An Appraisal of Anaesthesia Practices for Obstetric and Gynaecologic Surgeries in a Tertiary Health Center in Zaria, North Western Nigeria.

Abstract

Background: Anaesthesia is a critical aspect of every surgical procedure. Various options exist depending on the type of procedure, nature and the clinical state of the patient. This study reviewed the anaesthesia practices for Obstetric and Gynaecologic surgeries at Ahmadu Bello University Teaching Hospital, Zaria.

Materials and methods: It was a retrospective cross-sectional descriptive study conducted at Ahmadu Bello University Teaching Hospital, Zaria. Obstetric and Gynaecologic surgeries performed from 1 November 2022 to 31 October 2023 were included in the study. Relevant data for the study were obtained from the anaesthesia register in the theatre. The data were analysed with SPSS 20.

Results: The mean age ± SD of patients who had surgery was 32.1 ± 9.1 years. A total of 547 cases were reviewed, of which 273 (49.9%) were elective cases and 274 (51.1%) were emergency cases. Out of these, 254 (46.4%) were obstetric emergencies, 20 (3.7%) were gynaecologic emergencies, 149 (27.2%) were elective gynaecologic cases, and 124 (22.7%) were elective obstetric cases. The majority of the cases, 407 (74.4%), were American Society of Anaesthesiologists II. Spinal anaesthesia was the commonest type of anaesthesia used in obstetric surgeries 336 (91.8%), while general anaesthesia was the commonest type of anaesthesia used in gynaecologic surgeries 89 (79.5%). Senior registrars gave anaesthesia in 457 (83.5%) cases. Heavy Bupivacaine (0.5%) was the commonest agent used for spinal anaesthesia in 327(89.3%) cases, while plain bupivacaine (0.5%) was the least agent used in 39(10.7%). Propofol was the most common agent used for the induction of general anaesthesia in 72 (64.3%) cases, while ketamine was the least used agent in 40 (35.7%). Anaesthesia complications were recorded in only 24 (4.4%) of cases. The complications were recorded in 13 (54.2%) procedures done under neuraxial anaesthesia and 11 (45.8%) cases done under general anaesthesia. Cardiovascular instability was the most common complication recorded in 10 (41.7%) cases.

Conclusion: Spinal anaesthesia was the most common technique of anaesthesia in Obstetric surgeries, while general anaesthesia was the most common in Gynaecologic surgeries during the period under review. Complications of anaesthesia were uncommon.