A survey of 112,000 anaesthetics at one teaching hospital (1975–83)

Abstract

This paper describes the outcome of a nine-year post-anaesthetic followup program in a large teaching hospital (N = 112,721 anaesthetics). Between time periods 1975-78 and 1979-83, more seriously ill patients (higher ASA physical status) were being treated. Anaesthetic practice also changed, with an increased use of balanced (multiple drug) anaesthetic procedures, a decrease in the use of halothane and an increase in the use of monitoring. Nonfatal anaesthetic compl&ationsintraoperative, recovery room and postoperative-were rare but there was an increase in the reported complication rate over time. From 1975-78, 7.6per cent of aU cases had at least one intraoperative complication and from 1979-83, this rose to 10.6 per cent of aU cases. For recovery room complications, there was an increase to 5.9 per cent in 1979-83from 3.1 per cent in 1975-78. In time period 2 there was a 9.4 per cent chance of having a postoperative anaesthetic-related complication, and a 0.45 per cent chance of a significant morbidity as a result. This represents an increase over time period 1 (8.9 and 0.40 per cent respectively). It is concluded that the anaesthetic experience, while associated with low mortality rates in recent years, is still associated with significant morbidity. It is conjectural at present whether this is reflective of preoperative patient status, anaesthetic practice, or other undefined variables associated with an operative experience.

Serious intraoperative problems — a five-year review of 83,844 anesthetics

“…10,19,20,37 Cohen and coworkers found that, even with the same recording system, comparisons between hospitals were difficult. 6 However, for departmental use, the frequency and pattern of problems may be useful indicators of quality.…”

Adverse drug errors in anesthesia, and the impact of coloured syringe labels

“…Of the general anesthesia errors two occurred during preparation for anesthesia, 39 during induction, nine during maintenance, and six during emergence. Fifty-six of the drug errors occurred during the day (08-16), six during the evening (16)(17)(18)(19)(20)(21)(22)(23)(24), and one during the night (00-08).…”

Large volume gastroesophageal reflux: a rationale for risk reduction in the perioperative period

“…These 27 cases of aspiration, of which 13 occurred during the postanaesthetic period, led to four deaths and left two patients comatose. In Canada, Cohen et al 13 reported 34 and 38 cases of aspiration of gastric contents in a study of 112,721 anaesthetics during the periods extending from 1975 to 1978 and from 1979 to 1983 respectively, a mean stable incidence of 6.4/10,000. In Sweden, Olsson et ai.…”