Publication:
Cardiac arrest and complications after spinal anesthesia: The perioperative and anesthetic adverse event in Thailand (PAAd Thai) incident report study

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Issued Date

2021

Resource Type

Article

Language

eng

File Type

application/pdf

ISSN

1252208

DOI

10.35755/jmedassocthai.2021.04.12401

Other identifier(s)

2-s2.0-85104632366

Rights Holder(s)

Scopus

Bibliographic Citation

Journal of the Medical Association of Thailand. Vol 104, No.4 (2021), p.663-671

Suggested Citation

Sriramatr D., Chongarunngamsang W., Plansangkate P., Laosuwan P., Charuluxananan S., Nimmaanrat S., Pravitharangul T., Angkasuvan W. Cardiac arrest and complications after spinal anesthesia: The perioperative and anesthetic adverse event in Thailand (PAAd Thai) incident report study. Journal of the Medical Association of Thailand. Vol 104, No.4 (2021), p.663-671. doi:10.35755/jmedassocthai.2021.04.12401 Retrieved from: https://hdl.handle.net/20.500.14740/7839

Title

Cardiac arrest and complications after spinal anesthesia: The perioperative and anesthetic adverse event in Thailand (PAAd Thai) incident report study

Author(s)

Sriramatr D.
 Chongarunngamsang W.
 Plansangkate P.
 Laosuwan P.
 Charuluxananan S.
 Nimmaanrat S.
 Pravitharangul T.
 Angkasuvan W.

Abstract

Background: Spinal anesthesia is one of most common anesthetic techniques in Thailand. The Perioperative and Anesthetic Adverse Events in Thailand (PAAd Thai) Study was a multicentered project among 22 hospitals across the country to investigate the incidence of anesthesia related complications. Objective: To study the incidences of cardiac arrest and complication after spinal anesthesia including the contributing factors and suggested corrective strategies. Materials and Methods: This prospective descriptive study of the incident reports that occurred regarding spinal anesthesia collected from 22 participating hospital in the data collection between January and December of 2015 was completed. Three senior anesthesiologists reviewed the data and descriptive statistics were used. Results: Among 62,120 spinal anesthesia, there were 127 incidents (5.8%) among 2,206 incident reports related to anesthesia. There were seven cases of intraoperative cardiac arrest with an incidence of 1.13:10,000 spinal anesthesia (95% CI 0.55 to 2.33). Other complications were bradycardia with less than 40 beats per minute (50.4%), anaphylaxis or anaphylactoid reaction or drug allergy (14.2%), drug error (8.4%), coma or CVA or convulsion (3.9%), and suspected pulmonary embolism (3.9%). Adverse events occurred frequently with specialties or surgeries of orthopedics (44.1%), cesarean delivery (17.3%), urosurgery (17.3%), general surgery (14.2%), and gynecological surgery (4.7%), respectively. Conclusion: Contributing factors were inexperience, inappropriate decision making, haste, and inappropriate pre-anesthetic evaluation or preparation while factors minimizing incidents were vigilance, having experience, and experienced assistants. Suggested corrective strategies were quality assurance activity, guidelines especially monitoring, improvement of supervision, and additional training. © Journal of the Medical Association of Thailand | 2021

Subject(s)

Ampicillin
 Antihistaminic agent
 Atracurium besilate
 Atropine
 Bupivacaine
 Cephalosporin
 Chlorpheniramine
 Clindamycin
 Cloxacillin
 Dexamethasone
 Ephedrine
 Gelatin succinate
 Hypertensive factor
 Infusion fluid
 Ketorolac
 Methacrylic acid methyl ester
 Midazolam
 Morphine
 Oxygen
 Penicillin derivative
 Pethidine
 Polygeline
 Suxamethonium
 Adolescent
 Adult
 Aged
 American Society of Anaesthesiologists score
 Anaphylaxis
 Anesthesia complication
 Article
 Blood pressure
 Bradycardia
 Central venous pressure
 Cerebrovascular accident
 Cesarean section
 Child
 Coma
 Convulsion
 Decision making
 Electrocardiography
 Female
 General surgery
 Gynecologic surgery
 Heart arrest
 Heart muscle ischemia
 Human
 Immune system
 Incidence
 Lung embolism
 Major clinical study
 Male
 Mean arterial pressure
 Morphine
 Multicenter study
 Observational study
 Open reduction (procedure)
 Orthopedic surgery
 Oxygen desaturation
 Peripheral nerve injury
 Peroperative complication
 Pulmonary aspiration
 Rash
 Return of spontaneous circulation
 Spinal anesthesia
 Urologic surgery
 Very elderly

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URI

https://hdl.handle.net/20.500.14740/7839

Collections

Scopus: Year 1983-2021

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