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This guideline updates and replaces the 5th edition of the Standards of Monitoring published in 2015. The aim of this document is to provide guidance on the minimum standards for monitoring of any patient undergoing anaesthesia or sedation under the care of an anaesthetist. The recommendations are primarily aimed at anaesthetists practising in the UK and Ireland, but it is recognised that these guidelines may also be of use in other areas of the world. Minimum standards for monitoring patients during anaesthesia and in the recovery phase are included.

Peri-operative myocardial injury, detected by dynamic and elevated cardiac troponin (cTn) concentrations, is a common complication of noncardiac surgery that is strongly associated with 30-day mortality. Although active screening for peri-operative myocardial injury has been suggested in recent guidelines, clinical implementation remains tentative due to a lack of examples on how to tackle such an interdisciplinary project at a local level. Moreover, consensus on which assay and cTn cut-off values should be used has not yet been reached, and guidance on whom to screen is lacking.

Background: Prophylactic administration of tranexamic acid has been associated with reduced postpartum blood loss after cesarean delivery in several small trials, but evidence of its benefit in this clinical context remains inconclusive.

Study objective: To evaluate the efficacy of perioperative dexmedetomidine (DEX) administration for preventing delirium in adults after non-cardiac surgery.

Design: Systematic review and meta-analysis of randomized controlled trials (RCTs).

Interventions: Perioperative administration of DEX to prevent delirium in adults following non-cardiac surgery.

Measurements: The incidence of postoperative delirium (POD).

BACKGROUND In the United States, postoperative opioid prescriptions have been implicated in the so-called ‘opioid epidemic’. In Europe, the extent of overprescribing or misuse of opioids is not known.

OBJECTIVES To describe the proportion of persistent postoperative opioid use in adults (>18 years) in European countries.

DESIGN Systematic review of the published data.

DATA SOURCES We searched the electronic literature databases MEDLINE (Ovid), Embase (Ovid), PubMed/MEDLINE and Scopus.

Background: Anaesthesiologists are prone to patient safety situations after which second victim symptoms can occur. In international literature, a majority of these second victims indicated that they were emotionally affected in the aftermath of a patient safety incident (PSI) and received little institutional support after these events.

Objective: To study the current second victim support structures in anaesthesia departments in Belgium.

Purpose of review The current article reviews recent findings on the monitoring and hemodynamic support of septic shock patients.

Purpose of review: Quantification and optimization of perioperative risk factors focusing on anesthesia-related strategies to reduce postoperative pulmonary complications (PPCs) after lung and esophageal surgery.

Purpose of review The aim of this study was to discuss the implication of microvascular dysfunction in septic shock.

BACKGROUND Pectoral nerve blocks (PECS block) might be an interesting new regional anaesthetic technique in patients undergoing breast surgery.

OBJECTIVE The aim of this meta-analysis was to investigate postoperative pain outcomes and adverse events of a PECS block compared with no treatment, sham treatment or other regional anaesthetic techniques in women undergoing breast surgery.

DESIGN We performed a systematic review of randomised controlled trials (RCT) with meta-analysis and risk of bias assessment.