Review of early anaesthetic complications in a tertiary health care centre in South Eastern Nigeria

Abstract

Background: Over the years, anaesthetic practice has evolved, with attention paid to safety guidelines and quality assurance. This has resulted in reductions in anaesthesia-related complications. Objectives: This retrospective study examines surgical procedures and anaesthetic complications recorded in a tertiary hospital. Methodology: Anaesthetic records of all patients who had surgery during the study period were retrieved. The number of cases done by each surgical specialty, the anaesthetic techniques, and the anaesthetic complications encountered during anaesthesia and before discharge from the recovery room were recorded. Preoperatively, all patients were categorised according to the American Society of Anaesthesiologists (ASA) physical status classification. Cases were grouped according to surgical specialties. Data was analyzed with Statistical Package for the Social Sciences (SPSS) version 25. Results: Over a 2-year period, 1784 surgeries were conducted, General and Cardiothoracic surgeries accounted for the highest 354 (19.80%) and lowest 6 (0.30%) cases, respectively. The most common anaesthetic techniques employed were general anaesthesia with endotracheal intubation 731 (43.00%), subarachnoid block 559 (32.90%), and general anaesthesia with facemask 190 (11.20%). Seventy five (4.20%) cases had complications, 19 (1.07%) had hypotension, 15 (0.84%) had delayed recovery from anaesthesia, 9 (0.50%) cases had cardiac arrests and 5(0.28%) had laryngeal. Death on the table occurred in 5 cases (0.28%), bronchospasm, local anaesthetic (LA) toxicity and also nausea and vomiting occurred in 3 cases (0.17%) respectively. Coughing and vomiting, hypoxia and post spinal shivering occurred in 2 cases (0.11%), while total spinal, apnoea, failed intubation, bradycardia, pulmonary oedema, extrapyramidal side effects of metoclopamide and shock occurred in 1 patient (0.06%) each. Conclusion: Hypotension, delayed recovery and cardiac arrest were the most common complications in our environment. There was no association between the ASA physical status and the occurrence of anaesthetic complications.