2:39 2: Dizziness and nausea Cerebral. 2:57 1: Vomiting Gastro-intestinal
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1 Supplemental: Table B: Detailed description of adverse events by time, treatment group and procedure T-spinal to incident T-spinal to PACU discharge Group THA/TKA Adverse event description Adverse event type 2:39 2: Dizziness and nausea Cerebral 2:41 1: C, respiratory frequency 8 Temperature 2:57 1: Vomiting Gastro-intestinal 3:19 2: Severe pain, subsequent severe sedation from suppl. opioid Pain 3:45 1: Saturation 79-92%, 100% with oxygen. Shivering, temp 38.6 C Respiratory 3:50 3: Epigastric pain Miscellaneous 3:55 3: Chest pain, feeling of chest pressure Cardio-vascular 4:30 4: Left arm heavy and numb. History of cerebral apoplexy Cerebral 4:45 2: Hb 4.0 mmol/l. Sweating, chest pressure, low blood-pressure and low pulse. Bleeding 5:05 2: Hypotension Cardio-vascular 5:30 4: Severe pain Pain 5:40 4: Severe pain Pain 5:43 4: Severe pain Pain 5:52 3: Hypotension. Nausea, cold and sweating Cardio-vascular 5:55 3: Hypotension. Nausea, pale, sweating, near-syncope. 22:12 hours post-spinal: Dizzy HgB 5.4 mmol/l Cardio-vascular 1
2 6:00 2: Severe pain Pain 6:11 1: Bleeding from surgical wound. Compressive bandages soaked in blood Bleeding 6:13 2: Hypotension 58/40 Cardio-vascular 6:23 1: Chest pressure and tachycardia. Patient with known paroxysmal atrial fibrillation. Cardio-vascular 6:35 2: Hip dislocation Extremities 6:35 2: Syncope while in bed Cerebral 6:45 2: Syncope x 2 during mobilization Cerebral 6:56 1: Severe pain Pain 7:00 6: Tachycardia Cardio-vascular 7:00 3: Syncope Cerebral 7:27 2: Hypotension Cardio-vascular 7:30 2: Bleeding from surgical wound. Compressive bandages soaked in blood Bleeding 7:35 1: Numbness and loss of control of foot on operated leg Extremities 7:38 2: Hip dislocation Extremities 7:38 3: Hypotension and bradycardia, no cardiac symptoms. 19:20 hours post-spinal: Somnolent and subsequently diagnosed with acute a. cerebri media infarction, patient was observed and found normal 1 hour prior to incident. Cardio-vascular 7:41 1: Urinary retention Urological 2
3 7:46 6: Hypoxia and tachycardia. 9:14 hours post-spinal: POUR Respiratory 7:48 3: Knee dislocation, re-operation Extremities 7:50 6: Near-syncope, blurred vision, cold, sweating. Hypotension 83/50 mmhg. 23:5 hours post-spinal: Hgb 5.1. Cerebral 8:00 5: Unspecific arrhythmia Cardio-vascular 8:20 2: Severe pain Pain 9:00 4: Syncope Cerebral 9:15 1: Fainting and vomiting Cerebral 9:36 3: Blood sugar 21.0 mmol/l, patient with type-2 diabetes Miscellaneous 9:38 2: Severe pain Pain 10:20 5: Severe pain Pain 10:33 2: Blurred speech, patient under suspicion of pre-operative periodic ataxia. Resolves within 1 hour, no further actions. Cerebral 10:40 2: Severe pain Pain 11:34 5: Severe pain Pain 15 11:48 3: Urinary retention. Urological 12:15 3: Vomiting Gastro-intestinal 13:25 4: Severe pain Pain 13:30 2: Severe pain Pain 3
4 13:48 2: Severe pain Pain 15:41 3: Severe pain Pain 16:10 4: Urinary retention. Urological 17:17 1: Severe abdominal pain, relieved by bladder catheterization. 23:10 hours post-spinal: saturation 89%, tachycardia, ECG with suspicion of septal infarction. 19:10 3: Severe pain. Ongoing bleeding from surgical wound. 23:34 hours post-spinal: 2 near syncope episodes Urological Pain 20:03 3: Severe pain Pain 20:30 3: Syncope Cerebral 21:02 4: Severe pain Pain 21:39 6: Ongoing bleeding from surgical wound Bleeding 21:45 2: Severe pain Pain 22:28 2: Bradychardia, Bpm 22:42 post-spinal: severe pain Cardio-vascular 22:30 4: Severe pain Pain 22:46 1: Severe pain Pain 22:55 3: Severe pain Pain 22:57 3: Dizziness and fall Cerebral 4
5 23:00 2: Syncope and falls Cerebral 23:10 1: Severe pain Pain 23:10 3: Hypotension 85/53 mmhg Cardio-vascular 23:38 3: Severe pain Pain 23:39 4: Severe pain Pain 23:55 2: Nausea and vomiting Gastro-intestinal 23:56 4: Severe pain Pain 24:03 2: Severe pain Pain 24:21 3: Temperature 38.4, coughing. Suspicion of pulmonary edema/pneumonia Temperature 24:38 2: Severe pain Pain 24:43 3: Nausea and vomiting Gastro-intestinal 16 24:48 2: Dizziness and fatigue Cerebral 24:49 1: Severe pain Pain 24:52 3: Bradycardia and dizziness Cardio-vascular 25:00 3: Severe pain Pain 25:00 2: Tachycardia, 105 Bpm Cardio-vascular 25:03 1: Laryngeal edema and respiratory distress. Allergic reaction suspected Respiratory 5
6 25:04 4: Severe pain Pain 25:24 1: Increased creatinine Urological 25:25 1: Dizziness Cerebral 25:36 4: Severe pain Pain 26:11 2: Severe pain Pain 26:15 3: Fall, no syncope Cerebral 26:27 4: Tachycardia, 150 Bpm. Palpitations and headache. Urinary retention. Cardio-vascular 26:29 2: Severe pain Pain 26:59 3: Severe pain Pain 27:19 4: Severe pain Pain Supplemental: Legend: Table B Description adverse events recorded during the first 24 postoperative hours after primary total hip or knee arthroplasty. Routine round findings without clinical relevance were not recorded unless they resulted in treatment. Occurrence of non-related subsequent adverse events in the same patient is also described. T-spinal to incident: time from spinal anesthesia to adverse event. T-spinal to PACU discharge: Time from spinal anesthesia to postanesthesia care unit (PACU) discharge. Group: 1=motor-function assessment in PACU, 2=no motor-function assessment in PACU. THA/TKA column: THA=1, TKA=2. POUR = PostOperative Urinary Retention. 6
7 7
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Abdominal Pain 16,500.25 2.8 6,000.09 Acute & Subacute Endocarditis 15,339.30 3.0 5,113.10 Acute Myocardial Infarction 17,687.46 2.6 6,802.87 Alcohol Abuse & Dependence 19,126.64 4.2 4,553.96 Alcoholic