Tingting Huo1, Li Sun1, Su Min2, Wenzhi Li3, Xinhua Heng4, Lijun Tang5, Shengmei Zhu6, Hailong Dong1, Qiang Wang1, Lize Xiong7. 1. Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, PR China. 2. Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, PR China. 3. Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, PR China. 4. Department of Anesthesiology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, PR China. 5. Department of Anesthesiology, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai 200081, PR China. 6. Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, PR China. 7. Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, PR China. Electronic address: mzkxlz@126.com.
Abstract
STUDY OBJECTIVE: To determine the incidence of major complications in patients undergoing regional anesthesia (RA) in China. DESIGN: Multicenter prospective survey. SETTING: Eleven teaching hospitals in China. PATIENTS AND INTERVENTIONS: A total of 106,569 patients undergoing RA from April 1, 2009, to April 30, 2011, were involved. MEASUREMENT: Information on patients, types of surgery, and RA techniques was collected with a standardized chart. After RA, the patients were followed up by an investigator in each center for 1 to 3 weeks according to the patient's condition. Data were integrated and analyzed with a structured query language server system. MAIN RESULTS: Among the patients undergoing RA, 37 developed major complications, including Horner syndrome (n = 9; 0.84/10,000), recurrent laryngeal nerve blockade (n = 6; 0.56/10,000), cardiac arrest (n = 1; 0.09/10,000), hematoma (n = 2; 0.19/10,000), seizures (n = 5; 0.46/10,000), catheter break (n = 1; 0.09/10,000), paraplegia (n = 1; 0.09/10,000), cauda equina syndrome (n = 2; 0.19/10,000), and extensive neuraxial block (n = 10; 0.94/10,000). The incidence of major RA complications varied from 0.8/10,000 to 18.8/10,000 among centers and was highest in cervical plexum block. Plastic surgery had the highest incidence of complications (19.0/10,000), most of which were recurrent extensive neuraxial block. The total incidence of major RA complications was 3.47/10,000. CONCLUSION: This large, multicenter, prospective survey revealed the incidence of major complications after RA in China's hospitals. Although severe complication like cardiac arrest is rare, it is distressing and challenging. Hence, there is still a room to improve on daily basis to further reduce complications related to RA.
STUDY OBJECTIVE: To determine the incidence of major complications in patients undergoing regional anesthesia (RA) in China. DESIGN: Multicenter prospective survey. SETTING: Eleven teaching hospitals in China. PATIENTS AND INTERVENTIONS: A total of 106,569 patients undergoing RA from April 1, 2009, to April 30, 2011, were involved. MEASUREMENT: Information on patients, types of surgery, and RA techniques was collected with a standardized chart. After RA, the patients were followed up by an investigator in each center for 1 to 3 weeks according to the patient's condition. Data were integrated and analyzed with a structured query language server system. MAIN RESULTS: Among the patients undergoing RA, 37 developed major complications, including Horner syndrome (n = 9; 0.84/10,000), recurrent laryngeal nerve blockade (n = 6; 0.56/10,000), cardiac arrest (n = 1; 0.09/10,000), hematoma (n = 2; 0.19/10,000), seizures (n = 5; 0.46/10,000), catheter break (n = 1; 0.09/10,000), paraplegia (n = 1; 0.09/10,000), cauda equina syndrome (n = 2; 0.19/10,000), and extensive neuraxial block (n = 10; 0.94/10,000). The incidence of major RA complications varied from 0.8/10,000 to 18.8/10,000 among centers and was highest in cervical plexum block. Plastic surgery had the highest incidence of complications (19.0/10,000), most of which were recurrent extensive neuraxial block. The total incidence of major RA complications was 3.47/10,000. CONCLUSION: This large, multicenter, prospective survey revealed the incidence of major complications after RA in China's hospitals. Although severe complication like cardiac arrest is rare, it is distressing and challenging. Hence, there is still a room to improve on daily basis to further reduce complications related to RA.