[Critical anesthetic incidents in Uruguay - ten years after: comparative study (1990-2000).]

A survey of Critical Incidents (CI) in Anesthesia is described. Year 2000 results are compared to those obtained in 1990 in search for CI pattern changes throughout this decade.

Two different forms were used: the first, F1, was a list of predetermined CI to determine the relative frequency of each incident. The second, F2, requested the description of a specific incident chosen by the respondent.

In F1 forms, 9482 CI were recorded and the 13 most frequent CI accounted for 50% of events. Results were very similar to those found in 1990, since among the most frequent, 9 CI were repeated in both surveys. First and second most common incidents were also repeated: difficult intubation and arrhythmias. In form F2, 20% of CI had fatal consequences. Five CI accounted for 54% of deaths were due to 5 CI: unexpected cardiac arrest, pulmonary thromboembolism, acute myocardial infarction, vomiting aspiration and hypovolemic shock. Respiratory incidents accounted for 46% of CI, and 24% were due to hemodynamic causes. It is to be noted a significant CI increase during recovery and in the immediate postoperative period. Patients clinical observation accounted for 63% CI detection. A substantial increase in unpredictable events has been identified.

CI diversity was maintained with decreased respiratory events, although these are still the most frequent. There is a sharp decrease in severe hypoxia accidents related to esophageal intubation and nitrous oxide as single gas. Hemodynamic incidents severity was maintained.