Spinal anesthesia is responsible for more deaths than any other anesthetic in proportion to the number administered. The mortality diminishes with the experience of the operator. The relation of experience to mortality is shown in the accompanying chart. With the exception of the "less than 500" series, the figures quoted were obtained from the literature, from 1907 to 1930. Forty-one per cent of the "less than 500" series were obtained from surgeons personally interviewed when they visited our booth at the Scientific Exhibit of the American Medical Association in Philadelphia in June, 1931, where we demonstrated "The Cause and Prevention of Deaths from Spinal Anesthesia." Fifty-nine per cent were obtained from the literature. This indicates that when physicians and surgeons record their ability to manage certain diseases by reporting their results, the tendency is to accumulate a sufficient number of cases to bring their mortality rate within or usually below
BOWER JO, CLARK JH, BURNS JC. SPINAL ANESTHESIA: A NEW TECHNIC ADAPTABLE TO THE BEGINNER. JAMA. 1933;100(4):245–247. doi:10.1001/jama.1933.02740040013005
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