The implications of a national study of risk of anaesthesia

In order to set up measures to improve safety in anesthesia, the French Ministry of Health charged the Institut National de la Santé et de la Recherche Médicale (I.N.S.E.R.M.) with conducting an epidemiological survey of complications associated with anaesthesia. A prospective survey was carried out from 1978 to 1982 in a representative sample of 198,103 anaesthesias performed in 460 public and private institutions randomly selected throughout the country. There were 268 major complications associated with anaesthesia occurring during or within 24 hours after anaesthesia (incidence 1.35 per 1000), among these 67 were followed by death and 16 by coma. The incidence of deaths and comas totally attributable to anaesthesia was one per 7924. Half of the deaths and comas totally attributable to anaesthesia were from post-anaesthetic respiratory depression which could be directly linked to a dramatic lack of recovery rooms. The extension of the study to all institutions revealed that 25% of teaching hospitals, 43% of non-teaching hospitals and 20% of private clinics did not have a recovery room available. A total number of 12,000 recovery beds was estimated to be necessary in France; 40% being currently available leaving 60% to be created.