Real-time intraoperative monitoring of myocardial ischemia in noncardiac surgery.

FOR the past 15 yr, there has been intense interest in the anesthesia community in the detection of intraand postoperative myocardial ischemia as a means of optimizing patient care because of the accumulated evidence suggesting a strong association with perioperative cardiac morbidity and long-term outcome. ',*It is important to understand the limitations of the methods of detecting myocardial ischemia. This review will focus on understanding the current state of real-time intraoperative ischemia monitoring, while the reader is referred to other articles that highlight the importance of emergence and postoperative myocardial ischemia. 3,4 Although this review focuses on noncardiac surgery, many of the data were obtained from the cardiac surgical patient because of the lack of studies in the noncardiac surgical population. It is thought that data from patients undergoing cardiac surgery may be applied to those undergoing other surgical procedures.