.

• Invasive

Anesthesia Machine

• Airway pressure.

• Flow meter.

• ETT.

• Oxygen supply pressure.

• IN OUT valves.

• Bellows.

What?

• CVS: Precordial stethoscope, IBP, PAP, CVP, Processed ECG, TEE, SVV, PPV, CO.

• Respiratory: expired gas, inhalational anesthetic, lung water, mixed venous Oximetry.

• Neurological: Processed EEG, CSF pressure, Evoked potentials, JVB Oximetry, cerebral Oximetry.

What?

• Neuromuscular monitoring.

• Renal: UOP, pH.

• Coagulation monitors.

• Bleeding.

HEMODYNAMIC MONITORING

Joseph T.

Clover (1825–

1882).

Cope DK. Monitoring in the 19th century:from blood-letting to

blood-flow measurements.ASA Newsl 2002;66(9):6–8.

ABP

• Non- invasive

• Auscultatory.

• Oscillemetry.

• Invasive

• Indications.

• Sites.

• Complications.

• Technical factors.

Normal Arterial Wave

What?

• Vitals.

• Anesthesia machine.

• Specific systems: