MORBIDITY AND MORTALITY ASSOCIATED WITH ANESTHESIA

The incidence of serious complications associated with Anaesthesia app ears to have decreased in recent years. There are many reasons for thi s - better anaesthetic drugs and equipment, widespread availability of modern monitoring devices, improved standards of pre-, intra- and pos toperative care, increasing interest in techniques to identify and con trol common risk factors and increased number of qualified anaesthetis ts. Nevertheless, accidents continue to occur. The most common cause o f death or serious injury is still failure to ventilate the patient. A ll recent studies agree that the majority of accidents in modern pract ice are the consequence, not of equipment failure or adverse drug reac tions, but of human error. Mistake, lack of vigilance, inexperience, i nadequate supervision and failure of communication are identified as r ecurring problems. These problems need to be addressed if anaesthesia- related complications are to be further decreased. It seems reasonable to suggest that the use of anaesthesia simulators to train and test a naesthetists in difficult situations should be given a higher priority - both in basic training and in continued postgraduate education. Fur thermore, since anaesthesia-related adverse outcomes are rare, strict safety procedures must be applied to thousands of patients in order to prevent one catastrophe. During times of increasing competition for h ealth care money, anaesthetists must be resolute in defending and impr oving standards of training, monitoring and clinical care. Otherwise t he substantial improvement in anaesthesia practice accomplished over r ecent years may quickly be lost again. (C) Acta Anaesthesial Scandinav ica 40 (1996).