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Background: During anesthesia, electrocardiography (ECG) monitoring via electrode pads on the skin is necessary. They are many types of ECG electrode adhesive materials such as paper, polyester, plastic, and foam. Objectives: To study the effect of ECG electrode adhesive materials on ECG monitoring in terms of number of ECG electrode pads per case, ECG quality, user satisfaction, and cost. Methods: We did a randomized controlled trial that studied in patients with age between 18-80 years old, ASA class I-III who received anesthesia at Srinagarind hospital between October and December 2019. We excluded patients who had burned, abnormal ECG, and ischemic heart disease. We stratified patients into the chest, abdomen surgical area group and head, neck, extremities surgical area group for random allocation to receive either paper, polyester, plastic, or foam electrode pads. ECG monitoring was 3 leads placement that connected to minimized interference ECG cable in monitoring mode. We recorded the number of ECG electrode pads per case, ECG quality, user satisfaction, and cost. Results: We included 280 patients into study. Gender, age, ASA classification, surgical position, and duration of anesthesia were comparable. There was no statistically significant difference in number of ECG electrode pads per case, ECG quality. However, paper group and polyester group had higher cost than foam group (p<0.001).And in the head, neck, extremities surgical area group, plastic group had higher user satisfaction than foam group (p=0.007). Conclusions: Types of ECG electrode adhesive materials had no advantage in number of ECG electrode pads per case, ECG quality, and user satisfaction. However, paper group and polyester group had higher cost than others. Keywords: anesthesia, ECG electrode, monitoring
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