Medicolegal Aspects of Death Under Anesthesia

Abstract

Although surgical technique was in development, the patient presented a problem to the surgeon, chiefly because of active physical resistance and because the cries and screams were distracting and often left the patient emotionally and physically exhausted. These factors, combined with the inevitable infection, resulted in high mortality rates. No wonder that by the middle of the 19th century, when usage of general anesthesia started, there was greater decrease in the surgical mortality figures which in some reports reached nearly 50%. We have many types of anesthetic options varying between regional, neuro-axial block and general anesthesia. On the basis of anatomic considerations, regional anesthesia may be divided into infiltration anesthesia, intravenous regional anesthesia, topical anesthesia and peripheral nerve blockade (including plexus blockade). Neuro-axial anesthesia includes spinal, epidural, and caudal blocks which result in sympathetic blockade, sensory analgesia, or anesthesia and motor blockade, depending on the dose, concentration, or volume of local anesthetic, after insertion of a needle in the right place. The term anesthesia signifies insensibility to surgical pain. Other components of general anesthesia are amnesia, hypnosis (unconsciousness), muscle relaxation, inhibition of movement, and blunting of the autonomic response in response to noxious stimuli