clinical monitoring
Last reviewed 01/2018
Clinical monitoring of the depth of anaesthesia relies on the presence of autonomic reflexes:
- ophthalmic:
- pupil size, reducing with increasing depth, but may dilate in very deep anaesthesia
- opioids and anticholinergics alter pupil size by a central action and so make this index less valid
- cardiovascular:
- the trend in heart rate and arterial blood pressure is followed
- it may be modified by drugs, haemorrhage and body fluid abnormalities
- respiratory:
- the trend in rate, depth and rhythmicity of breathing
- effect of ventilation
- hiccuping or bronchospasm may indicate light anaesthesia
- skin:
- sweating can be a sign of light anaesthesia; reduced by anticholinergic agents
- colour; good perfusion indicated by pink hue
- capillary refill time; an indirect index of tissue perfusion
- temperature; particularly important in infants