Advertisement

General Anaesthesia

  • Samuel Hird
  • Rehana Iqbal
Chapter

Abstract

General anaesthesia for obstetric anaesthesia has declined however litigation has increased. Recognised standards exist to reduce the chance of complications which must be adhered to. Common reasons for litigation include awareness under general anaesthesia, harm from failed intubation which may include hypoxic injury to the patient and the fetus. Significant harm also occurs from aspiration, hypertensive intracranial haemorrhage and nerve injury under anaesthesia.

Keywords

General anaesthesia Obstetric surgery Gynaecological Surgery Awareness Airway Harm Death Hypertensive intracranial haemorrhage Post-operative 

References

  1. 1.
    Davies JM. Obstetric anaesthesia closed claims: trends over the last three decades. ASA Newsl. 2004;68(6):12–4.Google Scholar
  2. 2.
    Pandit JJ, Cook TM, the NAP5 Steering Panel. NAP5. Accidental awareness during general anaesthesia. London, The Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland; 2014. ISBN: 978-1-900936-11-8.Google Scholar
  3. 3.
    Kinsella SM, Winton AL, Mushambi MC, Ramaswamy K, Swales H, Quinn AC, Popat M. Failed tracheal intubation during obstetric general anaesthesia: a literature review. Int J Obstet Anaesth. 2015;24:356–74.CrossRefGoogle Scholar
  4. 4.
    Davies JM, Posner KL, Lee LA, Cheney FW, Domino KB. Liability associated with obstetric anaesthesia a closed claims analysis. Anesthesiology. 2009;110(1):131–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Ashpole KJ, Cook TM. Correspondence: litigation in obstetric general anaesthesia: an analysis of claims against the NHS in England 1995–2007. Anaesthesia. 2010;65:529–30.CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Association of Anaesthetists of Great Britain and Ireland (AAGBI). Consent for anaesthesia 2017. Anaesthesia. 2017;72:93–105.CrossRefGoogle Scholar
  7. 7.
    Association of Anaesthetists of Great Britain and Ireland. Recommendations for standards of monitoring during anaesthesia and recovery 2015. Anaesthesia. 2016;71:85–93.CrossRefGoogle Scholar
  8. 8.
    Association of Anaesthetists of Great Britain and Ireland. The anaesthesia team AAGBI. 2010. https://www.aagbi.org/sites/default/files/anaesthesia_team_2010_0.pdf.
  9. 9.
    England and Wales High Court (Queens Bench Division) Decisions Cornish & Anor, R. v (rev 1) [2016] EWHC 799 (QB) (15 April 2016).Google Scholar
  10. 10.
    Obstetric Anaesthetists’ Association. GA For Caesarean Section. Online. http://www.oaa-anaes.ac.uk/ui/content/content.aspx?id=180. Accessed 12 Feb 2017.
  11. 11.
    Mihai R, Scott S, Cook TM. Litigation related to inadequate anaesthesia: an analysis of claims against the NHS in England 1995–2007. Anaesthesia. 2009;64:829–35.CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    NICE (National Institute For Health And Care Excellence) Depth Of Anaesthesia Monitors BiSpectral Index (BIS), E-Entropy and Narcotrend-Compact-M. DG6. 2012.Google Scholar
  13. 13.
    Adams JP, Bell MDD, Bodenham AR. Quality and outcomes in anaesthesia lessons from litigation. Br J Anaesth. 2012;109(1):110–22.CrossRefPubMedCentralPubMedGoogle Scholar
  14. 14.
    Cook TM, MacDougall-Davis SR. Complications and failure of airway management. Br J Anaesth. 2012;109(1):i68–85.CrossRefPubMedCentralPubMedGoogle Scholar
  15. 15.
    Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, O’Sulivan EP, Woodall NM. Difficult airway society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015;115(6):827–48.CrossRefPubMedCentralPubMedGoogle Scholar
  16. 16.
    Mushambi SM, Kinsella SM, Popat M, Swales H, Ramaswamy KK, Winton AL, Quinn AC. Obstetric Anaesthetists’ Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia. 2015;70(11):1286–306.CrossRefPubMedCentralPubMedGoogle Scholar
  17. 17.
    Turner JA. Diagnosis and management of pre eclampsia an update. Int J Women’s Health. 2010;2:2327–37.Google Scholar
  18. 18.
    Knight M, Nair M, Tuffnell D, Kenyon S, Shakespeare J, Brocklehurst P, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving mothers’ care: surveillance of maternal deaths in the UK 2012–14 and lessons learned to inform maternity care from the UK and Ireland Con dential Enquiries into Maternal Deaths and Morbidity 2009–14. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2016.Google Scholar
  19. 19.
    McGlennan A, Mustafa A. General anaesthesia for caesarean section. Contin Educ Anaesth Crit Care Pain. 2009;9(5):148–51.CrossRefGoogle Scholar
  20. 20.
    Cook TM, Scott S, Mihai R. Litigation related to airway and respiratory complications of anaesthesia: an analysis of claims against the NHS in England 1995–2007. Anaesthesia. 2010;65:556–63.CrossRefPubMedCentralPubMedGoogle Scholar
  21. 21.
    Ngan Kee WD. Editorial: confidential enquiries into maternal deaths: 50 years of closing the loop. Br J Anaesth. 2005;94(4):413–6.CrossRefPubMedCentralPubMedGoogle Scholar
  22. 22.
    Crawforth K. The ANAA foundation closed malpractice claims study: obstetric anaesthesia. ANAA J. 2002;70(2):97–104.Google Scholar
  23. 23.
    McClure JH, Cooper GM, Saving Mothers C-BTH. Lives: reviewing maternal deaths to make motherhood safer: 2006–2008: a review. Br J Anaesth. 2011;107(2):127–32.CrossRefPubMedCentralPubMedGoogle Scholar
  24. 24.
    Ferner RE. Medication errors that have led to manslaughter charges. BMJ. 2000;321:1212–6.CrossRefPubMedCentralPubMedGoogle Scholar
  25. 25.
    Warner MA, Warner ME, Martin JT. Ulnar neuropathy. incidence, outcome and risk factors in sedated or anaesthetised patients. Anesthesiology. 1994;81(6):1332–40.CrossRefPubMedCentralPubMedGoogle Scholar
  26. 26.
    Warner MA, Martin JT, Schroeder DR, Offord KP, Chute CG. Lower-extremity motor neuropathy associated with surgery performed on patients in a lithotomy position. Anesthesiology. 1994;81:6–12.CrossRefPubMedCentralPubMedGoogle Scholar
  27. 27.
    Scottish Courts and Tribunals (Outer House, Court of Session) Decisions Thompson, G v Lothian Health Board [2000] 0768/5/1995 (20 April 2000).Google Scholar
  28. 28.
    Cooper GM, McClure JH. Anaesthesia chapter from saving mothers’ lives; reviewing maternal deaths to make pregnancy safer. Br J Anaesth. 2008;100(1):17–22.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.St Georges University Hospitals NHS Foundation TrustLondonUK

Personalised recommendations