Trends in Regional Anaesthesia for Gynaecological Surgeries in a Nigerian Tertiary Institution

Abstract

Background: Giving the benefits of Regional Anaesthesia (RA) for gynaecological surgeries, we encouraged the increasing usage of RA for gynaecological surgeries. This study examined the trend of practice of Anaesthesia for gynaecological surgeries in our institution and the progress made thus far.
Patients And Methods: This was a five year retrospective survey that reviewed anaesthesia for gynaeological surgeries at the University of Abuja Teaching Hospital between January 2012 and December 2016 using Doctors and Nurses theatre, recovery room and ward records. Only patients whose procedures were amenable to both General (GA) and Regional anaesthesia (RA) were included in the study. Data collected include age, indication for surgery, type of surgery, type of anaesthesia, nature of surgery (emergency/elective) and admission status (in-patient/ day cases).
Results: One thousand two hundred and four patients met the inclusion criteria. Five hundred and forty six patients (45.3%) had RA, 618 (51.3%) had GA, 34 patients (2.8%) and 1 patient (0.08%) had Spinal and Combined Spinal Epidural (CSE) anaesthesia respectively that failed and were converted to GA. Five other patients (0.4%)had other forms of anaesthesia that were unrelated to the two main forms of anaesthesia being studied. Majority 1,138 (94.5%) were electives while 66 (5.5%) were emergencies. In-patients were 838 (69.6%) while 336 (27.9%) were day cases. Regional
anaesthesia utilization increased from 21.8% in 2012 to 79.2% in 2016 while General anaesthesia utilization decreased from 73.9% in 2012 to 19.7% utilization in 2016. The use of RA increased significantly while the use of GA reduced significantly during the study period (P<0.001).
Conclusion: In our institution there is a changing trend towards the increasing use of RAfor Gynaecological surgeries.

Keywords: Trends, Regional anaesthesia, Gynaecological surgeries, General Anaesthesia