title: Accidents, near accidents and complications during anaesthesia. A retrospective analysis of a 10-year period in a teaching hospital.
abstract: A retrospective analysis is presented of all reports of faults, accidents, near accidents and complications associated with anaesthesia in one hospital from 1978 to 1987. 113,074 anaesthetics were administered in that period, of which 97,496 were for noncardiac procedures. There were 148 reports; 39 were of dental damage. Peri-operative cardiac arrests during noncardiac surgery were reported 29 times. Sixteen of these were fatal. Anaesthesia was thought to have played an important role in 13 cardiac arrests (1 per 7500 anaesthetics) and six were not successfully resuscitated (1 per 16,250 anaesthetics). There were 12 reports of postoperative peripheral neuropathies (1 per 9422 anaesthetics). Failure to check, lack of vigilance and inattention or carelessness were the most frequently associated factors with the rest of the reports.
authors.affiliation: Department of Anaesthesiology, University Hospital Leiden, The Netherlands.
authors.forename: V
authors.initials: V
authors.lastname: Chopra
authors.forename: J G
authors.initials: JG
authors.lastname: Bovill
authors.forename: J
authors.initials: J
authors.lastname: Spierdijk
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000009:adverse effects* / Q000401:mortality; D000761:Anesthesia Department, Hospital / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality; D006748:Hospital Departments / Q000592:standards*; D006801:Humans; D008508:Medication Errors / Q000706:statistics & numerical data; D008875:Middle Aged; D009426:Netherlands; D059348:Peripheral Nerve Injuries; D012189:Retrospective Studies; D012449:Safety