Date: 19 May 2012

Yesterday’s luxury – today’s necessity: end-tidal CO2 monitoring during conscious sedation

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The Canadian Journal of Anesthesia recently published the Canadian Anesthesiologists’ Society (CAS) “Guidelines to the Practice of Anesthesia – Revised Edition 2012” (hereafter referred to as the 2012Guidelines),1 which included an important amendment in the section regarding required monitors – CO2 monitoring (capnography) during conscious sedation. While a few practitioners may have been fortunate to use this valuable monitor for deeper levels of sedation during monitored anesthesia care, most others probably have not (or have chosen not to use it). As the practice of CO2 monitoring is now expected to change, at least for anesthesiologists, some practitioners may question the rationale for implementing this amendment.

Originally introduced in 1975, the CAS Guidelines are reviewed annually by the CAS Standards Committee, and changes are advanced for approval by the Board of Directors of the CAS. Many factors are considered when changes to the CAS Guidelines are contemplated, including