The Thai Anesthesia Incident Monitoring Study (Thai AIMS) of Postoperative Central Neurological Complications
Patiparn Toomtong MD*, Pin Sriprajittichai MD**, Somrat Charuluxananan MD**, Thanarat Suratsunya MD***, Worawut Lapisatepun MD****
Affiliation : * Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand *** Department of Anesthesiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand **** Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Objective : To analyze the incidents of central neurological complication in the Thai Anesthesia Incident
Monitoring Study (Thai AIMS).
Material and Method: A prospective descriptive multi-centered study of incident reports was conducted in 51
hospitals across Thailand from January to June 2007. Voluntary and anonymous reports of any adverse events
during the first 24 hrs of anesthesia were sent to the Thai AIMS data management unit. Three anesthesiologists
reviewed the possible central neurological complication reports. Descriptive statistics was used.
Results : There were 16 relevant incident reports of central neurological complications (7 cases of convulsion,
5 cases of cerebro-vascular accident and 4 cases of coma). Majority of patients appeared to be old with
underlying co-morbidities undergoing major surgical procedures under general anesthesia and required
more intensive intra-operative monitoring. These complications occurred commonly with patients of orthopedics,
cardiac, urologic and neurosurgical surgery. The majority of cerebro-vascular accident (80%) and coma
(75%) were considered preventable.
Conclusion : Inappropriate decision making and inexperienced anesthesiologists were common contributing
factors while suggested corrective strategies were quality assurance activity, clinical practice guidelines and
improvement of supervision.
Keywords : Convulsion, Cerebro-vascular accident, Coma, Neurological, Complication, Incident reports
