The Thai Anesthesia Incidents Study (THAI Study) of anesthetic outcomes: II. Anesthetic profiles and adverse events.

摘要: Background and rationale The purposes of the Thai Anesthesia Incidents Study (THAI Study) anesthetic outcomes were to survey patients, surgical, profiles determine factors related adverse events. Material method A prospective descriptive study occurrence screening was conducted in 20 hospitals comprised 7 university, 4 general district across Thailand. personnel required fill up patient-related, surgical-related, anesthesia-related variables on a structured data entry form. collected during preanesthetic evaluation, intraoperative period 24 hr postoperative period. Adverse events specific forms used record when they occurred. All keyed at management unit with double technique statistics first phase this study. Results total 163403 consecutive cases recorded 12 months. MD. anesthesiologists involved 82%, 89%, 45% 0.2% university hospitals, regional respectively. Nurse anesthetists took major involvement run by Ministry Public Health. Two-thirds did not receive any premedication (67%) midazolam most frequent administered (20%). Common monitoring non invasive blood pressure (NIBP) (97%), pulse oximetry (96%), electrocardiography (80%), urine output (33%), airway (27%) capnometry (19%) choices anesthesia (62%), spinal (23%), intravenous (6%), monitor care (4%), brachial plexus block (3%) epidural (1%). oxygen desaturation (31.9:10000), cardiac arrest (30.8:10000), death within hr. (28.3:10000), difficult intubation (22.5:10000),re-intubation (19.4:10000), unplanned ICU admission (7.2:10000), coma/cva/convulsion (4.8:10000), equipment malfunction/failure (3.4:10000), suspected myocardial ischemia or infarction (2.7:10000), awareness (3.8:10000), late detected esophageal (4.1:10000), failed (3.1:10000), anaphylaxis anaphylactoid reaction (2.1:10000), nerve injury (2:10000), pulmonary aspiration drug error (1.3:10000), hazard (1.5:10000), hospital (0.1:10000), (1.3:10000) mismatch transfusion (0.18:10000) Conclusion Respiratory common direct High incidence highlighted concerns for prevention strategies. can be institutional quality improvement, educational assurance further research patient safety anesthesia.