[Comparative analysis of the criteria for surveillance and monitoring in anesthesia, resuscitation and pain therapy. Recommendation of the Sociedad Española de Anestesia y Reanimación].
BACKGROUND
One part of morbidity and mortality associated with anesthesia is due to accidents. It is thought that an additional monitoring can prevent and avoid most of anesthetic accidents.


OBJECTIVE
In order to improve patient's safety and quality of anesthesia, Harvard University hospital approved in 1985 the rules for intraoperative monitoring. These were adopted by the American Society of Anesthesiologists (ASA) in 1986. In line with this procedure, professional associations of several countries pronounced their own rules. SEDAR did it in 1989. The purpose of this study was to compare spanish rules with those of America (Harvard and ASA), Australia, England and France.


RESULTS
Comparative analysis revealed that the spanish norms are more extensive since they include not only the intraoperative anesthetic activities, but also those related to recovery, pain, and obstetric anesthesia. However, it has some deficiencies such as the lack of a periodical revision, and of an adaptative period and assistance to the anesthesiologist provided by auxiliary personnel. Successful points were the recognition that pulse oximetry is essential, the preoperative verification of all material, and, more importantly, is the only one that considers essential capnography in the assessment of ventilation and pulse oximetry during regional anesthesia and postoperative phase.


CONCLUSIONS
Spanish norm is comparable to that of the other countries considered in this study. It shows important successful points and at the same time some significant deficiencies.
Herrera
A
A
Servicios de Anestesiología y Reanimación, Hospital Universitario Virgen del Rocío, Sevilla.
Pajuelo
A
A
Ureta
M P
MP
Gutiérrez-García
J
J
Ontanilla
A
A
Morano
M J
MJ
D000698:Analgesia / Q000009:adverse effects / Q000592:standards; D000758:Anesthesia / Q000401:mortality / Q000592:standards; D000776:Anesthesiology / Q000592:standards*; D001315:Australia / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005069:Evaluation Studies as Topic; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality / Q000517:prevention & control; D016343:Monitoring, Intraoperative / Q000592:standards; D008991:Monitoring, Physiologic / Q000592:standards*; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D012307:Risk Factors; D012955:Societies, Medical / Q000592:standards; D013030:Spain / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
Análisis comparativo de los criterios de vigilancia y monitorización en anestesia, reanimación y terapia del dolor. Recomendaciones de la SEDAR.