Do we monitor enough? We monitor too much

Not only may we monitor too much, we also may monitor improperly. By so doing we divert attention from the patient and the anesthetic and thereby often decrease the quality of care. Furthermore, the teaching of residents can be impeded by an overemphasis on monitoring, resulting in a wrong sense of values. The cost of monitoring is high, not only in financial terms, but also in terms of the time devoted to machines, electrodes, and sensors, and in terms of complications such as shearing, infections, vasospasm, hematomas, and even fatal hemorrhage. Not all monitoring is bad, however. Oxygen, temperature, blood pressure, and the electrocardiogram should be monitored, but we must avoid a lavish concept that monitoring will solve all our problems and eliminate the need for proper personal attention. Most important, we must avoid the notion that more monitoring is categorically better.