Intraoperative Form

The intraoperative form is where you document the anaesthesia in real time — or fill it in retrospectively. The centrepiece is the live intraoperative timetable.

Timing

• Start time: click Start Case to stamp the current time, or type it (HH:MM).
• End time: click End Case when the procedure finishes, or type it.

Each time has a date beside it, set with a day stepper (‹ Today ›):

• Start date: left at Today, a typed start time later than the current time is taken as yesterday. Step the date back, up to 14 days, to chart a case afterwards. On the phone, the Start at sheet has the same date stepper.
• End date: follows the start, or the next day when the end time is earlier than the start time. It can be stepped up to two days after the start, but never to a moment before the start.
• Long cases: a case longer than 24 hours shows a warning to check the end date.
• Case month: taken from the start date.
• Printed record: shows the day of the case, and says so when the end falls on a later day.

All dates and times are those of the case's own time zone.

When Start Case is clicked, a live orange clock bar appears in the timetable and the case status changes to In theatre on the dashboard.

Anaesthesia technique

Select one or more techniques:

Technique	Description
General Inhalation	Volatile agent as primary technique
General IV (TIVA)	Total intravenous anaesthesia
General Combined	Combination of inhalational and IV
Spinal	Single-shot or continuous spinal
Epidural	Lumbar or thoracic epidural
Combined Spinal-Epidural (CSE)	Combined technique
Peripheral Nerve Block	Any peripheral block
Local Anaesthesia	Infiltration or topical
Sedation	Monitored anaesthesia care

Airway management

Based on the selected technique, the airway section shows relevant options:

• Airway device — Face mask, Oral airway (OPA), Nasal airway (NPA), LMA, Oral ETT, Nasal ETT, Double Lumen Tube (DLT), Endobronchial tube, Surgical airway
• For ETT: tube size (mm) and cuffed/uncuffed
• For DLT: type, side, and size (Fr)
• Airway tools — Direct laryngoscopy, Video laryngoscopy, Fibreoptic bronchoscopy, Bougie, Stylet, Awake intubation, Retrograde intubation
• Cormack–Lehane grade — shown when direct or video laryngoscopy is selected
• Ventilation modes — VCV, PCV, PRVC, PSV, CPAP, BiPAP, etc.

Monitoring

Tick all active monitoring modalities:

• Standard: ECG, SpO₂, NIBP, EtCO₂, Temperature
• Extended: IBP, CVP, PA catheter, TEE, BIS, Entropy, NIRS, SSEP/MEP, TOF/NMT, BGL, ABG
• Other: Urinary catheter, Nasogastric tube

Vascular access

Add each IV line, central line, or epidural catheter:

• Site (peripheral IV, CVC — internal jugular, subclavian, femoral; arterial line — radial, femoral, brachial; epidural)
• Size (G for IV, Fr for central lines)

The intraoperative timetable

The timetable is the visual heart of LOSPOR. It displays everything that happens during the case on a shared timeline, with columns representing 5-minute intervals.

How times are recorded

The chart is built from the entries you save, and every screen, the printout and the research export read it the same way.

• An entry takes the time of the row you make it in. In the row the orange "now" line is in, the exact minute is recorded; in any other row, the start of that row. A stop entered in the 21:30 row records 21:30, even if you tap it at 22:19.
• A running infusion, fluid or agent ends at the "now" line, not a row beyond it, and its total counts only the time it actually ran.
• Entries that cannot be right are refused, with a message: a stop before its start, a change or stop of something that is not running, a stop placed before a later change of the same item, and vital signs in the future. Restarting something you stopped is fine.
• Deleting a start deletes its rate changes and its stop with it. On the phone, a delete offers Undo in the bar above the timetable, as an add does; Undo puts the entry back at the same time, a start with its changes and stop. On the web, Ctrl+Z undoes the last change, a delete included.
• "Now" is the server's time, not your device's. A phone or computer whose clock is a few minutes off still puts the now line, and what is planned or given, where they belong. A time you pick is never changed.

Planned entries

You can enter a drug, an event, a start, a rate or gas change, or a stop for a later time, for example a block planned ten minutes ahead. It is shown as a marker (dashed) and counts for nothing, in no total, until its time comes; then it counts as given from its own minute. A stop planned for later is marked on the running bar.

To plan a change to something already running, open a later row: what will still be running then is shown there, dashed (on the web, the running bar continues past now). Choose it to change its rate or settings, or stop it, at that row. This changes the same infusion; do not start the drug again, which would add a second infusion counted alongside the first. Nothing runs on past a planned stop or after the case has ended. A planned change names its time ("Propofol · at 14:35"), and a closed row shows what is planned there.

A stop entered ahead of its time

Stopping something for a time still to come (you expect the infusion to run for another half hour) keeps the bar running until then. When that time comes you are asked, above the chart and in the stop's own row:

• Stopped — it stopped at that time.
• Still running — the stop is taken back and the bar runs on.

The question stays until it is answered. End case asks it too, and a case cannot be finalised while one is open. Moving the stop to a new time asks again when that time comes.

Ending and resuming the case

End case lists everything still running. For each, choose Stop (it stops at the end time) or Continue postoperatively (it keeps running into recovery, and every total, such as fluid volumes and infusion amounts, is counted only up to the end time). Any planned entry still after the end must be marked Happened (moved to the end) or Didn't happen (deleted), and a stop entered ahead that is still unanswered is asked about there too; the case cannot be finalised while one remains.

Before it ends anything, End case checks the intraoperative record the way finalisation will. Anything that would stop the case from being finalised, such as a missing technique or no vital signs on the chart, is listed first, each with a link to where it is fixed, and the case is not ended until it is put right. Items that only deserve a look ask once and let you end the case.

Resume is offered for 30 minutes after the end, also when the case is opened again later, and offers to take back the stops End case made.

A case started 48 hours ago that was never ended, has had nothing saved to it for 48 hours and is not open on any screen ends on its own, at its last recorded entry. It says so when you open it, and Resume takes the end back at any time. A case charted afterwards, with a start typed days back, is never ended while you work on it.

A case open on another screen

One screen edits a case at a time. Any other screen with the case open says who is editing it and saves nothing, including chart entries and vitals autofill; choose Take over editing to change the case there.

If the same entry was changed on two screens (one of them offline), the change made last wins, whichever reaches the server first. The other is listed as refused, saying so.

Whether each entry is saved

Every item on the chart says whether it has reached the server: a small clock while it waits or is being sent, nothing once it is saved, and a red cross if the server refused it. Changes are sent in the order you made them, so a deletion never arrives before the entry it deletes.

A refused change is listed above the chart, with its time, what it was and why (for example, a later change made on another screen), until you mark it Seen. While part of a total has not reached the server yet, the total is shown with "≈"; the number itself does not change.

Vital signs

Click a column in the vital signs graph to enter or edit values for that time point:

• Systolic and diastolic blood pressure (displayed as a red line)
• Heart rate (displayed as a green dashed line)
• SpO₂ (displayed as a cyan line)
• EtCO₂ (optional)

The graph updates in real time as you enter data.

Values worth a second look are marked in amber with a short note, without blocking the save: systolic pressure below 60 or above 300 mmHg, diastolic above 150 mmHg, heart rate below 40 or above 250, SpO₂ below 80 %, EtCO₂ below 25 or above 60 mmHg (3.3 and 8 kPa), and temperature below 28 or above 41 °C.

AI monitor scan: click the camera icon to upload or photograph your anaesthesia monitor screen. Mistral AI reads the display and extracts visible vital signs values into the entry fields. Review before saving.

Privacy

Monitor images are sent to the configured AI provider for text extraction and are not stored by LOSPOR beyond the request. Avoid uploading images that show patient-identifying information.

Gas management

Record the fresh gas flow and composition:

• FGF — fresh gas flow in L/min
• Carrier gas — Air or N₂O (oxygen is always implicit)
• FiO₂ — inspired oxygen fraction (%)

Pediatric safeguards

Pediatric cases never inherit adult drug doses, infusion rates, concentrations, fluid quick values, gas settings, volatile-agent settings, equipment calculations, or ventilation settings. Manual charting remains available. A suggested value is shown only when its exact pediatric profile has completed clinical review.

See Pediatric mode.

Drugs (bolus)

Click + Drug in the timetable to log a bolus drug administration:

• Scenario pills for common workflows such as induction, relaxants, local/regional anaesthesia, opioids, vasoactive drugs, PONV/GI, obstetrics, and rescue drugs
• Favourite drugs selected in Settings
• Browse-all search across the canonical drug catalogue
• Dose and unit (mg, mcg, mL, etc.)
• Route-specific controls where applicable; for example IV lidocaine is entered as a dose, while local/neuraxial/peripheral block lidocaine uses concentration and volume
• The bolus appears as a vertical marker at the selected time point
• Each drug event stores the ATC code for the administered drug, enabling research queries by pharmacological class

Infusions

Add a continuous infusion with start time, end time, drug name, rate, and unit. Mobile/PWA uses the same scenario/favourites/browse pattern as bolus drugs. It appears as a hatched bar spanning the infusion duration.

The syringe and both rates.

• Syringe: pick the syringe the pump holds from the hospital's presets (for example "4 mg/50 mL"), or choose Other to set its amount and volume with sliders.
• Units: the rate can be entered in the drug's own unit, its other dose unit (for example mcg/min beside mcg/kg/min, or mcg/kg/min beside mg/kg/hr for propofol), or as the pump rate in mL/hr. Switching unit carries the value across.
• Both saved: the other rate is read out beside the box, and both are saved.
• Volume: with a syringe chosen, the millilitres given count in the fluid balance. Without one there is no mL total, never a guess.

A local anaesthetic infusion for a child is entered in mL/kg/hr at the strength picked:

• Limit: the slider's maximum follows the strength, so the dose never passes the limit for the child's age: 0.2 mg/kg/hr under 3 months, 0.3 up to 1 year and 0.4 from 1 year.
• Readout: the pump rate and the dose are read out, and the pump rate can be typed instead.

When Start is off, the screen says why: no rate, no strength, or no formulation.

Target-controlled infusions (TCI)

Propofol, remifentanil, sufentanil and alfentanil can be started as Rate or TCI. Choose TCI, then:

• Model:

  Drug	Adults	Children
  Propofol	Marsh, Schnider, Eleveld	Paedfusor, Kataria, Eleveld
  Remifentanil	Minto, Eleveld	Eleveld
  Sufentanil	Gepts	none
  Alfentanil	Maitre	none

  A model that cannot be used for this patient is greyed out, with the reason: for example Schnider or Minto in obesity, where their lean-body-mass formula fails. A patient outside the population a model was built on gets a warning, not a refusal.

• Cp or Ce: whether the pump targets the plasma or the effect-site concentration.

• Given with an opioid (Eleveld propofol only): the model's published switch, on by default.

• Syringe and target: the target is entered like a dose, in mcg/mL for propofol and ng/mL for the opioids. Before you start, LOSPOR shows about how much the pump will give in the first 10 minutes and per hour after that.

During the case:

• Change target: Change asks for a New target.
• On the web: the bar reads "Ce 4 mcg/mL · Schnider", with a thin dashed line for the predicted concentration.
• On the phone: tap a row to see the target and the predicted value at that time ("Propofol Ce 4 mcg/mL ≈3.6").

The total. The amount given is worked out from the model, the targets and the patient's age, weight, height and sex, as a pump would give it (up to 1200 mL/h).

• Pump total: the pump's own total can be entered in mL or in mg/mcg.

  • On the web: from the infusion's menu, on the stop or at any time after it.
  • On the phone: on the Stop sheet, or in End case.

  When entered, it counts, and the model's calculation is shown beside it.

• Missing patient data: without age, weight, height and sex in the preop, the total says that it needs them.

• mL without a syringe: a pump total in mL with no syringe recorded cannot become an amount, and the total says so.

LOSPOR documents a TCI; it never drives a pump. The pump's own total is the one to trust.

Totals use the patient's own measurements. A per-kg drug is counted on the ideal body weight or the actual weight, as the hospital's drug library sets for that drug; the choice is recorded when the infusion starts, so a later change to the library does not alter what was given. A per-m² drug is counted on body surface area. A total counts the minutes the infusion actually ran and adds mg and mcg together. If a drug set to ideal weight has only the actual weight to go on, the total says so with "(TBW)". The same total is shown on the phone, the web and the printed record.

Recorded allergies

A bolus or an infusion is checked against the allergies recorded in the preoperative form, whether typed there or accepted from the hospital system. If the drug matches one, LOSPOR asks before it is charted, naming the allergy and how it matches: the same drug, the same drug class (for example ampicillin with a penicillin allergy) or a possible cross-reaction (for example a cephalosporin with a penicillin allergy, or between neuromuscular blockers).

• Give anyway charts the dose with a note that you saw the allergy. A repeat of that dose keeps the note.
• Don't give charts nothing. A declined infusion is never shown as running.

The question comes only for a dose that can be charted: on a case that has not been started yet, the dose is refused first with "start the case first". On the phone the question opens as a sheet with the same two buttons; closing the sheet any other way counts as Don't give.

The check never blocks: the decision is yours. Allergies it cannot recognise (an unfamiliar name with no drug code) are listed as not checked automatically, beside the preoperative summary on the web and on the Equipment tab on the phone. A dose that matches an allergy and has no note appears as an item worth a look before finalisation.

Volatile agents

Record the volatile agent (Sevoflurane, Desflurane, or Isoflurane) used during the case. It appears as a shaded bar across the case duration.

Two or more agents can run at once, each on its own bar (its own lane on the web). Starting an agent while another runs asks whether to switch (the other is stopped at the same time) or run both.

IV fluids

Add fluid boluses or infusions with type (crystalloid, colloid, blood product) and volume. Each appears as a dotted bar in the event strip.

Pick the product itself and, where offered, its strength (saline 0.9% or 3%, HES 6% or 10%, mannitol 10% or 15%): the research export codes each fluid by exactly that, so a litre of saline and a litre of Hartmann's are told apart. Blood products are entered one unit at a time, by volume; each unit is exported as the product given and its transfusion.

Position

Select the patient position(s) used during the case: Supine, Prone, Lateral, Gynecological, Trendelenburg, Beach chair, Lithotomy, Jackknife, etc.

Premedication

Record the premedication given before the procedure (if different from what was prescribed in the preoperative form).

Each drug has its own dose, range and step for each route. Changing the route replaces the dose with that route's own, even a dose you typed: oral and intravenous doses of the same drug differ up to tenfold. Adult ketamine is recorded as the calculated mg from the recorded weight. Home medicines (warfarin, insulin, levothyroxine, a clonidine patch) start empty, as prescribed. A tablet strength the stepper cannot reach can always be typed.

Fluid balance

At the bottom of the form, a summary of total fluids is automatically calculated from the timetable:

• Crystalloids (mL)
• Colloids (mL)
• Blood products (mL)
• Drug infusions (mL), from each infusion's pump rate (or its TCI total) where the syringe is known
• Urine output (mL)

The total in adds the drug infusions to the fluids. You can also enter urine output and blood loss directly.

Complications

Free text field for intraoperative complications. Common complications (hypotension, bradycardia, bronchospasm, etc.) can be selected from a preset list.

Saving

The intraoperative form auto-saves continuously. Vital signs entered in the timetable are stored the same robust way on web and mobile — each 5-minute column is persisted as its own record the moment you finish typing it, so nothing depends on leaving the page open. If the connection drops, changes queue locally and sync automatically when it returns.

Each section is sent only when something in it changes. Premedication saves as you add, remove or mark it N/A. Urine output and blood loss save shortly after you enter them, and at once when you leave the tab or the form. Opening the form or switching tabs sends nothing.

When complete, click Save & continue to proceed to the postoperative form.

Mobile

On mobile, the intraoperative form uses the same tab-based layout (Overview, Anaesthesia, Timetable/Chart). The timetable adapts to screen width automatically — all controls remain fully reachable on a phone screen.

This live screen is for cases in progress. Once a case is finished it is locked, and opening its timetable from the case summary shows a read-only viewer instead — the printed record's chart, with pinch-to-zoom. See Protocol & Printing.

The Log tab is designed for fast, thumb-friendly event capture. Vital signs entry opens a dedicated sheet with large input fields. Drug and fluid logging use bottom sheets with preset options and confirmation actions.