I. Zabani et al., ELECTROCARDIOGRAPHIC MONITORING IN HEALTHY-YOUNG ADULT OUTPATIENTS - MANDATORY OR OPTIONAL, Canadian journal of anaesthesia, 45(5), 1998, pp. 424-428
Purpose: To determine the incidence and duration of ECG abnormalities
in healthy adults during short duration outpatient surgery and their r
elationship to important clinical events, Method: In 381, ASA Class I,
day surgery patients undergoing short surgical procedures the ECG was
monitored prospectively for evidence of abnormalities. The attending
anaesthetist administered the anaesthetic and made all clinical decisi
ons while relying on routine monitors (ECG, oximeter,BP capnometer, ox
ygen analyser, low pressure alarm and anaesthetic gas monitors), Intra
-operative events of clinical significance (e.g., light anaesthesia, r
egurgitation, coughing, hypotension, arteria[ desaturation, hiccoughs
etc), ECG abnormalities and their duration were documented. Results: E
lectrocardiographic abnormalities were detected in 21% of patients as
follows: sinus tachycardia (11%), artifacts (7%), premature atrial con
tractions (1.6%), lead disconnects (1%), sinus bradycardia (0.5%) and
premature ventricular contractions (0.3%). All abnormalities resolved
spontaneously within three minutes, Intra-operative incidents of conse
quence occurred in only 2.6%: light anaesthesia (5), arterial desatura
tion > 5% (2), hypotension (1), hiccough(1)and regurgitation (1). All
incidents were detected clinically and by pulse oximetry. The ECG did
not detect any of the incidents and was normal during the events. Conc
lusion: Routine ECG monitoring did not detect intra-operative incident
s in healthy adults during short outpatient procedures, Detected ECG a
bnormalities were benign and resolved spontaneously within three minut
es, Firm conclusions as to the safety implications of withdrawing ECG
monitoring cannot be drawn from this study, Guidelines may need to be
reviewed to determine whether ECG monitoring in such cases should be o
ptional rather than mandatory.