What intraoperative monitoring may be implemented, and why is this important?
Mr George Pocock, aged 63 years, is admitted for a liver resection. He had been well up until presenting to hospital one month ago. His haemoglobin is 111 mmol/L.
What will be an ideal response?
Answer:
The following monitoring will ensure that Mr Pocock is haemodynamically stable and will indicate to the anaesthetic team any change or deterioration so it can be addressed and managed immediately.
pulse oximeter (to measure oxygen saturation)
electrocardiograph (to measure heart rate and cardiac rhythm)
intermittent non-invasive blood pressure monitor (a manual BP is also required in addition to an arterial line in the event that there are complications with the arterial line)
continuous invasive blood pressure monitor—arterial line (to measure beat by beat blood pressure and take blood gases)
temperature monitor (to measure core body temperature intraoperatively to avoid inadvertent perioperative hypothermia occurring)
carbon dioxide monitor (CO2 monitoring is vital to show adequate ventilation of the patient)
neuromuscular monitor (to measure patient muscle relaxation intraoperatively)
volatile anaesthetic agent monitor (to measure the mean alveolar concentration (MAC) and reflects depth of anaesthesia)
BIS monitoring (monitors awareness under anaesthetic)
central venous pressure monitoring (CVP) (to monitor hydration status and measure right heart filling as a guide to intravascular volume).
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