Toomtong Patiparn, Sriprajittichai Pin, Charuluxananan Somrat, Suratsunya Thanarat, Lapisatepun Worawut
Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2009 Jan;92(1):27-33.
To analyze the incidents of central neurological complication in the Thai Anesthesia Incident Monitoring Study (Thai AIMS).
A prospective descriptive multi-centered study of incident reports was conducted in 51 hospitals across Thailand from January to June 2007. Voluntary and anonymous reports of any adverse events during the first 24 hrs of anesthesia were sent to the Thai AIMS data management unit. Three anesthesiologists reviewed the possible central neurological complication reports. Descriptive statistics was used
There were 16 relevant incident reports of central neurological complications (7 cases of convulsion, 5 cases of cerebro-vascular accident and 4 cases of coma). Majority of patients appeared to be old with underlying co-morbidities undergoing major surgical procedures under general anesthesia and required more intensive intra-operative monitoring. These complications occurred commonly with patients of orthopedics, cardiac, urologic and neurosurgical surgery. The majority of cerebro-vascular accident (80%) and coma (75%) were considered preventable.
Inappropriate decision making and inexperienced anesthesiologists were common contributing factors while suggested corrective strategies were quality assurance activity, clinical practice guidelines and improvement of supervision.
分析泰国麻醉事件监测研究（Thai AIMS）中中枢神经系统并发症的发生率。
2007年1月至6月在泰国全国51家医院开展了一项关于事件报告的前瞻性描述性多中心研究。麻醉前24小时内发生的任何不良事件的自愿且匿名报告被发送至Thai AIMS数据管理单元。三名麻醉医生对可能的中枢神经系统并发症报告进行了审查。采用描述性统计方法。
有16份关于中枢神经系统并发症的相关事件报告（7例惊厥、5例脑血管意外和4例昏迷）。大多数患者似乎为老年患者，有基础合并症，在全身麻醉下接受大手术，且术中需要更密切的监测。这些并发症常见于骨科、心脏、泌尿外科和神经外科手术患者。大多数脑血管意外（80%）和昏迷（75%）被认为是可预防的。
决策不当和麻醉医生经验不足是常见的促成因素，而建议的纠正策略包括质量保证活动、临床实践指南和加强监督。
