Surveillance of anesthetic related complications at Srinagarind Hospital, Khon Kaen University, Thailand.

ABSTRACT

OBJECTIVE: To identify the incidence of common anesthetic complications in 2003 at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand and find the strategies for prevention. MATERIAL AND METHOD: The study was part of a multi-center study conducted by the Thai Royal College of Anesthesiologists to survey anesthetic related complications in Thailand in 2003. The authors collected data from all the cases receiving anesthesia service at Srinagarind Hospital between January 1 and December 31, 2003, to report the incidence of common anesthetic complications and to assess the need to improve the quality of service. This was a prospective, descriptive study. When any anesthetic complications occurred, they were reported by anesthesia personnel and anesthesiologists. The reporting forms comprised four categories of complications, viz. respiratory, cardiovascular, neurological and others. Each category of complications has a guidebook for reference in order to correctly fill out the form. All the forms were verified by the principal author then included in the present study. RESULTS: A total of 10,607 patients were included and among these 268 incidents were recorded. The common incidents per 10,000 were desaturation (95.22), cardiac arrest (44.31), re-intubation (29.23), equipment failure (19.80) and difficult intubation (18.86). Main contributing factors were insufficient knowledge and inappropriate decisions. Suggested corrective strategies included quality assurance activities, additional training and improved supervision. CONCLUSION: Despite practical prevention guidelines being in place, the most common anesthesia incident at Srinagarind Hospital was respiratory incident. Continuing quality improvement is needed.