A study of anaesthesia-related cardiac arrest from a Chinese tertiary hospital

Abstract

BackgroundThe present survey evaluated the incidence of perioperative cardiac arrests in a Chinese tertiary general teaching hospital over ten years.MethodsThe incidence of cardiac arrest that occurred within 24 h of anaesthesia administration was retrospectively identified in the Third Affiliated Hospital of Sun Yat-Sen University between August 2007 and October 2017. Overall, 152,513 anaesthetics were included in the study period. Data collected included patient characteristics, American Society of Anaesthesiologists (ASA) physical status score, surgical specialty and anaesthesia technique. Cardiac arrests were assigned to one of three groups: “anaesthesia-related”, “anaesthesia-contributing” or “anaesthesia-unrelated”.ResultsIn total, 104 cardiac arrests (6.8:10,000) and 34 deaths (2.2:10,000) were obtained. Among them, eleven cardiac arrests events were anaesthesia-related, resulting in an incidence of 0.7 per 10,000 anaesthetics. Sixteen cardiac arrests events were found to be anaesthesia-contributing, resulting in an incidence of 1.0 per 10,000 anaesthetics. Cardiovascular adverse events were the major events that contributed to anaesthesia-related cardiac arrest. Differences were found between events related and unrelated to anaesthesia with regard to ASA physical status and anaesthesia technique (P < 0.05).ConclusionsAnaesthesia-related cardiac arrest occurred in 11 of 104 cardiac arrests within 24 h of anaesthesia administration. Most cardiac arrests related to anaesthesia were due to cardiovascular events, including arrhythmia and hypotension after intravenous narcotic, as well as haemorrhage. ASA physical status of at least 3 and subarachnoid block appeared to be relevant risk factors for anaesthesia-related cardiac arrest.

Anaesthesiology in China: present and future

“…From the 1990s to the 2000s, the global incidence of perioperative cardiac arrest ranged from 6.59/10 000 anaesthesia cases in highly developed countries to 20.68/10 000 in less-developed countries. 6 The incidence rates of overall and anaesthesia-related cardiac arrests in a Chinese tertiary hospital over a recent 10-yr period (2007e2017) were 6.8/10 000 and 0.7/10 000 anaesthesia cases 7 ; these values were comparable with those of highly developed countries [according to the Human Development Index (HDI) set by the United Nations Development Programme], such as USA, 8 Germany, 9 and Brazil. 10 In China, general anaesthesia accounts for~80% of anaesthetic procedures in most hospitals.…”

Adductor Canal Block in the Outpatient Clinic for Pain Control Following Knee Surgery

“…Although vascular injuries resulting from peripheral nerve blocks are rare complications, the risk of bleeding due to anticoagulation status is also concerning. (5)(6)(7)(8). The recently updated (2018) American Society of Regional Anesthesia (ASRA) guidelines recommend waiting 72 h after the last dose of apixaban for the block procedure (9).…”

Adductor Canal Block in the Outpatient Clinic for Pain Control Following Knee Surgery

“…The Visual Analogue Scale (VAS) score was used to evaluate the patients' pain during the knee rehabilitation program every two days in POD 5,7,9,15,17,19,21,23,25,27,and 29. We also evaluated the dose of analgesic (etoricoxib) consumption.…”

“…Damage to the vascular during peripheral nerve block is a rare complication. The bleeding risk due to anticoagulant drug use should be considered by the operator (17)(18)(19)(20). A recent update of American Society of Regional Anesthesia (ASRA) guidelines in 2018 recommended waiting 72 hours after the last dose of the anticoagulant drug for the block procedure (21).…”