A study upon the Cardiac Arrest during Operation.

Kim,  Yong Lak; Lee,  Kook Hyun; Moon,  Hyun Soo; Park,  Young Kwan; Kim,  Dong Hee

doi:1993.26.6.1104

Clinical Research Article

Korean Journal of Anesthesiology 1993;26(6):1104-1110.
DOI: https://doi.org/10.4097/kjae.1993.26.6.1104

A study upon the Cardiac Arrest during Operation.

Yong Lak Kim, Kook Hyun Lee, Hyun Soo Moon, Young Kwan Park, Dong Hee Kim

¹Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.
²Department of Anesthesiology, Puchon Sejong General Hospital, Korea.
³Department of Anesthesiology, Seoul Neurosurgical Clinic, Korea.

Abstract

Medical and mortality records of 50 cases of cardiac arrest that occurred during surgery at the operating room in the Seoul National University Hospital were reviewed to identify common factors of unexpected disasters. The cardiac arrest rate was 1:1333 among 66,481 patients from 1985 to 1988. The proportion of cardiae arrests primarily related to anesthetic was thought to be 1.1:10,000. The physical status of 145 patients was in the status I and II under the category of the American Society of Anesthesiologists (ASA). The praposed operation was elective in 38 cases and was an emergency in 12. General anesthesia was used in 48 patients. Cardiac arrests occurred before surgery in 5 patients and during surgery in 45 patients. Primary cardiovascular abnormalities contributed to the cause of cardiac arrest in 29 patients who needed a cardiothoracic operation. One patient had hyperpotassemia. Among these 30 patients, only two recovered. Two patients had vagal reflex followed by cardiac depression. Two patients had severe bronchospasm. One patient had malignant hyperpyrexia. Among 50 patients in this study, 5patients recovered completely, 36 patients died and the remaining 9 patients had major mobidity due to central nervous system damage. Cardiac arrest occurring during operations have tended to be treated as isolated events and go unreported. The outcome in this study was dismal. These results further suggest the need for the establishment of a registry for cardiac arrest case. In addition, the use of the monitors for ventilation and eirculation may decrease the incidence of the unexpected cardiac arrest.