Evidence Based Practice and Quality Assurance
Background: The anesthetics adverse events in a tertiary hospital in the Middle East have not been previously reported.
Aim of the Study: A prospective study of the major adverse anesthetic events and its relation to patient physical status.
Methods: Data from 36313 non-cardiac anesthetic were collected over 5 years (1994-1999) American Society of Anesthesiologist's Classification (ASA) was used for preoperative physical status assessment. Adverse events were recorded in the operating room by the anesthesiologist, Post-Anesthesia Unit (P.A.C.U) and postoperative within 24 hours by an anesthetist. Data were encoded using a customized database. Cardiac arrest, aspiration, neurological deficits, and death were analyzed using SAS software.
Results: ASA (3.4.5) were 29.9%, (2) was 39.6%, and (1) was 30.5%. Results were reported as rates/10,000 anesthetics. Cardiac arrest was encountered in (5.51). Intraoperative was (3.03) and PACU was (2.48) and its relationship to ASA was highly significant (p-value < 0.001). Aspiration was encountered in 1.9 anesthetics: intraoperatively (1.38) and PACU (0.55). Neurological deficits occurred in (2.2). The peri-operative mortality rate was (4.13) intraoperative was (0.083) and PACU was (1.65) and postoperative within 24 hours was (1.65), its relations to ASA were highly significant (p ≥ 0.0001). The percentage of aspiration and neurological events are related to the ASA classification but not statistically significant, because of the insufficient number of events. No major complication was recorded in caesarian sections.
Conclusion: The incidence of adverse events correlates with ASA physical status classifications. Preoperative identification and treatment of patient risk factors could improve anesthetic outcome.