Cardiac arrest during regional and general anaesthesia (retrospective 10 year study)

Abstract

Cardiac arrest and death may occur unexpectedly. The aim of this study was to analyse retrospectively the occurrence of cardiac arrest over a 10 year period. Cardiac arrests which occurred during regional and general anaesthesia between 1985 and 1994 were analysed retrospectively. Patients with uncontrollable haemorrhage or with terminal illness were not included in this study. Eighteen cardiac arrests occurred in 67.970 general anaesthesia cases (1/3.762) and in 3 out of 3.525 patients who received regional (spinal-epidural) anaesthesia (1/1.175). In the general anaesthesia group 9 resuscitations were not successful (mortality; 1/7.907). Of the 9 patients who were successfully resuscitated 7 subsequently died. The 2 successful resuscitations were discharged from hospital in healthy condition. In the regional anaesthesia group, 3 cases of cardiac arrest were not successfully resuscitated. In the general anaesthesia group the causes of cardiac arrests included hypotension due to haemorrhage (5 cases; 27.7%), hypoxia (12 cases; 66.6%), ill-advised usage of intravenous drugs (1 case; 5.7%). Following regional anaesthesia, the cause of cardiac arrest was hypotension. We conclude that the occurrence of cardiac arrest is associated with the physical status of patient (ASA classification), emergency surgery, the judgement and skill of the physicians, and inadequate patient monitoring.