Prevention of Pulmonary Thromboembolism Related to Anesthesia

Abstract

The comprehensive summary of the annual surveillance of anesthesia-related mortality and morbidity (1994-2001) by Japan Society of Anesthesiologist (JSA) Committee on Operating Room Safety reported that intraoperative critical pulmonary embolism, including pulmonary thromboembolism (PTE), air embolism and fat embolism, occurred 0.63 cases per 10,000 cases in 5,383,059 cases. The predicted incidence of perioperative PTE was calculated to be 2.01 cases per 10,000 cases from above data and results of another report. First annual report of perioperative critical PTE in 2002 was published by the working group for prevention of PTE in JSA. It revealed that the overall incidence of perioperative critical PTE was 4.41 cases per 10,000 cases and mortality rate was 15.4%. Incidence of perioperative critical PTE (per 10,000c cases) referred to by surgical sites were as followed; extremities including hip joints 7.6 cases, thoracotomy with laparotomy 7.5 cases, spine 7.3 cases, Cesarean section 6.5 cases, thoracotomy 6.1 cases, craniotomy 5.7 cases, heart or great vessels 5.23 cases, laparotomy 4.7 cases, chest or abdominal wall 1.9 cases and head or ENT 0.6 cases. The percentage of preventative measures applied in PTE patients were as followed; nothing 43.8%, elastic bandage and elastic stocking 35.8%, intermittent pneumatic compression 31.7%, anticoagulants 8%. In summary, although the incidence of perioperative critical PTE in Japan was less than that in western countries in spite of less preventative measures for PTE, it was increasing year by year and distribution patterns in Japan referred to by age, preoperative physical status and surgical sites were comparable in western countries.