Enhancing the Safety of Sedation : A Medical Accident Analysis Model

Abstract

  The incidence of accidents involving sedation, which is widely practiced in the dental and medical fields, has been increasing. To analyze the causes of medical accidents during sedation in Japan and to improve the safety of sedation, case reports describing sedation accidents were searched for using the “Case search” function in the Project to Collect Medical Near-miss/Adverse Event Information of the Japan Council for Quality Health Care database. A statistical analysis was then performed using the P-mSHELL model, which is used for medical accident analyses. The results showed that among the accident factors, patient factors had a large influence on the occurrence of serious disabilities. A significant association was observed between outcome and the timing of the accident (preoperative, intraoperative, and postoperative), while no significant association was found between outcome and the type of drug that was used. On the other hand, a significant association was observed between respiratory depression, the most common type of accident, and the use of multiple drugs. To prevent sedation accidents, it is important to monitor patients throughout the perioperative period. For high-risk patients, in particular, prior assessment of the patient’s condition and strict postoperative management are essential to prevent serious accidents.