This document discusses monitoring during anesthesia. It defines monitoring as the continuous recording of particular data to observe and regulate a process. There are two main types of monitoring - clinical monitoring done by an experienced anesthesiologist observing vital signs, and instrumental monitoring using medical devices. Standards require qualified medical staff to monitor oxygenation, ventilation, circulation, temperature, and depth of anesthesia throughout all general and regional anesthetics and recovery. A variety of devices are recommended for monitoring at different stages of anesthesia.

1. DR. MUNNI AZAM
DA STUDENT
ShSWMCH

2.  MONITOR: is from MONERE means
warning .An electronic device used to record ,
regulate or control a process or system .
 MONITORING:
Monitoring means continuous recording of
particular data

3.  Observation
 Vigilance
 Instrumentation
 Interpretation and corrective
therapy when needed .

8.  Clinical monitoring
 Instrumental monitoring

9.  The most important factor for clinical monitoring
is the continuous presence of a trained and
competent anaesthetist .
The experienced anaesthetist will monitor.
 Circulation :
Pulse, Temperature, Rhythm And Quality, Urine
Out put ,Vein feeling .
 Respiration : Pattern ,Reservoir bag movement ,
Tidal volume .
 Oxygenation : Skin , Blood color, Mucous
membrane
 Depth of Anaesthesia : Pupillary sign, Muscle
movement , Lacrimation .

10. Of the patient :
 Circulation: Non invasive blood pressure , Urine
output, Invasive blood pressure , Central venous
pressure , Electrocardiogram ( ECG), Pulse
oxymetry .
 Respiration : Pulse oxymetry ,Capnography ,
Airway pressure
 Neuromuscular transmission : Nerve stimulation
, when relaxant are used
 Metabolic monitoring : Temperature , Acid-base
balance , Blood glucose .

12. Of the Anaesthetic machine :
 Loss of reduction of gas supply :
Gas pressure , Oxygen failure warning device ,
Gas concentration
 Breathing system disconnection or ventrilator
failure :
Airway pressure , inspired and expired CO2
concentration .
 Vaporizer malfunction :
inspired and expired volatile agent.

23. Standards of monitoring are two types :
 Standard I .
 Standard II .

24. # Standard I :
 Qualified anaesthesia personell shall be
present in the room throughout the conduct
of all general anaesthetics regional
anaesthetics and monitor anaesthesia care .

25. # Standard II :
 During all anaesthetics the patients
oxygenation , ventilation , circulation , and
temperature shall be continually evaluated .

26. Oxygenation :
Objective : To ensure adequate oxygen
concentration in the inspired gas and the blood
during all anaesthetics

28.  Inspired gas : During every administration of
general anaesthesia using an anaesthesia
machine , the concentration of oxygen in the
patient breathing system shall be measured
by an oxygen analyzer with a low oxygen
concentration limit alarm is use .
 Blood oxygenation : During all anaesthetics a
quantitative method of assessing oxygenation
such as pulse oxymetry shall be employed *
adequate illumination and exposure of the
patient are necessary to asses color .

29. Ventilation :
 Objective : To ensure adequate Ventilation of
the patient during all anaeshtetics

31. Circulation :
 Objective : To ensure the adequacy of the
patients circulatory function during all
anaesthetics .

33.  Body temperature :
 Objective : To aid in the maintenance of
appropriate body temperature during all
anaesthetics .

39. During general anaesthesia :
Induction of anaesthesia :
 Pulse oximeter .
 Non – invasive blood pressure monitor
 Electrocardiograph
 Capnograph
The following must also be available :
 A nerve stimulator whenever a muscle relaxant is
used .
 A means of measuring the patients temperature .

40. Maintenance of anaesthesia :
 Pulse oximeter
 Non – invasive blood pressure monitor
 Electrocardiograph
 Capnograph
 Vapour analyzer .
The following must also be immediately available :
 A nerve stimulator whenever a muscle relaxant is
used .
 A means of measuring the patients temperature .

41. Recovery from anaesthesia :
 Pulse oximeter
 Non – invasive blood pressure monitor
The following must also be available :
 Electrocard
 iograph
 Nerve stimulator
 Means of measuring temperature
 Capnograph .

43. Regional techniques and sedation for operative
procedures:
 Patients must have appropriate monitoring
including the following device
 Pulse oximeter
 Non – invasive blood pressure monitor
 Electrocardiograph