The Thai Anesthesia Incidents Study (THAI Study) of Ambulatory Anesthesia: II Anesthetic Profiles and Adverse Events

Background: There is a continuing trend to have more elective surgery performed on an outpatient basis. Objective: To determine anesthetic profiles and adverse events in practice of ambulatory anesthesia for elective surgery in different levels of hospitals across Thailand. Material and Method: A prospective descriptive study was conducted in 20 hospitals comprising seven university, five regional, four general and four district hospitals across Thailand. Consecutive patients undergoing anesthesia for elective surgery were included. The included patients, classified as outpatients, were selected and extracted for summary of the result by using descriptive statistics. Results: The authors reported 7786 outpatients receiving anesthesia for elective surgery. The majority of patients were in ASA class 1 and 2 (96.2%) while the rest were in ASA class 3 (3.8%). Nearly 90 % of the ASA class 3 patients were in university hospitals. The majority of patients (83.1%) did not receive premedication. Diazepam was used more frequently (11.5 % vs. 0.1%) than other drugs. Noninvasive blood pressure monitoring and pulse oximetry were used in greater than 90%, while electrocardiogram (EKG) was used in 67.2 % and end tidal CO2 in only 6.8%. The three most common anesthetic techniques were general anesthesia (including inhalation anesthetics), total intravenous anesthesia (TIVA), and monitored anesthesia care (MAC). Regional anesthesia was performed in 12 % of cases. The three most common regional anesthetic techniques were brachial plexus block (7.1%), spinal anesthesia ( 2.21%), and other peripheral nerve blocks (2.06%). Propofol was th