Abstract
The methods of gathering information to determine the safety of anesthesia and to establish the risk of mortality and morbidity include anecdotal tales, in-hospital audit and peer review, reports to medical protective societies, retrospective studies, reviews of specific problems and prospective studies. All these methods have limitations and, in particular, do not readily differentiate the anesthetic from the surgical contributions. However, it appears that over the past 30 years the risk of death directly attributable to anesthesia has decreased from 1 in 2680 to about 1 in 10 000. The main causes of death are faulty anesthetic techniques due to human error, drug overdose, coexistent disease and failure of immediate postoperative care. Equipment failure, poor preoperative assessment, halothane-associated hepatitis and malignant hyperthermia, although often cited in the literature, are rarely the cause of problems associated with anesthesia.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- BEECHER H. K., TODD D. P. A study of the deaths associated with anesthesia and surgery: based on a study of 599, 548 anesthesias in ten institutions 1948-1952, inclusive. Ann Surg. 1954 Jul;140(1):2–35. doi: 10.1097/00000658-195407000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burnham M., Craig D. B. A post-anaesthetic follow-up program. Can Anaesth Soc J. 1980 Mar;27(2):164–168. doi: 10.1007/BF03007781. [DOI] [PubMed] [Google Scholar]
- Cooper J. B., Newbower R. S., Kitz R. J. An analysis of major errors and equipment failures in anesthesia management: considerations for prevention and detection. Anesthesiology. 1984 Jan;60(1):34–42. doi: 10.1097/00000542-198401000-00008. [DOI] [PubMed] [Google Scholar]
- DINNICK O. P. DEATHS ASSOCIATED WITH ANAESTHESIA; OBSERVATIONS ON 600 CASES. Anaesthesia. 1964 Oct;19:536–556. doi: 10.1111/j.1365-2044.1964.tb00423.x. [DOI] [PubMed] [Google Scholar]
- DRIPPS R. D., LAMONT A., ECKENHOFF J. E. The role of anesthesia in surgical mortality. JAMA. 1961 Oct 21;178:261–266. doi: 10.1001/jama.1961.03040420001001. [DOI] [PubMed] [Google Scholar]
- Dundee J. W. Anaesthetists without Althesin. Lancet. 1984 Apr 21;1(8382):909–909. doi: 10.1016/s0140-6736(84)91369-2. [DOI] [PubMed] [Google Scholar]
- EDWARDS G., MORTON H. J., PASK E. A., WYLIE W. D. Deaths associated with anaesthesia; a report on 1,000 cases. Anaesthesia. 1956 Jul;11(3):194–220. doi: 10.1111/j.1365-2044.1956.tb07975.x. [DOI] [PubMed] [Google Scholar]
- Fee J. P., Black G. W., Dundee J. W., McIlroy P. D., Johnston H. M., Johnston S. B., Black I. H., McNeill H. G., Neill D. W., Doggart J. R. A prospective study of liver enzyme and other changes following repeat administration of halothane and enflurane. Br J Anaesth. 1979 Dec;51(12):1133–1141. doi: 10.1093/bja/51.12.1133. [DOI] [PubMed] [Google Scholar]
- Goldman L., Caldera D. L. Risks of general anesthesia and elective operation in the hypertensive patient. Anesthesiology. 1979 Apr;50(4):285–292. doi: 10.1097/00000542-197904000-00002. [DOI] [PubMed] [Google Scholar]
- Goldstein A., Jr, Keats A. S. The risk of anesthesia. Anesthesiology. 1970 Aug;33(2):130–143. doi: 10.1097/00000542-197008000-00006. [DOI] [PubMed] [Google Scholar]
- Harrison G. G. Death attributable to anaesthesia. A 10-year survey (1967--1976). Br J Anaesth. 1978 Oct;50(10):1041–1046. doi: 10.1093/bja/50.10.1041. [DOI] [PubMed] [Google Scholar]
- Hughes D. G., Longan M., Ryan D. W. Blue jumpers and pink trousers. Anesth Analg. 1981 Jun;60(6):453–454. [PubMed] [Google Scholar]
- Kalow W., Britt B. A., Richter A. The caffeine test of isolated human muscle in relation to malignant hyperthermia. Can Anaesth Soc J. 1977 Nov;24(6):678–694. doi: 10.1007/BF03006711. [DOI] [PubMed] [Google Scholar]
- Lunn J. N. Deaths associated with anaesthesia. Anaesthesia. 1979 Mar;34(3):229–230. doi: 10.1111/j.1365-2044.1979.tb06298.x. [DOI] [PubMed] [Google Scholar]
- Lunn J. N., Hunter A. R., Scott D. B. Anaesthesia-related surgical mortality. Anaesthesia. 1983 Nov;38(11):1090–1096. doi: 10.1111/j.1365-2044.1983.tb12486.x. [DOI] [PubMed] [Google Scholar]
- Marx G. F., Mateo C. V., Orkin L. R. Computer analysis of postanesthetic deaths. Anesthesiology. 1973 Jul;39(1):54–58. doi: 10.1097/00000542-197307000-00010. [DOI] [PubMed] [Google Scholar]
- Pugh R. N., Murray-Lyon I. M., Dawson J. L., Pietroni M. C., Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973 Aug;60(8):646–649. doi: 10.1002/bjs.1800600817. [DOI] [PubMed] [Google Scholar]
- Strunin L., Davies J. M. The liver and anaesthesia. Can Anaesth Soc J. 1983 Mar;30(2):208–217. doi: 10.1007/BF03009354. [DOI] [PubMed] [Google Scholar]
- Utting J. E., Gray T. C., Shelley F. C. Human misadventure in anaesthesia. Can Anaesth Soc J. 1979 Nov;26(6):472–478. doi: 10.1007/BF03006159. [DOI] [PubMed] [Google Scholar]
- Writer W. D., Davies J. M., Strunin L. Trial by media: the bupivacaine story. Can Anaesth Soc J. 1984 Jan;31(1):1–4. doi: 10.1007/BF03011475. [DOI] [PubMed] [Google Scholar]
- Wyant G. M., Craig D. B., Pietak S. P., Jenkins L. C., Dunn A. J. Safety in the operating room. Can Anaesth Soc J. 1984 May;31(3 Pt 1):287–301. doi: 10.1007/BF03007890. [DOI] [PubMed] [Google Scholar]
- Zissos A., Strunin L. A micro-computerized anaesthetic record system. Can Anaesth Soc J. 1982 Mar;29(2):168–173. doi: 10.1007/BF03007998. [DOI] [PubMed] [Google Scholar]