Retrospective Audit of Critical Events under Anesthesia at Tertiary Care Nephro-Urology Set Up
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 6
Abstract
Introduction: Critical events under anesthesia can cause sudden and dramatic complications. Recognition and analysis of such events helps to improve OR practices (in order to prevent recurrence of the same); thereby improving the overall quality of anesthetic practice. Unlike other countries which have national registries to capture such incidents, India relies on a voluntary and non-standard reporting of critical incidents under anesthesia. None of these papers have studied anesthesia-related complications in patients who have predominant renal dysfunction. Materials and Methods: A retrospective audit was performed of all critical incident reports filed in our department from 01/01/2015 to 31/12/2015. The data was analyzed to identify the incidence, causes and outcomes of these events. Results: Of 1217 anaesthetics administered, 2.54% of patients had reported adverse events during surgery. Most complications occurred in the elderly patients (41.9%) and those who were ASA grade III or above (45.1%). More than half (54.8%) of the complications involved the cardiovascular system. There were two deaths during this period (mortality=0.16%). Conclusions: Though anesthesia related complications have declined dramatically with the use of advanced monitoring and safer drugs, there is still potential for improvement. Use of checklists and standard protocols can help mitigate much of the human error associated with these critical events. The larger proportion of cardiovascular complications in our patients is probably a reflection of the higher incidence of cardiovascular complications in patients who have renal dysfunction.
Authors and Affiliations
Alka S. Deo
Peri-Operative Considerations in Gout and Hyperuricemia: A Narrative Review
Gout is a chronic metabolic, inflammatory disease causing hyperuricemia with formation and deposition of monosodium urate crystals in joints, tissues and involving multiple systems. It has important anaesthetic and criti...
A comparative study of Inj. Bupivacaine 0.5% and Inj. Ropivacaine 0.5% for Supraclavicular Brachial Plexus Block
Context: Bupivacaine is a commonly used local anesthetic in peripheral nerve blocks. Ropivacaine is a newer local anesthetic and has better safety profile. The study was done to compare the two drugs. Aims: To compare th...
Effect of Etomidate and Propofol on the Onset of Neuromuscular Blockade a Randomized Prospective Comparative Study
The onset time of neuromuscular blockade can be influenced by factors such as hypnotics which interfere with muscle blood flow and muscle relaxation induced by nondepolarizing neuromuscular blockers. Aim: This study was...
Oral Premedication in Paediatric Surgeries under General Anaesthesia with Ketamine versus Midazolam: A Comparative Study
Background: Pre-operative anxiety (anxiety regarding impending surgical experience) in children is a common phenomenon that has been associated with a number of negative behaviors during the surgical experience (e.g. agi...
Prevention of Hypotension Following Subarachnoid Block; Efficacy of Preloading with Hydroxyethyl Starch Versus Ringer’s Lactate Solution
Background: Arterial hypotension is a potential hazard associated with spinal anesthesia. Routinely, crystalloids and colloids are used for managing hypotension. While crystalloids easily move out of the intravascular sp...