Optimising Anaesthesia Care for Open Abdominal Myomectomy: A Decade-Long Retrospective Analysis from a Nigerian Hospital.

Abstract

Background: Anaesthesia for open abdominal myomectomy is customised to provide a comfortable and pain-free surgical experience for the patient, taking into consideration their medical history, personal preferences and the results of the pre-anaesthesia assessment.

Objective: The aim of this audit is to assess our current anaesthesia protocols, identify any improvements made since the previous audit and examine the factors that may have contributed to these changes.

Methodology: An analysis was conducted on the various types of anaesthesia techniques administered during open abdominal myomectomy surgeries, based on operating theatre records from 1 January 2014 to 31 December 2023. Patients undergoing gynecological procedures other than open abdominal myomectomy were excluded from the study. The findings were presented in the form of figures, proportions and percentages.

Results: Our institution provided anaesthesia for 559 open abdominal myomectomies. The predominant technique utilised was Combined Spinal-Epidural Anaesthesia (CSEA), which constituted 44% of the cases, followed by spinal anaesthesia (SA) at 29%, GA at 19% and EA at 8%. Furthermore, as the proportion of the Senior Anaesthesia Registrars and Consultant Anaesthetists increases, the proportion of highly skilled anaesthesia techniques like CSEA and EA increases, while GA and SA techniques reduce.

Conclusion: Our study reveals a notable evolution in anaesthesia techniques for open abdominal myomectomy at our institution, driven by post-graduate medical training, advances in medical research and the strategic use of available resources to enhance safety and care quality.