Anaesthetic Mortality: A Clinical And Medico-Legal Scenario

The death that occurs inside the operation theater often evoked considerable distress to the relatives of the patient and the subsequent misgivings on the team of doctors that performed the surgery. Anesthetic death is defined as death occurring within 24 hours of administration of anesthesia due to causes related to anesthesia. However, death may occur even afterwards due to its complications. The American Society of Anesthesiologists (ASA) has devised a classification system to grade the preoperative condition of the patient. The state of general anesthesia of necessity deprives the patient of the majority of his protective reflexes. In India, if the patient dies when a surgical procedure performed under anesthesia, often the anesthetist is unfairly accused of causing the death. The examination should be done into consideration by the pathologist when investigating an anesthetic death. There are no diagnostic findings at autopsy in most instances of anesthesia related deaths because there are no path gnomic pathological changes found in deaths caused neither by anoxia nor in acute cardiovascular collapse unless there is some underlying cause, such as a myocardial infarction. The analyses help in detecting and estimating the quantity of the drug given, estimating overdose of premedication of anesthetic agent. Morbidity and mortality during anesthesia has been markedly reduced due to better understanding of human physiology and pathology of disease processes.