Monitoring Perioperative Ischemia

This report addresses monitoring for ischemia during surgery and whether perioperative ischemia leads to increased morbidity and mortality in patients with cor onary artery disease (CAD) who are undergoing sur gery. Based on previous studies, it is generally accepted that perioperative ischemia is common in patients with CAD undergoing noncardiac surgery. The incidence of ischemia during the operative period varies greatly with cardiac risk factors, type of surgery, duration of surgery, and the monitor used to detect ischemia. Be cause perioperative cardiac morbidity is the leading cause of death after anesthesia and surgery, it is pru dent for the anesthesia clinician to have an understand ing of the tools available for monitoring as well as their clinical utility. These tools are summarized, and recom mendations are made regarding their use.