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The Role of Anesthesia in Surgical Mortality

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1961

Year

TLDR

The study evaluated 33,224 patients who received either spinal anesthesia or general anesthesia with added muscle relaxants to determine anesthesia’s role in surgical mortality. No anesthesia‑related deaths occurred among physically fit patients, but as patients’ condition worsened, anesthesia contributed to death in 1 of 16 spinal and 1 of 10 general cases, and muscle relaxants showed no inherent toxicity, with deaths linked to procedural errors.

Abstract

The role of anesthesia in contributing to surgical mortality has been studied in 33,224 patients given either spinal anesthesia or a general anesthetic to which muscle relaxants were added. There were no deaths atributable to anesthesia in the 16,000 physically fit patients anesthetized by either technique. As the patients' physical condition worsened, deaths related to anesthesia increased in incidence; in the moribund patients, 1 in 16 patients given spinal anesthesia died of causes related to the anesthetic, and in 1 in 10 patients, general anesthesia could not be excluded as contributing to death. Of 6,000 physically fit patients who received a muscle relaxant, none died. No evidence of an inherent toxicity of muscle relaxants could be found. When deaths were related to the use of muscle relaxants, errors of omission or commission were always apparent.