Regional Anesthesia Surveillance System: first experiences with a quality assessment tool for regional anesthesia and analgesia.
BACKGROUND
The incidence of complications related to regional anesthesia and analgesia is hardly known and estimates are based on extrapolation from controlled trials, insurance registries and retrospective chart reviews and only a few attempts of prospective data collection have been made. We designed a surveillance system for regional anesthesia for easy and reliable data acquisition.


METHODS
A list of definitions of complications and quality indicators of interest was created and introduced in a single institution. Data are collected within the hospital information system and by individual reports of complications from trained reporters in the Acute Pain Service. A data cross-check is performed by the Surveillance coordinator.


RESULTS
We present complications rates for 9790 catheter days and 4547 punctures for continuous neuraxial and peripheral nerve blocks between October 2003 and January 2006. Most complications were related to catheter dislocation and 'wet taps'. Serious complications such as neurologic deficits, bleeding complications and infections were rare. Data quality reached 98% reliability of complication coding.


CONCLUSIONS
This is the description of a prospective regional anesthesia surveillance system, which currently allows longitudinal analysis of performance parameters at a single institution and will provide data about the incidences of complications related to regional anesthesia and analgesia in the future.
Schulz-Stübner
S
S
Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. Sebastian-schulz-stubner@uiowa.edu
Kelley
J
J
D000767:Anesthesia, Epidural / Q000009:adverse effects*; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007484:Iowa / Q000453:epidemiology; D009407:Nerve Block / Q000009:adverse effects*; D011159:Population Surveillance; D011183:Postoperative Complications / Q000145:classification* / Q000453:epidemiology / Q000209:etiology; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration; D012042:Registries; D018461:Soft Tissue Infections / Q000145:classification / Q000453:epidemiology / Q000209:etiology