[Systematic recording of perioperative events associated with anesthesia as quality indicator in ambulatory anesthesia].
OBJECTIVE
To analyze the quality of several anesthetic techniques used for major outpatient surgery in our hospital, by quantifying for each the relative risk (RR) of adverse events during anesthesia and in the postoperative period.


METHODS
One thousand seventeen patients who underwent surgery between 18 May 1998 and 23 October 1998 were studied retrospectively.


RESULTS
The mean age of the patients was 52.27 +/- 24.65 yr; 44.18% were ASA I, 40.56% were ASA II, 14.56% ASA III and 0.67% ASA IV. Mean time of surgery was 33 +/- 16.49 min and mean recovery time until discharge was 77.3 +/- 93.4 min. Admission was necessary for 0.6% of the patients and re-admission for 0.3%. General anesthesia was used with 19%, anesthetic monitoring with 17%, regional anesthesia (including peribulbar) with 46% and local anesthesia plus sedation with 16.6%. In 95% of the cases, no adverse events occurred during anesthesia; in 94.8% no such events occurred during the early recovery period. During surgery and postoperative recovery, intradural anesthesia was associated with significantly greater RR of adverse events in comparison with general anesthesia (6.6 and 2.2 respectively) and in comparison with monitored anesthesia (7.2 and 3.3). No differences in RR were found between general anesthesia and monitored anesthesia. Problems were slight to moderate in severity and mainly related to nausea and vomiting (2%).


CONCLUSIONS
Recording perioperative events permits evaluation of the quality of anesthesic procedures. Intradural anesthesia is associated with more complications.
García-Aguado
R
R
Unidad de Cirugía Mayor Ambulatoria (UCMA), Hospital General Universitario de Valencia. aguador@arrakis.es
Vivó Benlloch
M
M
Arcusa Mon
M J
MJ
Peiró Alós
C
C
Zaragoza Fernández
C
C
Castaño Conesa
S
S
Grau Real
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000758:Anesthesia / Q000009:adverse effects* / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011786:Quality Control; D012189:Retrospective Studies; D012306:Risk