Advances in Anaesthetic Monitoring for the 1990s

Given the anaesthesiologists 'credo 'vigilance' it should come as no surprise that monitoring is accorded high priority in anaesthetic practice. Although the critical basics of monitoring have changed little since the earliest days of the specialty, namely visual observation (i.e. skin colour, rate and depth of respiration, position and location of patient and endotracheal tube etc.) and physical contact with the patient (i.e. finger on the pulse for heart rate and estimation of blood pressure, temperature, peripheral perfusion etc.) there is no question that technological advances have greatly enhanced these basic observations. The 1980s were especially pivotal. In this decade major advances have been made in respiratory and cardiovascular monitoring. Many of these advances have been credited with facilitating a major reduction in perioperative anaesthetic morbidity and mortality. For instance, with the routine use of pulse oximetry and capnography, the chance of an unrecognized esophageal intubation of sufficient duration to result in anoxic brain damage have been almost eliminated.