The Thai Anesthesia Incidents Study (THAI Study) of Perioperative Convulsion
Phuping Akavipat MD*, Mali Rungreungvanich MD**, Varinee Lekprasert MD**, Surirat Srisawasdi MD**
Affiliation : *Department of Anesthesiology, Prasat Neurological Institute, Bangkok 10400 ** Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Objectives : To identify the incidence of perioperative convulsion within 24 hours, outcome, predisposing risk
factors, contributing factors related to anesthesia and corrective strategies.
Materials and Methods : The prospective cohort study enrolled all anesthetics from twenty eligible hospitals in
Thailand between March 1, 2003, and February 28, 2004. Postoperative convulsion incidents were extracted
from the Thai Anesthesia Incidents Study (THAI Study) database in terms of demographic data, details of
events, outcome, contributing factors related to anesthesia and corrective strategies.
Results :The incidence of perioperative convulsion was 3.1 per 10,000 from all 172,592 anesthetics. Most
patients (73.59%) recovered in 24 hours. The majority of risk factors were related to surgery (67.92%) and
patient factors (54.72%) while anesthesia was the minor factor (30.19%). The contributing factors related to
anesthesia were medication error (route, type, time) 43.75% and human error (inadequate care, inadequate
knowledge, inadequate communication) 43.75%. The important corrective strategies included improved super-
vision and clinical practice guideline.
Conclusion : The incidence of postoperative convulsion was 3.1 per 10000. Anesthesia was the minor contrib-
uting factor. The most important risk factors included medication error and human error.
Keywords : Postoperative convulsion, Anesthetic related, Incidence, Contributing factors
