Patterns of Immediate Post-Anesthetic Complications and their Associated Factors among Adult Patients in the Operating Theatre Recovery Room Following Major Surgery at Bugando Medical Centre Mwanza Tanzania
- Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS – Bugando] : 2019
- 63 Pages Includes References and Appendices
Abstract:
Background: The subject of post-anesthetic complication in the recovery room and its prevention has continued to generate interest in the last decade. Unfortunately, there is a paucity of published data regarding this subject in Tanzania and Bugando Medical Centre (BMC) in particular. This study was designed to describe the patterns of immediate post-anesthetic complications and associated factors among patients admitted in the operating theatre recovery room following all surgeries at Bugando Medical Centre.
Methods: This was a cross sectional study of patients aged 18 years and above admitted in the operating theatre recovery room following major surgery at BMC from March 2019 to June 2019. Patients were followed up post-operatively till complete recovery to determine the patterns of immediate post-anesthetic complications and their associated factors. Data were analyzed using STATA.
Results: A total of 430 patients (M:F ratio = 1:1.7) were studied. The median age at presentation was 35 years. Of all patients, 294(68.4%) developed immediate post- anesthetic complications. Of these, postoperative nausea and vomiting were the most common post-anesthetic complication accounting for 43.5% of cases followed by pain 19.5%. ASA II (OR 2.1; 95% CI [1.1-3.7]; p-value = 0.017), type of anesthesia (OR 0.3; 95% CI [0.1-0.6]; p-value = 0.017) and surgical procedure performed (Laparotomy) (OR 37.1; 95% CI [1.6-841.2]; p-value= 0.023) were found to be statistically significantly associated with post-anesthetic complications on multivariate logistic regression analysis.
Conclusion: This study has demonstrated that the incidence of immediate post-anesthetic complications among patients admitted in the operating theatre recovery room of Bugando Medical Centre high despite recent advances in anesthetic techniques and the introduction of newer anesthetic drugs. ASA II and general anesthesia are associated with post-anesthetic complications. We recommend that factors responsible for increased incidence of immediate post-anesthetic complications at Bugando Medical Centre should be addressed so as to reduce the occurrence of these complications.
= OPERATIONAL DEFINITIONS Patterns was defined as types of immediate complications occurring in the recovery room following major surgery. OPERATIONAL DEFINITIONS Major surgery was defined as any intervention occurring in a hospital operating theatre involving the incision, excision, manipulation, or suturing of tissue, usually requiring regional or general anesthesia or sedation. OPERATIONAL DEFINITIONS Immediate post-anesthetic complications was defined as complications observed from the time of admission of the patient in the recovery room to the time when patient is transferred out from recovery room. OPERATIONAL DEFINITIONS Duration of surgery was defined as the total time between knife to skin, to the closure of skin, and for endoscopic surgery is the time duration from introduction of scope to the patient and removal of scope from the patient after completing the surgery. OPERATIONAL DEFINITIONS Duration of anesthesia was defined as the total time from preoxygenation to the end of extubation for the patient who underwent general anesthesia. And for loco-regional anesthesia is the total time from administration of local anesthetics to the end of surgery.
= ABBREVIATIONS ASA American Association of Anesthesiologist BMC Bugando Medical Centre BMI Body Mass Index CNS Central Nervous System CTZ Chemoreceptor Trigger Zone CUHAS Catholic University of Health and Allied Science DBP Diastolic Blood Pressure EMD Emergency Medicine Department GOPD Gynecology Outpatient Department ICU Intensive Care Unit PACU Post Anesthesia Care Unit PAR Post Anesthesia Recovery PONV Post-Operative Nausea and Vomiting SBP Systolic Blood Pressure SOPD Surgical Outpatient Department V/Q Ventilation Perfusion Coefficient