Anesthesia during total electrical failure, or what would you do if the lights went out?

This case report describes anesthetic management and monitoring of a patient undergoing abdominal surgery during a 45-minute loss of electrical power. Physical examination, electrical devices with battery backup power, and mechanical devices provided essential monitoring of the patient. Other methods of ensuring the adequacy of ventilation, circulation, and monitoring during total electrical failure are discussed. To decrease the risk during power outages, the authors recommend the following: (1) preparation of an organized plan for such an event that includes ensuring that equipment has reliable backup sources of power; (2) proper maintenance of equipment and batteries; and (3) knowledge of the power requirements of anesthesia equipment and monitoring devices.