TITLE:
Anesthesia Alert—A Preoperative Safety Concept for the Surgeon
AUTHORS:
Bogdan Protyniak, Paul Pearce, Luciana Giambarberi, Atul Kumar, Michael A. Goldfarb
KEYWORDS:
Difficult Airway, Anesthesia Complications, Operating Room Safety
JOURNAL NAME:
Surgical Science,
Vol.6 No.4,
April
14,
2015
ABSTRACT: Background: Advances in modern
medicine and surgical technique have allowed patients with multiple
comorbidities to undergo invasive surgery electively. This places additional
stress on hospital resources to anticipate and deal with potential
complications. We have introduced a preoperative safety concept called
“Anesthesia Alert”. The surgeon or preoperative interviewing anesthesiologist
assigns an Anesthesia Alert when booking to denote possible difficulty with
anesthesia induction or intubation. As a result, two anesthesiologists and
fiber optic equipment are made available on the day of surgery. Methods: A
retrospective study of patients from all surgical specialties who were assigned
Anesthesia Alerts between January 2012 and November 2012. Records were analyzed
for reasons requiring Anesthesia Alerts. Patient demographics, comorbidities,
and perioperative complications were reviewed. Results: A total of 112 patients
formed this study group. Difficult airway comprised the majority of Anesthesia
Alerts (n = 75, 67.0%). Hypertension was the most prevalent comorbidity among
patients. There were only 7 patients (6.3%) admitted to the ICU postoperatively
and no mortalities. Conclusion: Perioperative patient safety is an evolving
concept that requires a team approach amongst the surgeon, anesthesiologist,
and operating room staff. An Anesthesia Alert raises awareness for possible
complications during anesthesia induction as well as allocates resources to
increase patient safety and avoid preoperative delays. Most importantly, this
concept places the onus on the surgeon to alert the anesthesiologist for
possible complications during induction and extubation.