Risk Management in Anesthesia Practice: A Systematic Review Across the Five Stages of Risk Control

Abstract

Risk management is a cornerstone of patient safety in anesthesia, where complex procedures, physiological variability, and time-critical decisions create inherent risks. Effective risk control requires a structured approach that spans all phases of anesthesia care. The present review systematically examined the five stages of risk management, which are risk awareness, risk identification, risk assessment, risk management, and risk evaluation, within anesthesia practice. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science for articles published between January 2000 and December 2024, using the keywords “anesthesia”, “risk management”, “patient safety”, and “perioperative”. Inclusion criteria were peer-reviewed studies, guidelines, and systematic reviews addressing any stage of anesthesia risk management. Findings highlight that anesthesia risks arise from human factors, equipment/technical failures, environmental conditions, and hospital system issues. Successful strategies include preoperative briefings, structured checklists, incident reporting, root cause analysis, and implementation of validated risk matrices. Continuous feedback and integration with hospital safety systems enhance sustainability. For anesthesia providers, applying a stage-based model promotes early hazard recognition, prioritization of high-impact risks, and targeted preventive measures. Embedding these processes into daily practice not only reduces adverse events but also fosters a culture of safety, improving both patient outcomes and team performance.