What do we know about anesthetic mortality?

A detailed review of the published literature on systematic studies on anesthetic deaths after 1950 is made in this article. According to the author the high estimate of errors in all these studies resulted from failure to entertain the possibility of any cause of death other than anesthetic error. The myth that anesthetic drugs are different from all other drugs, and that they are absolutely safe unless someone errs, is to be dispelled. Drugs used in clinical anesthesia are potent and potentially lethal, and have primary desired actions, and unwanted side effects. The role of anesthesia in surgical mortality is greater than anyone has yet imagined; risks are not completely preventable because patients do not respond to drugs with stereotyped responses, but, at times, with adverse responses.