We use capnography for every one of our procedures that involve intravenous anesthesia. (JADA 149(1) pages 38-50, January 2018). We have extensive training and background in anesthesia and we are experts in these areas of care along with many years of experience. I can say without hesitation that the use of capnography (monitoring of CO2) provides little value for increased safety for procedures such as ours where the patient is not intubated and managed with a titrated dose of anesthetic agents. We also monitor EKG, pulse oximetry (P02), blood pressure, pulse and respirations, and I feel all of these are appropriate and necessary.

Clearly the C02 monitoring works and we get a wave reading of the CO2 level. But in an open system (just sampling the exhaled air as is done for non-intubated patients) this monitoring does not give me additional valuable information compared to the cost to the patient of the additional monitoring and equipment. I understand the argument that any safety that we can provide is good, but the blind “following the crowd” in order to sell more and more complicated monitoring equipment that I see from legislators and researchers seems silly. The use of this equipment has been legislated and we conform accordingly, but my opinion remains the same that it is unfortunate that patients have to bear the additional expense of monitoring that may not be necessary.