The Thai Anesthesia Incidents Study (THAI Study) of perioperative convulsion

Objectives: To identify the incidence of perioperative convulsion within 24 hours, outcome, predisposing risk factors, contributing factors related to anesthesia and corrective strategies. Material and Method: The prospective cohort study enrolled all anesthetics from twenty eligible hospitals in Thailand between March 1, 2003, and February 28, 2004. Postoperative convulsion incidents were extracted from the Thai Anesthesia Incidents Study (THAI Study) database in terms of demographic data, details of events, outcome, contributing factors related to anesthesia and corrective strategies. Results: The incidence of perioperative convulsion was 3.1 per 10,000 from all 172,592 anesthetics. Most patients (73.59%) recovered in 24 hours. The majority of risk factors were related to surgery (67.92%) and patient factors (54.72%) while anesthesia was the minor factor (30.19%). The contributing factors related to anesthesia were medication error (route, type, time) 43.75% and human error (inadequate care, inadequate knowledge, inadequate communication) 43.75%. The important corrective strategies included improved supervision and clinical practice guideline. Conclusion: The incidence of postoperative convulsion was 3.1 per 10000. Anesthesia was the minor contributing factor. The most important risk factors included medication error and human error.