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Objective To report the major complications (epidural hematoma and abscess) of postoperative thoracic epidural analgesia in patients who underwent lung surgery. Design Prospective, monocentric study. Setting A university hospital. Participants All lung surgical patients who received postoperative thoracic epidural analgesia between November 2007 and November 2015. Interventions Thoracic epidural analgesia for patients who underwent lung surgery. Measurements and Main Results During the study period, data for 2,907 patients were recorded. The following 3 major complications were encountered: 1 case of epidural hematoma (0.34 case/1,000; 95% confidence interval 0.061-1.946), for which surgery was performed, and 2 cases of epidural abscesses (0.68 case/1,000; 95% confidence interval 0.189-2.505), which were treated medically. Conclusions The risk range of serious complications was moderate; only the patient who experienced an epidural hematoma also experienced permanent sequelae.

Background Several studies have highlighted the importance of critical incident (CI) reporting in order to enhance patient safety. We have implemented an anonymous procedure for CI reporting in our department of paediatric anaesthesia. This study aims at analysing those CIs so as to improve patient care and risk management. Material and methods CIs were reported by the anaesthetic team using the World Health Organization classification and analysed using the ORION methodology. CIs were classified according to type, surgery and complications. Risk factors and consequences for patients and for the institution were analysed. Risk factors with high degree of harm for the patient were identified using a univariate analysis and odds ratios (OR). Results Over an 18-month period, 114 CIs were reported for 103 patients (median age: 7.0 years [95% CI: 3.6–9.8]). We found that 29.9% of reported CIs had consequences for the patients and 76.3% were considered preventable. The two main types of CI were “respiratory” (28.8%) and “drug-related” (22.8%) incidents. The main risk factor was ‘human error’ (42.3%). Several consequences for the patient and the hospital were identified. An ASA score ≥ 3 (OR: 2.52; [95% CI: 1.10–5.78]) was an independent risk factor for a high degree of patient harm. Conclusion Improving quality of care must be a priority for paediatric anaesthesiologists as most of the CIs observed are preventable and have consequences for the patient and the institution.