Introduction: Critical events under anesthesia can cause sudden and dramatic complications. Recognition and analysis of such events helps to improve OR practices (in order to prevent recurrence of the same); thereby improving the overall quality of anesthetic practice. Unlike other countries which have national registries to capture such incidents, India relies on a voluntary and non-standard reporting of critical incidents under anesthesia. None of these papers have studied anesthesia-related complications in patients who have predominant renal dysfunction.

Materials and Methods: A retrospective audit was performed of all critical incident reports filed in our department from 01/01/2015 to 31/12/2015. The data was analyzed to identify the incidence, causes and outcomes of these events.

Results: Of 1217 anaesthetics administered, 2.54% of patients had reported adverse events during surgery. Most complications occurred in the elderly patients (41.9%) and those who were ASA grade III or above (45.1%). More than half (54.8%) of the complications involved the cardiovascular system. There were two deaths during  this period (mortality=0.16%).

Conclusions: Though anesthesia related complications have declined dramatically with the use of advanced monitoring and safer drugs, there is still potential for improvement. Use of checklists and standard protocols can help mitigate much of the human error associated with these critical events. The larger proportion of cardiovascular complications in our patients is probably a reflection of the higher incidence of cardiovascular complications in patients who have renal dysfunction.

Keywords: Critical Events; Critical Incident Reporting; Anaesthesia; Anaesthesia Mortality; Critical Incident Reporting Form;
Renal Insufficiency Chronic.