Abstract
Sedation of patients can only be accomplished safely if the physiologic effects of the sedative agents are continuously evaluated by a trained individual who is assisted by data provided by devices, that monitor the cardiopulmonary system (1). Since sedation is on a continuum from the awake and alert state to general anesthesia, the monitors employed during sedation should be similar to those used during the provision of anesthesia. More than 15 years ago, the American Society of Anesthesiologists (ASA) published standards for monitoring during anesthesia (2). These guidelines have been extended into the post-anesthesia care unit, and have more recently been applied to sedation (1,3). It is important that the safety standards for monitoring be maintained regardless of the individuals providing sedation or the specific environment. This chapter reviews the current guidelines for monitoring during sedation and the specific devices used to monitor patients, including a brief description of how they work, and concludes with special recommendations for monitoring during magnetic resonance imaging (MRI).
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References
Practice guidelines for sedation and analgesia by non-anesthesiologists. A report by the American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. (1996) Anesthesiology 84(2), 459–471.
Website: American Society of Anesthesiologists standards for intraoperative monitoring. http://www.asahq.org/standards/homepage.
Website: American Society of Anesthesiologists standards for post anesthesia care unit monitoring. http://www.asahq.org/standards/homepage.
Website: American Society of Anesthesiologists guidelines for non-operating room anesthetizing locations. http://www.asahq.org/standards/homepage.
Eichorn, J. H., Cooper, J. B., Colen, D. J., Maier, W. R., Phillip, J. H., and Seman, R. G. (1986) Standards for patient monitoring during anesthesia at Harvard Medical School. JAMA 256, 1017–1020.
Website: American Society of Anesthesiologists Continuum of Depth of Sedation. http://www.asahq.org/standards/homepage.
Malviya, S., Voepel-Lewis, T., Tait, A. R., Merkel, S., Tremper, K. K., and Naughton, N. (2002) Validity and Reliability of the University of Michigan Sedation Scale (UMSS) in children undergoing sedation for computerized tomography. Br. J. Anaesth. 88(2), 241–245.
Tremper, K. K., and Barker, S. J. (1989) Pulse Oximetry. Anesthesiology 70, 98–108.
Tremper, K. K., and Barker, S. J. (1994) Monitoring of oxygen, in Clinical Monitoring for Anesthesia and Critical Care, 2nd ed. (Lake, C., ed.), W. B. Saunders Co., Philadelphia, PA, pp. 196–212.
Barker, S. J., and Tremper, K. K. (1987) The effect of carbon monoxide inhalation on pulse oximeter signal depiction. Anesthesiology 67, 559–603.
Barker, S. J., Tremper, K. K., and Hyatt, J. (1989) Effects of methemoglobin anemia on pulse oximetry and mixed venous oximetry. Anesthesiology 70, 112–117.
Anderson, S. T., Hajduczek, J., and Barker, S. J. (1988) Benzocaine-induced methemoglobinemia in an adult: accuracy of pulse oximetry with methemoglobinemia. Anesth. Analg. 67(11), 1099–1101.
Barker, S. J., and Shah, N. K. (1997) The effects of motion on the performance of pulse oximeters in volunteers (revised publication). Anesthesiology 86(1), 101–108.
Dumas, C., and Wahr, J. A. Tremper, K.K. (1996) Clinical evaluation of a prototype motion artifact resistant pulse oximeter in the recovery room. Anesth. Analg. 83(2), 269–272.
Malviya, S., Reynolds, P. I., Voepel-Lewis, T., Siewert, M., Watson, D., Tait, A. R., et al. (2000) False alarms and sensitivity of conventional pulse oximetry versus the Masimo SET technology in the pediatric postanesthesia care unit. Anesth. Analg. 90(6), 36–40.
Davis, R. F. (1985) Clinical comparison of automated auscultatory and oscillometric and catheter transducer measurements of arterial pressure. J. Clin. Monitoring1, 114–120.
Breuner, J. M. R., Kernis, L. J., and Kusman, J. M. (1981) Comparison of direct and indirect methods of measuring arterial pressure, Part III Med. Instruments. 15, 183–190.
Stanley, T. E., and Reves, J. G. (1994) Cardiovascular monitoring, in Anesthesia 4th ed. (Miller, R, ed.), Churchill Livingston, New York. NY. pp. 1164–1165.
Young, P. G., and Gedes, L. A. (1987) The effect of cuff pressure deflation rate on accuracy in indirect measurement of blood pressure with auscultatory effort. J. Clin. Monitoring. 3, 155–160.
Rapid interpretation of EKG. (1981) Dale Dubin, Cover Publishing Company, Tampa, FL.
Practical Electrocardiography, 7th ed. (1983) (Marriott, Henry, J. L., ed.), Williams & Wilkins, Baltimore/London.
Hillel, Z., and Thys, D. M. (2000) Electrocardiography, in Anesthesia 5th ed., Volume 1 (Miller, R. D., ed.), Churchill Livingston, Philadelphia, PA, pp. 1231–1254.
Griffin, R. N., and Kaplan, J. A. (1986) Comparison of ECG V5, CS5, CV5 and II by computerized ST segment analysis (abstract). Anesth. Analg. 65S1.
London, N. J., Hollenberg, M., and Wong, N. G., et al. (1988) Intraoperative myocardial ischemia: localization by continuous 12 lead electrocardiography. Anesthesiology 69, 232–238.
Gravenstein, J. S., Panlus, D. A., and Hayes, J. J. (1989) Capnography, in Clinical Practice. Butterworks.
Good, M. L., Gravenstein, N. (1993) Capnography, in Anesthesia EquipmentPrinciples and Applications (Ehrenwerth, J., and Eisenkraft, J. B., eds.), CV Mosby-Year Book. St. Louis, MO, pp. 237–248.
Hughes, C. W., and Bell, C. (1993) Anesthesia equipment in remote hospitals, in Anesthesia Equipment-Principles and Applications (Ehrenwerth, J., and Eisenkraft, J. B., eds.), CV Mosby Year Book, St. Louis, MO, pp. 565–587.
Peden, C. J. (1999) Monitoring patients during anesthesia for radiological procedures. Curr. Opin. Anes. 12, 405–410.
Basheim, G., and Syrovy, G. (1991) Burns associated with pulse oximetry during magnetic resonance imaging. Anesthesiology (75), 382–383.
Shellock, F. G. (1998) MR imaging of metallic implants and materials: a compilation of the literature. Am. J. Roentgenol. 151, 811–814.
Menon, D. K., Peden, C. J., Hallsas, Sargentoni, J., et al. (1992) Magnetic resonance for anesthetists, Part I: physical principles, applications, safety aspects. Anaesthesiology 47, 240–255.
Canal, E., and Shellock, F. G. (1992) Patient monitoring during clinical MR imaging. Radiology 85, 623–629.
Keller, E. K., Casey, F. X., Engels, H., Lauder, E., et al. (1998) Accessory equipment considerations with respect to MRI compatibility. J. Magn. Resonance Imaging 8, 12–18.
Website: Canale magnetic resonance safety web site. http://www.canal.arad. upmc.edu/mr-safety/.
Shellock, F. G., and Shellock, V. J. (1998) Cardiovascular catheters and accessories: ex vivo testing of ferromagnetism, heating, and artifacts associated with MRI. J. Magn. Resonance Imaging 8(6), 1338–1342.
Tremper, K. K., and Barker, S. J. (1986) Pulse Oximetry and oxygen transport, in Pulse Oximetry. (Payne, J. P., Severinghaus, J. W., eds.), Springer-Verlag, Berlin, pp. 19–27.
Barker, S. J., and Tremper, K. K. (1987) Pulse oximetry: applications and limitations, in Advances in Oxygen Monitoring, (Barker, S. J., Tremper, K. K., eds.), Int. Anesthesiology Clin. 25, 155–175.
Pologe, J. A. (1987) Pulse Oximetry: Technical Aspects of Machine Design, International Anesthesiology Clinics, Advances in Oxygen Monitoring. (Tremper, K. K., and Barker, S. J., eds.), Little, Brown and Company, pp. 142).
Mark, J. B., Slaughter, T. F., and Reves, J. G. (2000) Cardiovascular Monitoring, in Anesthesia, Fifth Edition, Volume 1, (Miller, R. D., ed.), Churchill Livingston, Philadelphia, PA, p. 1122, Figure 30–3.
Narang, J., and Thys, D. M. (1992) Electrocardiographic monitoring, in Anesthesia Equipment: Principles and Applications. (Ehrenwerth, J., and Eisenkraft, J. B., eds.), CV Mosby Year Book, St. Louis, pp. 284.
Thys, D. M., and Kaplan, J. A. (1987) The ECG in Anesthesia and Critical Care, Churchill Livingston, New York, NY.
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Tremper, K.K. (2003). Patient Monitoring During Sedation. In: Malviya, S., Naughton, N.N., Tremper, K.K. (eds) Sedation and Analgesia for Diagnostic and Therapeutic Procedures. Contemporary Clinical Neuroscience. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-295-1_8
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DOI: https://doi.org/10.1007/978-1-59259-295-1_8
Publisher Name: Humana Press, Totowa, NJ
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