Abstract:

Perioperative patient safety relies on real-time， accurate， and individualized bedside monitoring. Traditional single-parameter surveillance is limited in simultaneously evaluating anesthetic drug effects， organ perfusion， and internal homeostasis. This narrative review systematically summarizes key technological advances in bedside anesthesia monitoring from 2023 to 2025， structured into three core dimensions： innovative basic vital sign monitoring， organ-targeted precision monitoring and internal environment homeostasis assessment. We highlight breakthroughs including end-tidal propofol detection， extended minimum alveolar concentration （eMAC） multimodal depth of anesthesia monitoring， point-of-care ultrasound-integrated hemodynamic assessment， and wearable noninvasive respiratory and metabolic monitoring. Clinical performance， validation evidence grades， advantages， and limitations of each technology are critically compared to address the weakness of previous reviews that only enumerate devices without systematic evidence integration. Current shared bottlenecks include insufficient technical operation standardization， limited high-quality multicenter RCT evidence， unbalanced cost-utility of equipment purchase and maintenance， and large variability in clinical interpretation of monitoring indexes. Future development paths center on multimodal physiological data fusion， explainable artificial intelligence-driven early warning， lightweight wireless wearable monitoring devices， and full closed-loop continuous monitoring covering preoperation-intraoperation-PACU-ward phases. This review provides an evidence-based framework for precision anesthesia practice and perioperative adverse event risk reduction.

Key words: bedside anesthesia monitoring, end-tidal propofol, point-of-care ultrasound, multimodal monitoring, perioperative patient safety