Scribd
Upload
12 views9 pages

65. Intraoperative Monitoring

The intraoperative phase involves monitoring the patient from the time they enter the surgical suite until they reach recovery. Essential monitoring devices include pulse oximeters, blood pressure monitors, and ECGs, while key parameters such as respiratory and cardiovascular status must be continuously assessed. Effective communication among the surgical team and proper equipment settings are crucial for patient safety during surgery.

Uploaded by

Athul
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
12 views9 pages

65. Intraoperative Monitoring

The intraoperative phase involves monitoring the patient from the time they enter the surgical suite until they reach recovery. Essential monitoring devices include pulse oximeters, blood pressure monitors, and ECGs, while key parameters such as respiratory and cardiovascular status must be continuously assessed. Effective communication among the surgical team and proper equipment settings are crucial for patient safety during surgery.

Uploaded by

Athul
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 9

INTRAOPERATIVE MONITORING

INTRAOPERATIVE PHASE
The intraoperative phase starts when the patient is
wheeled into the surgical suite and ends when the
patient is wheeled to recovery room. During this
phase, the patient will be placed under anesthesia
and surgical team performs their role during
surgery. As the surgery begins, the patient's vital
signs will be closely monitored by anesthetist.

Monitoring the Patient During Surgical


Procedure
Patient receiving anesthesia during surgery requires
continuous monitoring and assessment of
physiological state and ame depth of anesthesia.
The following monitoring devices are essential to
monitor anesthetized patient.
 Pulse oximeter
 Blood pressure monitor/cardiac monitor
 ECG
 Airway pressure
 Catheter
 Oxygen analyzer
Along with the monitoring devices, clinical
observation is also necessary which includes pupil
size, reflexes, chest rise, mucosal color and muscle
tone.
An anesthetist should check all the equipment
before administering anesthesia. He should check
oxygen supply, breathing system, vapor analyzer,
infusion device and alarms.

Parameters to be Checked During Surgery


Respiratory
 Oxygen saturation
 Respiratory rate
 Respiratory depth
 Airway patency
Cardiovascular
 Heart rate
 Pulse rate
 Rhythm
 Arterial blood pressure
 Capillary refill time

Body temperature
 Hypothermia
 Cold & clammy skin

Patient neurological status


 Reflexes
 Muscle tone
 Pupillary reaction
 Heart and respiratory rate
Function of equipment
 Vaporizer
 Oxygen flow meter
 Pressure relief valve

RESPIRATORY
 Check the airway patency and position of ET
tube, listen for accumulation of moisture in the
endotracheal tube.
 Check for respiratory rate 10-20 breaths/min.
 Breathing should be smooth. Labored breathing
indicates airway obstruction.
 Low respiration rate indicates apnea and bag
mask should be used immediately.
 Oxygen saturation must be maintained 95-100%
(SPO₂)
 Pulse oximeter should be connected properly.
 The reading less than 90% indicates hypoxia.
Early hypoxia is difficult to identify as cyanosis
only becomes apparent.
CARDIOVASCULAR
 Heart rate should be 80-120 bpm.
 Bradycardia indicates excessive anesthetic
effect and tachycardia indicates inadequate
anesthetic level.
 Prolonged capillary refill indicates hypotension.
 Prolonged capillary refill is caused by the poor
perfusion, hypothermia, vasodilation and
cardiac failure.
 Continued BP monitoring is essential to check
the adequacy of blood flow to the tissues.
 If the mean arterial blood pressure is below 60
mm Hg, it indicates tissue perfusion is
inadequate.
 Hypotension can be caused by deep anesthetic
effect as hypovolemia.

BODY TEMPERATURE
 Loss of body heat occurs in the first few
minutes of anesthesia.
 Supplemental heat source should be provided
and avoid burns and hypothermia.

ANESTHETIC DEPTH
 Anesthetist should monitor the stage of
anesthesia constantly.

REFLEXES
 Protective reflexes are progressively depressed
at the increasing depth of anesthesia.

PUPILLARY RESPONSE
 Pupillary reflex and size of pupil may provide
information regarding anesthesia depth.
COMMUNICATION
 During the progress of the procedure, proper
communication should be maintained with
surgical team.
 Communication also includes: progress of the
procedure, anesthesia stage, counting of gauze
and instruments.

EQUIPMENT SETTING
According to condition of the patient and
anesthesia level, the vaporizer must be set, oxygen
flow meter must be set and pressure relief valve
should be in OPEN position except when manually
ventilating the patient.

BIBLIOGRAPHY
1. Lippincott, manual of nursing practice, 8th
edition, Indian edition, jaypee brothers medical
publishers.

You might also like