A patient is scheduled for monitored anaesthesia care (MAC) for an outpatient colonoscopy. Which of the following is NOT among the ASA-recommended minimum monitoring standards for MAC sedation?

• A Continuous pulse oximetry
• B Capnography (ETCO2) monitoring
• C Non-invasive blood pressure monitoring at ≤5-minute intervals
• D Pulmonary artery catheter for cardiac output monitoring ✓

Explanation

ASA standards for basic anaesthetic monitoring (2020 update) mandate: (1) qualified anaesthesia personnel present, (2) continuous oxygenation assessment by pulse oximetry, (3) continuous ventilation assessment — for moderate/deep sedation, capnography is now required by updated guidelines, (4) circulation monitoring with NIBP at ≥5-minute intervals and continuous ECG. Pulmonary artery catheterisation is invasive and not part of standard MAC monitoring; it is reserved for select complex cardiac cases. Note: capnography during moderate/deep sedation is now a standard requirement per the 2020 ASA update.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

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