Publication: Unintended intraoperative awareness: An analysis of Perioperative Anesthetic Adverse Events in Thailand (PAAd Thai)
Issued Date
2021-01-01
Resource Type
ISSN
18786847
09246479
09246479
Other identifier(s)
2-s2.0-85105725903
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Mahidol University
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SCOPUS
Bibliographic Citation
International Journal of Risk and Safety in Medicine. Vol.32, No.2 (2021), 123-132
Suggested Citation
Phuping Akavipat, Jatuporn Eiamcharoenwit, Yodying Punjasawadwong, Siriporn Pitimana-Aree, Wimonrat Sriraj, Prok Laosuwan, Somchai Viengteerawat, Wirat Wasinwong Unintended intraoperative awareness: An analysis of Perioperative Anesthetic Adverse Events in Thailand (PAAd Thai). International Journal of Risk and Safety in Medicine. Vol.32, No.2 (2021), 123-132. doi:10.3233/JRS-200023 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78743
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Title
Unintended intraoperative awareness: An analysis of Perioperative Anesthetic Adverse Events in Thailand (PAAd Thai)
Abstract
BACKGROUND: Despite the improvement of anesthetic-related modalities, the incidence of unintended intraoperative awareness remains at around 0.005-0.038%. OBJECTIVE: We aimed to describe the intraoperative awareness incidents that occurred across Thailand between January to December, 2015. METHODS: Observational data was collected from 22 hospitals throughout Thailand. The awareness category was selected from incident reports according to the Perioperative Anesthetic Adverse Events in Thailand (PAAd Thai) study database and descriptive statistics were analyzed. The awareness characteristics and the related factors were recorded. RESULTS: A total of nine intraoperative awareness episodes from 2000 incidents were observed. The intraoperative awareness results were as follows: experience of pain (38.1%), perception of sound (33.3%), perception of intubation (9.5%) and feeling of paralysis (14.3%). The observed factors that affect intraoperative awareness were anesthesia-related (100%), patient-related (55.5%), surgery-related (22.2%) and systematic process-related (22.2%). The contributing factors were situational inexperience (77.8%) and inappropriate patient evaluation (44.4%). An awareness of anesthetic performer (100%) and experience (88.9%) were defined as incident-mitigating factors. The suggested corrective strategies were quality assurance activity (88.9%), improved supervision (44.4%) and equipment utilization (33.3%), respectively. CONCLUSION: Nine intraoperative awareness incidents were observed, however the causes were preventable. The anesthetic component seems to be the most influential to prevent these events.