theatre and surgery
Monitoring during
anaesthesia and recovery
The 2015 Association of Anaesthetists and Great Britain and Ireland standards of monitoring during
anaesthesia and recovery is a landmark guideline that builds upon previous recommendations
Kariem El-Boghdadly
MBBS FRCA
Anaesthetic registrar,
Department of
Anaesthesia, Guy’s
& St Thomas’
NHS Foundation Trust,
London, UK
Andrew Klein
MBBS FRCA
Consultant, Department
of Anaesthesia
and Intensive Care,
Papworth Hospital,
Cambridge, UK
Increasing demands on the provision of
anaesthetic services have been met with greater
patient safety. While the primary determinant of
anaesthetic safety is the presence of trained and
experienced anaesthetists, human error remains
unavoidable. 1 Rather than prevent adverse
incidents, patient monitoring may reduce the risk
of harm by detecting and alerting the caregiver to
a change in patient condition, thereby increasing
the margin of safety. 2-4 The Association of
Anaesthetists of Great Britain and Ireland (AAGBI)
has championed a multitude of safety standards,
and the latest update on the anaesthesia
standards of monitoring 5 details practical and
invaluable guidance to be implemented by both
individual practitioners and institutions. While
the 2015 recommendations are an update and
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replacement of the 4th edition of the guidelines,
it provides a contemporary model to include
modern technological and service provision
advancements.
The anaesthetist’s presence during
anaesthesia
During all forms of anaesthesia, including all
periods of general anaesthesia, sedation, local
or regional anaesthesia, an appropriately
experienced anaesthetist must be present at all
times. Trained Physician Assistants (Anaesthesia)
(PA (A)) have recently been introduced into UK
clinical practice, and can fulfil the requirement
of anaesthetic presence under the supervision of
a consultant anaesthetist. In patients who are not
sedated, having local or peripheral nerve block