The full text of this article hosted at iucr.org is unavailable due to technical difficulties.

Guidelines
Open Access

Recommendations for standards of monitoring during anaesthesia and recovery 2015 : Association of Anaesthetists of Great Britain and Ireland

M. R. Checketts

Consultant, Chair of Working Party

Department of Anaesthesia, Dundee, UK

AAGBI

Search for more papers by this author
R. Alladi

Associate Specialist, Representative

Department of Anaesthesia, Tameside Hospital, Ashton‐under‐Lyne, UK

Royal College of Anaesthetists

Search for more papers by this author
K. Ferguson

Consultant

Aberdeen Royal Infirmary, Aberdeen, UK

Search for more papers by this author
L. Gemmell

Consultant

Department of Anaesthesia, North Wales Trust, North Wales, UK

Search for more papers by this author
J. M. Handy

Consultant

Department of Anaesthesia and Intensive Care, Chelsea and Westminster Hospital, London, UK

Search for more papers by this author
A. A. Klein

Consultant

Department of Anaesthesia and Intensive Care, Papworth Hospital, Cambridge, UK

Search for more papers by this author
N. J. Love

Consultant, Representative, Group of Anaesthetists in Training

AAGBI

Department of Anaesthesia and Intensive Care Medicine, North Devon District Hospital, Barnstaple, Devon, UK

Search for more papers by this author
U. Misra

Consultant

Department of Anaesthesia, Sunderland Royal Hospital, Sunderland, UK

Search for more papers by this author
C. Morris

Consultant

Department of Anaesthesia and Intensive Care, Royal Derby Hospital, Derby, UK

Search for more papers by this author
M. H. Nathanson

Consultant

Department of Anaesthesia, Nottingham University Hospitals, Nottingham, UK

Search for more papers by this author
G. E. Rodney

Consultant

Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee, UK

Search for more papers by this author
R. Verma

Consultant

Department of Anaesthesia, Derby Teaching Hospitals, Derby, UK

Search for more papers by this author
J. J. Pandit

Consultant

Department of Anaesthesia, Nuffield Department of Anaesthetics, Oxford University Hospitals, Oxford, UK

Search for more papers by this author
First published: 19 November 2015
Cited by: 109

This is a consensus document produced by members of a Working Party established by the Association of Anaesthetists of Great Britain and Ireland (AAGBI). It has been seen and approved by the AAGBI Board of Directors. Date of review: 2020.

This Guidelines is accompanied by an editorial by Lumb and McLure, Anaesthesia, 2016; 71: 3–6.

§

You can respond to this article at http://www.anaesthesiacorrespondence.com

Summary

This guideline updates and replaces the 4th edition of the AAGBI Standards of Monitoring published in 2007. The aim of this document is to provide guidance on the minimum standards for physiological monitoring of any patient undergoing anaesthesia or sedation under the care of an anaesthetist. The recommendations are primarily aimed at anaesthetists practising in the United Kingdom and Ireland. Minimum standards for monitoring patients during anaesthesia and in the recovery phase are included. There is also guidance on monitoring patients undergoing sedation and also during transfer of anaesthetised or sedated patients. There are new sections discussing the role of monitoring depth of anaesthesia, neuromuscular blockade and cardiac output. The indications for end‐tidal carbon dioxide monitoring have been updated.

Number of times cited according to CrossRef: 109

  • , Core body temperature monitoring using Baska airway, Trends in Anaesthesia and Critical Care, 10.1016/j.tacc.2019.01.003, (2019).
  • , Guidelines for the safe practice of total intravenous anaesthesia (TIVA), Anaesthesia, 74, 2, (211-224), (2018).
  • , Fibreoptic‐guided tracheal intubation through i‐gel® and LMA® Protector supraglottic airway devices ‐ a randomised comparison, Anaesthesia, 74, 2, (203-210), (2018).
  • , Intravenous anaesthetic agents, Anaesthesia & Intensive Care Medicine, 10.1016/j.mpaic.2018.12.008, (2019).
  • , The anaesthetic machine, Anaesthesia & Intensive Care Medicine, 10.1016/j.mpaic.2018.12.003, (2019).
  • , Measuring depth of anaesthesia using changes in directional connectivity: a comparison with auditory middle latency response and estimated bispectral index during propofol anaesthesia, Anaesthesia, 74, 3, (321-332), (2018).
  • , The RECITE-US study: Stacking the odds in a chronic patient safety threat, Journal of Clinical Anesthesia, 10.1016/j.jclinane.2019.02.004, 56, (132-133), (2019).
  • , Recent advances in understanding and managing postoperative respiratory problems, F1000Research, 10.12688/f1000research.16687.1, 8, (197), (2019).
  • , Butyrylcholinesterase deficiency and its clinical importance in anaesthesia: a systematic review, Anaesthesia, 74, 4, (518-528), (2019).
  • , Practical aspects of ultrasound-guided regional anaesthesia, Anaesthesia & Intensive Care Medicine, 10.1016/j.mpaic.2019.01.021, (2019).
  • , Mid‐point transverse process to pleura block for surgical anaesthesia, Anaesthesia Reports, 7, 1, (1-3), (2019).
  • , The effect of 6% hydroxyethyl starch (130/0.4) on acute kidney injury in paediatric cardiac surgery: a prospective, randomised trial, Anaesthesia, 73, 2, (205-215), (2017).
  • , Standardised recording of neuromuscular block reversal, Anaesthesia, 73, 4, (523-523), (2018).
  • , Alternative electrocardiography electrode placement, Anaesthesia, 73, 4, (525-525), (2018).
  • , Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies, Anaesthesia, 73, 11, (1400-1417), (2018).
  • , In‐vitro analysis of a novel ‘add‐on’ silicone cuff to improve sealing properties of tracheal tubes, Anaesthesia, 73, 11, (1372-1381), (2018).
  • , Comparison of a novel clinical score to estimate the risk of REsidual neuromuscular block Prediction Score and the last train-of-four count documented in the electronic anaesthesia record, European Journal of Anaesthesiology, 10.1097/EJA.0000000000000861, 35, 11, (883-892), (2018).
  • , The Technology of Processed Electroencephalogram Monitoring Devices for Assessment of Depth of Anesthesia, Anesthesia & Analgesia, 10.1213/ANE.0000000000002331, 126, 1, (111-117), (2018).
  • , Common controversies surrounding anesthesia for procedures in the Interventional Pulmonology Suite, Minerva Anestesiologica, 10.23736/S0375-9393.18.12673-3, 84, 10, (2018).
  • , Closed-loop monitoring by anesthesiologists—a comprehensive approach to patient monitoring during anesthesia, Korean Journal of Anesthesiology, 10.4097/kja.d.18.00033, 71, 5, (417-418), (2018).
  • , Non‐invasive blood pressure measurement displays, Anaesthesia, 73, 10, (1299-1299), (2018).
  • , Non‐invasive blood pressure measurement displays – a reply, Anaesthesia, 73, 10, (1300-1300), (2018).
  • , Core temperature measurement through the gastric channel of the i‐gel®, Pediatric Anesthesia, 28, 6, (566-567), (2018).
  • , Moderate vs. deep neuromuscular blockade and monitoring, Anaesthesia, 73, 1, (132-133), (2017).
  • , Response to ‘Objective neuromuscular monitoring: the challenges limiting its use’ by Dr. El‐Orbany, Acta Anaesthesiologica Scandinavica, 62, 2, (268-269), (2018).
  • , Coding for anaesthetic and peri‐operative practice, Anaesthesia, 73, 1, (130-132), (2017).
  • , Combined thoracic paravertebral and pectoral nerve blocks for breast surgery under sedation: a prospective observational case series, Anaesthesia, 73, 4, (438-443), (2018).
  • , Entropy interference from operating tables, Anaesthesia, 73, 4, (520-521), (2018).
  • , Do you believe that processed EEG helps to prevent intraoperative awareness?, Korean Journal of Anesthesiology, 10.4097/kja.d.18.00309, 71, 6, (427-429), (2018).
  • , Anaesthesia for children with left ventricular assist devices undergoing non-cardiac surgery, BJA Education, 10.1016/j.bjae.2018.09.002, (2018).
  • , The anesthesiologist and the EEG: Current uses and future trends in the operating room, Trends in Anaesthesia and Critical Care, 10.1016/j.tacc.2018.10.004, (2018).
  • , Consensus Statement on Perioperative Use of Neuromuscular Monitoring, Anesthesia & Analgesia, 10.1213/ANE.0000000000002670, 127, 1, (71-80), (2018).
  • , Clinical Pharmacology of Drugs Acting at the Neuromuscular Junction, Basic Sciences in Anesthesia, 10.1007/978-3-319-62067-1_8, (139-159), (2017).
  • , Nitrous oxide‐based vs. nitrous oxide‐free general anaesthesia and accidental awareness in surgical patients: an abridged Cochrane systematic review, Anaesthesia, 73, 3, (365-374), (2017).
  • , Arachnoid Cyst—Anesthesia and Postoperative Management, Arachnoid Cysts, 10.1016/B978-0-12-814378-0.00015-7, (207-226), (2018).
  • , Catheter Laboratory Design, Staffing and Training, Primary Angioplasty, 10.1007/978-981-13-1114-7_6, (69-81), (2018).
  • , Neuromonitoring in the ambulatory anesthesia setting, Current Opinion in Anaesthesiology, 10.1097/ACO.0000000000000654, 31, 6, (667-672), (2018).
  • , Chagas Cardiomyopathy: A Comprehensive Perioperative Review, Journal of Cardiothoracic and Vascular Anesthesia, 10.1053/j.jvca.2018.04.046, 32, 6, (2780-2788), (2018).
  • , Anaphylaxis to all neuromuscular blocking agents, Anaesthesia Cases, 6, 2, (34-36), (2018).
  • , Neostigmine‐induced weakness: what are the facts?, Anaesthesia, 73, 9, (1055-1057), (2018).
  • , Bespoke intra‐operative anaesthesia – the end of the formulaic approach?, Anaesthesia, 73, 9, (1062-1066), (2018).
  • , Intra‐operative failure of sevoflurane vaporiser, Anaesthesia, 73, 9, (1174-1175), (2018).
  • , The Effect of Preload on Electromyographic Train-Of-Four Ratio at the First Dorsal Interosseous Muscle during Spontaneous Recovery from Neuromuscular Blockade, Anaesthesia and Intensive Care, 10.1177/0310057X1804600613, 46, 6, (614-619), (2019).
  • , Is the new, noninvasive, continuous cardiorespiratory monitoring reliable during neonatal ECMO?, Heart & Lung, 10.1016/j.hrtlng.2018.06.007, 47, 6, (638-645), (2018).
  • , Guidelines for the management of tracheal intubation in critically ill adults, British Journal of Anaesthesia, 10.1016/j.bja.2017.10.021, 120, 2, (323-352), (2018).
  • , Nurse-led extubation in the post-anaesthesia care unit, Journal of Perioperative Practice, 10.1177/1750458918793366, 28, 12, (362-365), (2018).
  • , Pseudocholinesterase Deficiency: What the gastroenterologist needs to know, The American Journal of the Medical Sciences, 10.1016/j.amjms.2018.11.002, (2018).
  • , Suitability of the forearm for non‐invasive blood pressure measurement in children, Pediatric Anesthesia, 27, 11, (1125-1130), (2017).
  • , Quantitative Neuromuscular Blockade Monitoring, A & A Case Reports, 10.1213/XAA.0000000000000568, 9, 7, (190-192), (2017).
  • , Uncommon Events May Be More Common Than You Think, A & A Case Reports, 10.1213/XAA.0000000000000570, 9, 7, (187-189), (2017).
  • , A quality improvement program involving protocolised reversal from neuromuscular block, Anaesthesia, 72, 9, (1152-1153), (2017).
  • , Cerebral oximetry and its role in adult cardiac, non‐cardiac surgery and resuscitation from cardiac arrest, Anaesthesia, 72, S1, (48-57), (2017).
  • , Monitoring regional blockade, Anaesthesia, 72, S1, (70-75), (2017).
  • , Implications of the 2015 AAGBI recommendations for standards of monitoring during anaesthesia and recovery, Anaesthesia, 72, S1, (3-6), (2017).
  • , Conceptual and technical insights into the basis of neuromuscular monitoring, Anaesthesia, 72, S1, (16-37), (2017).
  • , What is the real oximeter gap?, Anaesthesia, 72, 12, (1565-1567), (2017).
  • , Neuromuscular monitoring and the cost of antagonism: when will we learn? A reply, Anaesthesia, 72, 12, (1559-1560), (2017).
  • , Real‐time ultrasound‐guided axillary vein cannulation in children: a randomised controlled trial, Anaesthesia, 72, 12, (1516-1522), (2017).
  • , Laboratory evaluation of a novel anaesthesia delivery device, Anaesthesia, 72, 1, (63-72), (2016).
  • , Should blood glucose measurement be a standard of monitoring? A reply, Anaesthesia, 72, 5, (659-659), (2017).
  • , Should blood glucose measurement be a standard of monitoring?, Anaesthesia, 72, 5, (658-659), (2017).
  • , A method of recording electronic anaesthetic monitor data for research, Anaesthesia, 72, 2, (267-269), (2017).
  • , AAGBI: Safer pre‐hospital anaesthesia 2017, Anaesthesia, 72, 3, (379-390), (2017).
  • , The role and limitations of EEG‐based depth of anaesthesia monitoring in theatres and intensive care, Anaesthesia, 72, S1, (38-47), (2017).
  • , How I do it: Awake craniotomy, Acta Neurochirurgica, 159, 1, (173), (2017).
  • , ‘Failed supraglottic airway’: an algorithm for suboptimally placed supraglottic airway devices based on videolaryngoscopy, British Journal of Anaesthesia, 118, 5, (645), (2017).
  • , Postoperative management of the difficult airway, BJA Education, 17, 7, (235), (2017).
  • , Dynamic ultrasound-guided short-axis needle tip navigation technique vs. landmark technique for difficult saphenous vein access in children: a randomised study, Anaesthesia, 72, 12, (1508), (2017).
  • , Cerebral oximetry and postoperative delirium after cardiac surgery: a randomised, controlled trial, Anaesthesia, 72, 12, (1456-1466), (2017).
  • , Measurement of gas concentrations, Anaesthesia & Intensive Care Medicine, 18, 12, (644), (2017).
  • , Drug detection in breath: non-invasive assessment of illicit or pharmaceutical drugs, Journal of Breath Research, 11, 2, (024001), (2017).
  • , Current Status of Neuromuscular Reversal and Monitoring, Anesthesiology, 126, 1, (173), (2017).
  • , Intubated Versus Nonintubated General Anesthesia for Video-Assisted Thoracoscopic Surgery—A Case-Control Study, Journal of Cardiothoracic and Vascular Anesthesia, 31, 2, (411), (2017).
  • , Glottic impersonation, perhaps, but direct visualization remains vital to confirm successful intubation, Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 64, 8, (874), (2017).
  • , Assessing anesthetic activity through modulation of the membrane dipole potential, Journal of Lipid Research, 58, 10, (1962), (2017).
  • , Effectiveness of enhanced pulse oximetry sonifications for conveying oxygen saturation ranges: a laboratory comparison of five auditory displays, British Journal of Anaesthesia, 10.1093/bja/aex343, 119, 6, (1224-1230), (2017).
  • , State of the Art in Airway Management During GI Endoscopy: The Missing Pieces, Digestive Diseases and Sciences, 62, 5, (1385), (2017).
  • , Current Status of Neuromuscular Reversal and Monitoring, Anesthesiology, 127, 4, (723), (2017).
  • , Antagonism of moderate neuromuscular block with sugammadex versus neostigmine, British Journal of Anaesthesia, 118, 3, (459), (2017).
  • , Apnoeic oxygenation with high‐flow nasal oxygen for laryngeal surgery: a case series, Anaesthesia, 72, 11, (1379-1387), (2017).
  • , Sugammadex: when should we be giving it?, Anaesthesia, 72, 10, (1170-1175), (2017).
  • , Comparison of reversal with neostigmine of low‐dose rocuronium vs. reversal with sugammadex of high‐dose rocuronium for a short procedure, Anaesthesia, 72, 10, (1185-1190), (2017).
  • , Sedation in children – is it time to change our practice?, Anaesthesia, 71, 5, (501-505), (2016).
  • , Botox injections and monitoring neuromuscular blockade – a reminder, Anaesthesia, 71, 6, (732-732), (2016).
  • , General anaesthesia vs. conscious sedation for transfemoral aortic valve implantation: a single UK centre before‐and‐after study, Anaesthesia, 71, 8, (892-900), (2016).
  • , Reversing non‐depolarising muscle relaxants, nausea and residual curarisation, Anaesthesia, 71, 4, (478-478), (2016).
  • , AAGBI recommendations for standards of monitoring during anaesthesia and recovery 2015, Anaesthesia, 71, 4, (470-471), (2016).
  • , The winds of change ‐ progress in the implementation of universal capnography, Anaesthesia, 71, 4, (363-368), (2016).
  • , Appropriate dosing of sugammadex to reverse deep rocuronium‐induced neuromuscular blockade in morbidly obese patients, Anaesthesia, 71, 3, (265-272), (2015).
  • , Digital palpation of the pilot balloon vs. continuous manometry for controlling the intracuff pressure in laryngeal mask airways, Anaesthesia, 71, 10, (1169-1176), (2016).
  • , Neuromuscular monitoring and the AAGBI 2016 monitoring guidelines, Anaesthesia, 71, 8, (981-982), (2016).
  • , Automated electronic anaesthesia records, Anaesthesia, 71, 7, (850-851), (2016).
  • , The ‘go‐between’ study: a simulation study comparing the ‘Traffic Lights’ and ‘SBAR’ tools as a means of communication between anaesthetic staff, Anaesthesia, 71, 7, (764-772), (2016).
  • , The end of paper anaesthetic charts?, Anaesthesia, 71, 7, (849-850), (2016).
  • , Electronic anaesthesia records – a reply, Anaesthesia, 71, 7, (851-851), (2016).
  • , A national survey of the impact of NAP4 on airway management practice in United Kingdom hospitals: closing the safety gap in anaesthesia, intensive care and the emergency department, British Journal of Anaesthesia, 117, 2, (182), (2016).
  • , The Effect of Quantitative Neuromuscular Monitoring on the Incidence of Residual Neuromuscular Blockade and Clinical Outcomes, Current Anesthesiology Reports, 10.1007/s40140-016-0156-7, 6, 2, (170-177), (2016).
  • , The effect of a secondary task on identification accuracy of oxygen saturation ranges using an enhanced pulse oximetry sonification, Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 60, 1, (628), (2016).
  • , The United Kingdom National Audit Projects: a narrative review, Southern African Journal of Anaesthesia and Analgesia, 22, 2, (38), (2016).
  • , Introducing capnography monitoring into an endoscopy service, Gastrointestinal Nursing, 14, 4, (37), (2016).
  • , Intravenous anaesthetic agents, Anaesthesia & Intensive Care Medicine, 17, 3, (155), (2016).
  • , Capnography standards for outside the operating room, Current Opinion in Anaesthesiology, 29, 4, (485), (2016).
  • , Team working in airway crisis: role of operating department practitioner in management of failed intubations, British Journal of Anaesthesia, 117, 5, (553), (2016).
  • , Dilutional effect of nasal oxygenation: Reply, British Journal of Anaesthesia, 117, 4, (537), (2016).
  • , Postoperative awake paralysis in the intensive care unit after cardiac surgery due to residual neuromuscular blockade: a case report and prospective observational study, Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 63, 6, (725), (2016).
  • , Comparison of Kinemyography and Electromyography during Spontaneous Recovery from Non-Depolarising Neuromuscular Blockade, Anaesthesia and Intensive Care, 10.1177/0310057X1604400618, 44, 6, (745-751), (2019).
  • , Guidelines for the safe provision of anaesthesia in magnetic resonance units 2019, Anaesthesia, , (2019).
  • , Legal and ethical implications of defining an optimum means of achieving unconsciousness in assisted dying, Anaesthesia, , (2019).
  • , Values of heart rate at rest in children and adults living at different altitudes in the Andes, PLOS ONE, 10.1371/journal.pone.0213014, 14, 2, (e0213014), (2019).