JPNATC ANESTHESIA AUDIT 2012

1. DEPARTMENT OF
ANAESTHESIOLOGY
CENSUS 2012

2. 3201
3902
4173
5208
0
1000
2000
3000
4000
5000
6000
2009 2010 2011 2012
NumberofSurgeries
OT CENSUS

3. Clinical Load
1943
57
1272
1936
0 500 1000 1500 2000 2500
GEN SURG
UROLOGY
NEUROSURG
ORTHO 37%
24.5%
(1%)
37.5%

4. GENERAL SURGERY (n=2000)
1647,
82.35%
353,
17.65%
Male
Female
2011
2012
Sex distribution

5. GENERAL SURGERY (n=2000)
963, 48%1037, 52%
Elec ve
Emergency
845, 54%
706, 46% 2011
2012
Elective/emergency

6. GENERAL SURGERY (n=2000)
1702, 85%
263, 13%
35, 2%
Adults
Paediatric
Geriar c
1401, 90%
138,
9%
12, 1%
2011
2012
Age distribution

7. 1402,
70%
498, 25%
100, 5%
G.A
Regional
GA+Regional
GENERAL SURGERY (n=2000)
1120,
72%
388,
25%
43, 3%
2011
2012
Type of anaesthesia

8. 838
576
54
5 25 10 19 3
0
100
200
300
400
500
600
700
800
900
ETT PLMA FOB CLASSICLMA I-GEL COBRAPLA DLT SUBMENTAL
No.ofcases
Airway Control (n=1502)
56%
38%

9. Type of Surgeries
21%
20%
16%
6%
5%

10. ASA Grading
1324, 66%
409, 20% 151, 8% 86, 4%
30, 2%
ASA 1 ASA 2 ASA 3 ASA 4 ASA 5

11. Comorbidities
16%
8%
1.6%

12. Intraoperative Complications
6.6%
4.4%

13. 1588, 80%
387, 19%
25, 1%
WARD
ICU
EXPIRED
Patient Disposition
2011
2012

14. 1083,
85.14%
189,
14.86%
Male
Female
NEUROSURGERY (n=1272)
2011
2012
Sex distribution

15. NEUROSURGERY (n=1272)
548, 43%
724, 57%
Elec ve
Emergency
2011
2012
Elective/emergency

16. NEUROSURGERY (n=1272)
1101, 87%
126, 10%
45, 3%
Adults
Paediatric
Geriar c
2011
2012
Age distribution

17. Airway Control
1044, 82%
71, 6% 157, 12%
DL ETT LMA FOB ETI

18. Type of Surgeries
28%
24%
14%
12%
7% 6% 5%

19. ASA Grading
594, 47%
291, 23%
297, 23%
53, 4%
37, 3%
ASA 1 ASA 2 ASA 3 ASA 4 ASA 5

20. Comorbidities
13.5%
8.2%
2.2%
1.5%1%

21. 158
126
12 11
5 3
18
3
0
20
40
60
80
100
120
140
160
180
BLEED
IN
GH
YPO
TEN
SIO
NARRH
YTH
M
IA
BRO
N
CH
O
SPASMD
ESATU
RATIO
N
D
ELAYED
AW
AKEN
IN
GBRAD
YCARD
IA
CARD
IAC
ARREST
No.ofcases
Intraoperative Complications
12%
10%

22. Patient Disposition
2011
2012

23. 1609,
83.11%
327,
16.89%
Male
Female
ORTHOPAEDICS (n=1936)
2011
2012
Sex distribution

24. ORTHOPAEDICS (n=1936)
1158, 60%
778, 40%
Elec ve
Emergency
2011
2012
Elective/emergency

25. 1714, 89%
121, 6%
101, 5%
Adults
Paediatric
Geriar c
ORTHOPAEDICS (n=1936)
1237,
88%
64, 5%
101,
7%
2011
2012
Age distribution

26. ORTHOPAEDICS (n=1936)
2011
2012
Type of anaesthesia

27. 595, 48%
403, 33%
112, 9%
95, 8%
29, 2%
SAB
CSE
USguided BPBlock
PNSguided BPblock
Femoral N Block
Distribution of Regional
Anaesthesia
2012
2011

28. 460
186
156
140
111 107 99
86 83 83 72
30
0
50
100
150
200
250
300
350
400
450
500
Fem
ur
H
um
erus
Tibia
BB
leg
BBFAA
cetabulum
/
D
ebridem
ent
Spine
Im
plantrem
ovalExt
fixatorA
m
puta
onA
rthroscopy
Numberofsurgeries
Type of surgeries
(24%)
(10%)

29. ASA Grading
1409, 73%
462, 24% 50, 2%
15, 1%
0, 0%
ASA 1 ASA 2 ASA 3 ASA 4 ASA 5

30. 429
263
55
33 26 26
0
50
100
150
200
250
300
350
400
450
500
HTN DM IHD COPD/
ASTHMA
CHRILLNESS TB
Numberofpaents
Comorbidities
22%
14%
3%

31. 112
65
12
7 5 3
13
0
0
20
40
60
80
100
120
BLEED
IN
GH
YPO
TEN
SIO
NARRH
YTH
M
IA
BRO
N
CH
O
SPASMD
ESATU
RATIO
N
D
ELAYED
AW
AKEN
IN
GBRAD
YCARD
IA
CARD
IAC
ARREST
Numberofcases
Intraoperative Complications
6%
3%

32. 54, 3%
1882, 97%
ICU WARD EXPIRED
Patient Disposition

33. Invasive Monitoring
436
140
40
139
0
100
200
300
400
500
600
700
TRIPLELUMEN PICC DOUBLELUMEN
IJV
575
SCV
76%

34. ANAESTHESIA IN PERIPHERY

35. ACHIEVEMENTS
• Dedicated Pain team for postoperative pain
relief
• Large number of trauma cases with difficult
airway managed successfully
• Largest number of major surgeries (spine,
pelvis, etc.) managed
• Publications: Twenty two
• Dedicated Pain team for postoperative pain
relief
• Large number of trauma cases with difficult
airway managed successfully
• Largest number of major surgeries (spine,
pelvis, etc.) managed
• Publications: Twenty two
• Academic activities conducted by the dptt
- Ultrasound guided regional anaesthesia
workshop
- FCCS programme
- Mechanical ventilation workshop
• Dedicated Pain team for postoperative pain
relief

36. • Large number of trauma cases with difficult
airway managed successfully
• Largest number of major surgeries (spine,
pelvis, etc.) managed
• Nurses educational programme
• Inauguration of Pre-anaesthesia clinic
• OT services expanded (TC1 OT)
ACHIEVEMENTS

37. TC1 – OT (n=437)
127
57
84
169
0
20
40
60
80
100
120
140
160
180
Gen Surgery Urology Neurosurgery Orthopaedics
29%
39%
19%
13%

38. • Requirement of a pre-anaesthesia room
- central lines
- performance of blocks
LACUNAE

39. Thank you