The Thai Anesthesia Incidents Study (THAI Study) of Ambulatory Anesthesia: Part I: Method, Geographic Distribution and Population
Sureerat Srisawasdi MD*, Yodying Punjasawadwong MD**, Thewarug Werawatganon MD***, Wiroj Pengpol MD****, Prachumpon Kongrit*****, Oraluxna Rodanant MD***, Surasak Tanudsintum MD******
Affiliation : * Department of Anesthesiology, Ramathibodi Hospital, Mahidol University, Bangkok ** Department of Anesthesiology, Chiang Mai University, Chiang Mai *** Department of Anesthesiology, Chulalongkorn University, Bangkok **** Division of Anesthesia, Rajburi Hospital, Rajburi ***** Department of Anesthesiology, Maharaj Nakhonsithammaraj Hospital, Nakhonsithammaraj ****** Department of Anesthesiology, Phramongkutklao College of Medicine, Bangkok
Background : There is a continuing trend to have more elective surgical operations performed on an outpatient
basis.
Objective : To determine the proportional distribution of anesthetic procedures performed in ambulatory
elective surgery at different levels of hospitals across Thailand.
Materials and Methods : A prospective and descriptive study was conducted at 20 hospitals comprising seven
universities, five regional, four general and four district hospitals across Thailand. Consecutive outpatients
who were undergoing elective surgical operation were included and their relevant data were selected and
extracted for summary by using descriptive statistics.
Results : From the database of 118,027 anesthetics performed for elective surgical operation, 7,786 (6.6%)
were outpatients. According to this, 7,016 (90.1%) were practiced in university hospitals, 656 (8.4%) in
regional or tertiary hospitals, 71 (.9%) in general or provincial hospitals, and 43 (0.6%) in district hospitals.
The frequency of the ambulatory anesthesia was higher in hospitals in the central region, especially in
university hospitals in Bangkok than in other regions. The majority of cases (86%) received their initial pre-
anesthetic evaluation in the operating room while 12% were evaluated at the outpatient office. About 28% of
the cases presented with pre-anesthetic abnormal conditions. The relatively common pre-anesthetic diseases
were hypertension, diabetes mellitus, anemia, arrhythmia, and asthma.
Conclusion : From the results of the present study, the authors have concluded that the rate of expansion of
ambulatory anesthesia in Thailand is relatively slow, and varies according to the type of hospital and its
geographic region. This indicates further studies should be formally conducted to determine factors affecting
the practice of ambulatory surgery in Thailand. A large proportion of patients receive initial pre-anesthetic
evaluation in the operating room on the day of surgery. This indicates that a system of pre-anesthetic evalua-
tion should be set up for outpatients such as a pre-anesthetic care clinic should be set up for outpatients.
Keywords : Ambulatory, Anesthesia, Outpatient
