Misconceptions about why anesthesia is safer

Posted by Clark Venable on 12/22/2005

Walter Olson has taught me much about the legal system as it pertains to medicine via the PointOfLaw forum. I have to take exception with a post made today however. In pointing to an article that considers whether the lessons of patient safety in anesthesiology are generalizable to other fields of medicine, he writes:

"Incidentally, because anesthesiologists are now more vigilant than ever not to court an overdose risk by giving patients any more than the minimum they need, there is apparently a rising incidence of the phenomenon of "anesthesia awareness", in which underdosed patients are actually aware of the surgery in progress and perhaps end up undergoing psychological trauma as a result. So what happens next? You guessed it."

Overdose risk is not and was never a cause of patient morbidity and mortality in my field. Second, it is not at all clear whether the 'rising incidence of the phenomenon of anesthesia awareness' is anything but a) better reporting (i.e. you don't find what you don't look for) b) realization among patients that there's something else they can sue for or c) an effort by one medical device company which makes depth of anesthesia monitors to panic hospitals and anesthesia groups into buying their product (a product which, by the way, has not been shown to decrease the incidence of awareness).

The specialty is actively engaged in evaluating this 'problem' with the same approach it has used to improve patient safety in other areas such as airway management and positioning injuries.

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    (PointOfLaw Forum : 12/22/2005; 1:46:11 PM)