Clinical Analysis of Anesthesia for Emergency Operation / 대한마취과학회지

ABSTRACT

We analyzed 1468 cases of anesthesia for emergency operation which were performed at the department of anesthesiology, Yongsan hospital from January 199l to December 1992. The patients were evaluated according to clinical department, age, sex, disease, ASA classification of physical status, day month, beginning time of operation, anesthetic method, duration of operation or anesthesia, perioperative patient care, past history of operation, operator and insurance. The results were as follows; 1) The percentage of anesthesia for emergency operation was 17.8 % of total anesthetic cases. 2) The departmental distribution was general surgery(47.3%), obstetrics and gynecology(19.0%), neurosurgery(14.6%) and orthopedic surgery(l1.2%). The greatest number of patients was found in the 20-29 years of age consisting of 30.9% of the patients. The male patients comprised of 51.6% while the female patients comprised of 48.4 % of the patients. 3) Most common diseases were appendicitis(57.8%) in general surgery, Cesarean section(50.2%) and ectopic pregnancy(30.8%) in obstetrics and gynecology, ICH(38.3%), EDH(20.1%) and SDH(20.l%) in neurosurgery, tendon rupture(11.0%) and tibia frature(9.8%) in orthopedic surgery. 4) The majority of patients were classified as ASA 2E comprising of 58.6% of the patients. 5) The greatest number of emergency operations was performed on Saturday(16.8%) and in August(10.3%). 6) 45% of emergency operations was performed during 12-18 oclock. 7) The anesthetic methods for emergency operation were inhalational anesthesia(94.3%), regional anesthesia(4.6%) and intravenous anesthesia(l.1%). 8) The percentage of duration of anesthesia and operation which was less than one hour was 70.1% and 77.7%, respectively. 9) 81.1% of patients who underwent the emergency operation was cared in the emergency room preoperatively, and 78.3% of operated patients was transferred to ward. 10) Concerning the past operation history 66.3% of patients never had the operation history, and 26.0% of them underwent operation once, 11) 84.6% of emergency operations was performed by staff doctors, arid 15.4% of them was performed by residents. 12) Concerning the classification of insurance the percentage of medical insurance was 83.4%, and 10.1% of the patients didnt reeeive favors of any type of insurance. Conclusively, in proportion as patients for emergency operation are incresing, the importance of anesthetic management for them is being emphasued. Therefore anesthesiologists have to focus on perioperative anesthetic management and postoperative care in recovery room and ICU to decrease the incidence of complications, morbidity and mortality of emergency operation.